The Dangers of NSAID's - by The Evidence Based Chiropractor

NSAID's are taken by millions of Americans each and every day.  Below is another great infographic from Mercola which outlines just how dangerous these over-the-counter drugs can be.

Did you know that current research shows spinal manipulation to be a clinically superior treatment option than Diclofenac for spine pain? A few months ago, members of The Evidence Based Chiropractor received a monthly MD Research Brief from SPINE Journal which was a double blind RCT comparing spinal manipulation to Diclofenac.  The authors concluded that, "“Final evaluation showed manipulation being significantly better than NSAID and clinical superior to placebo.”  Are you a member yet?

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-The Evidence Based Chiropractor is the leading DC/MD marketing and outreach group in the world.  Our 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.

10 Banned Foods Americans Eat Everyday by Mercola

A wonderful infographic from Mercola. 

Are you eating food that's already banned in other countries but is still allowed to poison and kill Americans? Learn these pernicious ingredients and common foods through this infographic. Use the embed code to share it on your website.

<img src="http://media.mercola.com/assets/images/infographic/banned-foods-infographic.jpg" alt="10 Banned Foods to Avoid" border="0" style="max-width:100%; min-width:300px; margin: 0 auto 20px auto; display:block;"><p style="max-width:800px; min-width:300px; margin:0 auto; text-align:center;">Are you eating <a href="http://www.mercola.com/infographics/10-banned-foods.htm"><strong>"food that's already banned"</strong></a> in other countries but is still allowed to poison and kill Americans? Learn these pernicious ingredients and common foods through this infographic. Use the embed code to share it on your website.</p>

The Evidence Based Chiropractor

The Business of Spinal Fusions- by The Evidence Based Chiropractor

Spinal fusions are big business in the United States.  In 2013, over 87% of the surgical spinal procedures involved a fusion.  The US performs over double the amount of yearly fusions compared to Canada, the United Kingdom, Western Europe, and Australia.  Nearly 500,000 fusion are being performed this year (nearly 250,000 were performed in 2001).  

Are these procedures providing superior outcomes for our patients?  It would appear the answer is no.

In 2006, a Medicare physicians panel found that "it was less than reasonably likely that spinal fusion would provide a long-term benefit for patients suffering from degenerative disc disease."  Medicare never translated this finding into their policies, however, other insurers have picked up on the fact that spinal fusion utilization may be far greater than its effectiveness.

Blue Cross & Blue Shield has now excluded spinal fusion as a covered procedure for degenerative disc disease without gross instability.   They recommend at least 3 months of conservative spine care.  Cigna also has a similar recommendation.  Even the International Society for the Advancement of Spine Surgery said “increasing success and optimism may be leading some surgeons to overuse procedures beyond what the current state of medical evidence really supports.”  Also of note is between 2006-2009 the cost of a spinal fusion nearly doubled.  This is in part due to the surgical implant companies increasing the pricing of instrumentation.  

Many health care facilities are building multidisciplinary health care centers.  These spine centers include medical doctors, chiropractors, and other allied health practitioners.  Preliminary data shows that these spine centers are providing a higher quality of care, with great patient satisfaction, good outcomes, and a model of care based on best practice and evidence based guidelines for spine care.  Whether or not a spinal fusion is right for you is a decision to be made between you and your doctor.  However, growing evidence would suggest that conservative spine care may be more effective for many individuals. 

Lumbar Stenosis- by The Evidence Based Chiropractor

A recent (2014) study in SPINE examined the use of decompression without fusion for lumbar stenosis.  They found that decompression without fusion can be just as effective as methods involving fusion, but has significant cost saving advantages and fewer complications.  Generally, this decompression is accomplished by a laminectomy.  

If fusion is warranted, they encourage the use of bone graft as opposed to instrumentation (hardware).  It seems as though bone grafting is also more cost effective while providing similar outcomes.  The study found that complication rates rose significantly for patients who underwent a laminectomy with fusion compared to those who just received a laminectomy.  

It makes sense to me that limiting the use of instrumentation/hardware would yield decreased complications and perhaps even slight outcomes advantages.  Instrumentation (while necessary with certain procedures) permanently alters the bio-mechanics of the spine and places vertebral segments adjacent to the surgical site at increase risk for degeneration.

Additionally, I believe it is important to stress that previous research has shown that chiropractic care (specifically flexion/distraction technique) has provided relief from lumbar stenosis.  The complication rate for conservative chiropractic care is significantly lower than surgical intervention, and both have proven to be effective treatments.  The degree, or amount of stenosis (and its impact on function) will play a large role in determining whether conservative care is an option for each individual patient.  The bottom line is that physicians should be aware that surgical intervention is not the only treatment option available for patients with lumbar stenosis.  

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-The Evidence Based Chiropractor is the leading DC/MD marketing and outreach group in the world.  Our 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.

" Marketing Chiropractic to Medical Doctors" Now Available in iBooks - by The Evidence Based Chiropractor

Jeff Langmaid DC, founder of The Evidence Based Chiropractor, is proud to announce the worldwide release of his new book, “Marketing Chiropractic to Medical Doctors”.  It is currently available worldwide in over 15 countries through iBooks.

“Marketing Chiropractic to Medical Doctors” by Dr. Jeff Langmaid- https://itunes.apple.com/us/book/marketing-chiropractic-to/id878253789?mt=11&ign-mpt=uo%3D4

Published by The Evidence Based Chiropractor, this book continues to position Dr. Langmaid as the leading authority on interdisciplinary communication in chiropractic.  Touching upon his experience in practicing with one of the nations largest orthopedic groups, Dr. Langmaid provides other chiropractors with a step-by-step guide to build interdisciplinary referral relationships through research.

Dr. Langmaid commented, "Spine care in the United States is nearly a $100 billion dollar industry, yet clinical outcomes continue to languish and the number of people suffering from spine complaints continues to rise.  Evidence-based practice has continued to show chiropractic care as a safe and effective treatment option.  Unfortunately, many medical doctors do not have referral relationships with doctors of chiropractic, and their patients suffer.  My new book provides chiropractors with the tools and knowledge necessary to forge these relationships."

A leading voice in interdisciplinary communication, Dr. Jeff Langmaid, has been an active speaker, writer, and thought-leader in the marketing of chiropractic to medical doctors.  “Marketing Chiropractic to Medical Doctors” will, for the first time, provided chiropractic physicians with a step by step guide to market their practice with elegance and professionalism to other physicians in their communities.  Dr. Langmaid remains in private practice in Tampa Bay, FL.