Unnecessary Spinal Fusions Costing Billions of Dollars - by The Evidence Based Chiropractor

In October 2013, the Washington Post wrote a scathing article on spinal fusion surgeries being performed in Florida (and throughout the US).  In part, they found that more than 50% of the 465,000 fusions performed in 2011 did have have adequate documentation to necessitate the surgery.  

Over the past 20 years the rate of spinal fusion surgery has increased six fold.  Yet, nearly all long term outcome assessments show we are not adequately treating spine related complaints. 

In the past, extensive and expensive lobbying efforts have succeeded in suppressing the advancement of clinical guidelines.  At this time, there are no accepted models of when a spinal fusion is truly necessary.  The Post found, "...at a broader level, the rapid rise of spinal fusions in the United States, especially for diagnoses that generally don't require the procedure, has raised questions from experts about whether, amid medical uncertainty, the financial rewards are spurring the boom.".  

At the very least, barring an emergency/red flag presentation, patients should be encouraged to explore ALL conservative options available to them prior to entertaining the idea of fusion surgery.  Research continues to show chiropractic as the best first line treatment option.  If unsuccessful, then physical therapy, medication, and/or injections may be considered.  This article does not even begin to touch on the adjacent segment disease which affects the vertebral segments surrounding the surgical fusion site.  

With significant complication rates, sky high prices, and potentially un-ethical decision making from the physicians and hospital systems; it is more imperative than ever to promote the safety and efficacy of conservative care. 

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Chiropractic Care Superior to Medical Care for Adults Over 55 with Low Back Pain- by The Evidence Based Chiropractor

In 2009, the Journal of Manipulative and Physiological Therapeutics completed a randomized controlled trial comparing 2 types of spinal manipulation (low velocity and high velocity) with standard medical care for adults over 55 with low back pain.

They found that both types of manipulation were clinically superior to conservative medical care for sub-acute and chronic low back pain.  In their own words, "“Participants who received either form of SM (spinal manipulation) were approximately 30% to 40% better on the average in functional status than those who received minimal conservative medical care". 

This research is extremely important for two reasons.  First, many studies examining the effectiveness of spinal adjusting focus on acute spine conditions.  Historically, spinal adjusting has performed very well for acute conditions, and shown limited effectiveness for chronic spine complaints.  This study is one of the first to show efficacy for sub-acute and chronic complaints.  Additionally, with our aging population, many health care providers will begin to see a large increase in the amount of seniors who have spinal complaints.  This study begins to show that spinal adjusting and chiropractic care is an effective treatment option for these patients.  

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-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together

Acetaminophen Use During Pregnancy Linked to ADHD Risk in Children

Safety of Acetaminophen Use During Pregnancy is Questioned in New Research Study

Last week JAMA Pediatrics published a study which showed an increased prevalence of ADHD in children whose mothers took Tylenol (acetaminophen) during their pregnancy.  While causation was not show, correlation was strong.

With over 10% of children (over 6 million) currently diagnosed and being "treated" for ADHD; this research is extremely important.  

The study looked at over 64,000 Danish mothers and their children.  It was found that mothers who took acetaminophen at any point during the pregnancy had a 28% increased chance of their children having ADHD.  If acetaminophen was taken during the second and third trimesters, then the likelihood of ADHD increased by 63%! 

Tylenol has long been known to cross the placental barrier between mother and fetus.  The implications have been unclear, but exposure to any medication during pregnancy should be carefully considered.  

As chiropractors this is EXTREMELY important research.  Over 80% of women develop pregnancy-related low back pain during the second and third trimesters of their pregnancy.  They may be urged to take an over the counter pain killer (such as Tylenol) as a first line defense by their OB/GYN.  It is imperative that we communicate and demonstrate the proven safety and efficacy of chiropractic care for these expecting mothers.  Their children may be depending on us.  

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-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together.

Spinal Manipulation Performs Better than NSAID's for Low Back Pain

In April 2013, SPINE Journal found that spinal manipulation outperforms NSAID's when treating low back pain.  

Even with this research being produced many medical doctors are still prescribing medications instead of making the appropriate referrals.  It is our job to make sure they know about this research.

Interested in more? See the Top 10 Chiropractic Research articles by clicking here.

See the SPINE article here.

JOIN US Today AND RECEIVE ZIP CODE EXCLUSIVITY AND A 30 MINUTE IMPLEMENTATION CALL IN ADDITION TO IMMEDIATE ACCESS TO OUR MEMBERS VAULT AND YOUR CUSTOMIZED MONTHLY MD RESEARCH BRIEF. 

-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together.

Decreasing Intradiscal Pressure in the Cervical and Lumbar Spine through Chiropractic- by The Evidence Based Chiropractor

Traction, as a treatment, has been used for centuries in an attempt to relieve radiculopathy and pain.  Seated, standing, supine, mechanical, manual; there are a vast variety of options when performing traction on a vertebral region.

Nearly every primary care physician and orthopedist refer daily to physical therapy for some form of traction.  They refer for traction because they are attempting to decrease intradiscal pressure.  What many of them don't know is that a chiropractic technique called flexion/distraction is a far superior treatment choice.  It is our responsibility, as chiropractors, to promote and emphasize the effectiveness and safety of this treatment.  

Over 65% of chiropractors report using flexion/distraction in their practice.  Research studies have proven that flexion/distraction of the cervical and lumbar spine decreases intradiscal pressure with clinical significance.  Decreased intradiscal pressure is thought to improve tissue flow gradients, alter nociception, and allow retraction of prolapsed disc material.  We have randomized controlled trials (RCT) which have demonstrated the effectiveness of flexion/distraction for treating radiculopathy.  Additionally, the traction which many physical therapists use is void of any localizing effect!  Essentially, a little bit of the force/traction is applied everywhere; whereas with chiropractic flexion/distraction, we are able to focus at individual vertebral levels with much greater specificity.  

The Evidence Based Chiropractor's February 2014 MD Research Brief is going to focus on a piece of research supports the specificity and effectiveness of chiropractic flexion/distraction.

Intradiscal Pressure Changes During Manual Cervical Distraction: A Cadaveric Study.  Evidence Based Complementary and Alternative Medicine. Volume 2013, Article ID 954134

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