The Evidence Based Chiropractor Blog

Hundreds of chiropractic marketing and research articles to help you grow.

Jeff Langmaid 4/16/14 Jeff Langmaid 4/16/14

"Back Pain- 5 Things You Need to Know" from The Evidence Based Chiropractor

We are happy to release our first publication in our new patient education series. You can get a FREE copy of "Back Pain-5 Things You Need to Know" right HERE.

Jeff Langmaid 4/4/14 Jeff Langmaid 4/4/14

SPINE JOURNAL regarding chiropractic, "a statistically and clinically significant benefit..."

In 2013, SPINE Journal produced the research article, "Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain: The Results of a Pragmatic Randomized Comparative Effectiveness Study."

In it, the authors came to the following conclusions-

“The results of this trial suggest that Chiropractic Manipulative Therapy in conjunction with standard medial care offer a significant advantage for decreasing pain and improving physical functioning when compared to standard care alone, for men and women between the ages of 18-35 with acute low back pain.”

“There was a statistically and clinically significant benefit to those patients receiving chiropractic manipulative treatment...”

“The majority of systematic reviews find that chiropractic manipulative therapy appears to reduce pain and disability at least moderately for many low back pain patients.”

“73% of participants in the SMC plus CMT group rated their global improvement as pain completely gone, much better, or moderately better, compared with 17% in the SMC group.”

This is further proof that working together and promoting multidisciplinary care will yield superior outcomes for our patients.

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Jeff Langmaid 3/28/14 Jeff Langmaid 3/28/14

Chiropractic Care Supported by the American Pain Society and American College of Physicians - by The Evidence Based Chiropractor

A variety of clinical guidelines support and encourage the use of chiropractic care due to its safety and efficacy. In 2007, the Annals of Internal Medicine released a series of clinical guidelines. The clinical guidelines for the treatment of low back pain were supported by the American Pain Society and the American College of Physicians.

These guidelines reveal some interesting data. They report 65% of primary care physicians recommend massage, 55% recommended ultrasound, and 22% recommended (of performed) spinal manipulation. They also found that only 2 treatment options show strong efficacy for the management/treatment of acute (<4 weeks duration) low back pain. These treatment options were spinal manipulation and heat. For sub-acute and chronic low back pain the researchers still found spinal manipulation to be a valuable treatment option.

When we look at this study we can draw a few conclusions. First, only a small minority (22%) of physicians are recommending spinal manipulation to their patients. Second, spinal manipulation is a recommended treatment option.

The discrepancy in the recommendations from the clinical guidelines and the recommendations by the physicians is no surprise. Other studies have shown that primary care physicians recommendations for low back pain are "high discordant" with current research. Without a profession wide marketing and outreach campaign for the promotion of this research, the task falls to us, as individual providers to build referral relationships.

Jeff Langmaid 3/14/14 Jeff Langmaid 3/14/14

Top 5 Pain Interventions to Avoid- by The Evidence Based Chiropractor

The top 5 pain inventions to avoid by the ASA touch on a variety of spine related conditions. This list was created because many medical doctors are commonly performing these procedures in spite of the fact that evidence based guidelines suggest they shouldn't.

At the top of the list is a recommendation to avoid prescribing opioid analgesics for non cancer pain. These are commonly prescribed even though there is an extremely high addiction rate and virtually no benefit in terms of outcomes.

As you look through the list, you will find a array of procedures/interventions which are probably being performed on your current patients. As evidence based practitioners it is imperative that we stay up to date on these topics and keep our patients informed regarding their health care choices.

The following five recommendations were made-

http://www.medscape.com/viewarticle/819517

Don't prescribe opioid analgesics as first-line therapy to treat chronic noncancer pain. Consider multimodal therapy, including nondrug treatments, such as behavioral and physical therapies, before pharmacologic intervention. If drug therapy appears indicated, try nonopioid medication, such as nonsteroidal anti-inflammatory drugs, or anticonvulsants, before starting opioids.
Don't prescribe opioid analgesics as long-term therapy to treat chronic noncancer pain until the risks are considered and discussed with the patient. Inform patients of the risks of such treatments, including the potential for addiction. Review and sign a written agreement identifying both your and the patient's responsibilities (eg, urine drug testing) and the consequences of noncompliance with the agreement. Be cautious in coprescribing opioids and benzodiazepines. Proactively evaluate and treat, if indicated, the nearly universal adverse effects of constipation and low testosterone or estrogen.
Avoid imaging tests, such as MRI, computed tomography, or radiography, for acute low back pain without specific indications. Avoid these interventions for low back pain in the first 6 weeks after pain begins if there are no specific clinical indications (eg, history of cancer with potential metastases, known aortic aneurysm, progressive neurologic deficit). Most low back pain doesn't require imaging, and performing such tests may reveal incidental findings that divert attention and increase the risk of having unhelpful surgery.
Don't use intravenous sedation, such as propofol, midazolam, or ultra-short-acting opioid infusions for diagnostic and therapeutic nerve blocks, or joint injections, as a default practice. (This recommendation does not apply to pediatric patients.) Ideally, diagnostic procedures should be performed with local anesthetic alone. Intravenous sedation can be used after evaluation and discussion of risks, including interference with assessing the acute pain-relieving effects of the procedure and the potential for false-positive responses. Follow ASA Standards for Basic Anesthetic Monitoring in cases where moderate or deep sedation is provided or anticipated.
Avoid irreversible interventions for noncancer pain, such as peripheral chemical neurolytic blocks or peripheral radiofrequency ablation. Such interventions may be costly and carry significant long-term risks of weakness, numbness, or increased pain.

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Jeff Langmaid 3/13/14 Jeff Langmaid 3/13/14

Adding Chiropractic to Standard Medical Care Provides Astounding Results- by The Evidence Based Chiropractor

Adding chiropractic care to standard medical care provides SIGNIFICANTLY better results for low back pain than standard medical care alone. This 2013 study from SPINE found that, "“The results of this trial suggest that Chiropractic Manipulative Therapy in conjunction with standard medial care offer a significant advantage for decreasing pain and improving physical functioning when compared to standard care alone, for men and women between the ages of 18-35 with acute low back pain".

The global improvement questionnaires show that the chiropractic patients had greater improvements and only a few reported worsening conditions. However, the standard medical group saw only a few people get better, with most of the patients getting worse. This study clearly shows that patients receiving a combination of medical care and chiropractic care have superior improvements when compared to those only receiving medical care.