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Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data.

OBJECTIVES: Radicular low back pain (rLBP) is often treated off-label with gabapentin or by chiropractors using chiropractic spinal manipulative therapy (CSMT). To date, no studies have examined the association between these interventions. We hypothesised that adults under 50 years of age receiving CSMT for newly diagnosed rLBP would have reduced odds of receiving a gabapentin prescription over 1 year-follow-up. DESIGN: Retrospective cohort study. SETTING: US network including linked medical records, medical claims and pharmacy claims of >122 million patients attending large healthcare organ…

Neck pain and Headache Complicated by Persistent Syringomyelia After Foramen Magnum Decompression for Chiari I Malformation: Improvement with Multimodal Chiropractic Therapies.

BACKGROUND Patients with Arnold-Chiari Malformation I (CM-I) treated with foramen magnum decompression (FMD) can have ongoing neck pain, hea … pain, headaches, and persistent syringomyelia after FMD for CM-I who improved following multimodal chiropractic and rehabilitative therapies. Given the limited, low-level evidence for these interventions in patients with persistent symptoms and syringomyelia after FMD, these therapies cannot be broadly recommended, yet could be considered on a case-by-case ba …

Visit Frequency and Outcomes for Patients Using Ongoing Chiropractic Care for Chronic Low-Back and Neck Pain: An Observational Longitudinal Study.

BACKGROUND: Chronic spinal pain is prevalent and long-lasting. Although provider-based nonpharmacologic therapies, such as chiropractic care, have been recommended, healthcare and coverage policies provide little guidance or evidence regarding long-term use of this care. OBJECTIVE: To determine the relationships between visit frequency and outcomes for patients using ongoing chiropractic care for chronic spinal pain. STUDY DESIGN: Observational 3-month longitudinal study. SETTING: Data collected from patients of 124 chiropractic clinics in 6 United States regions. METHODS: We examined the …

Full-Coverage Chiropractic in Medicare: A Proposal to Eliminate Inequities, Improve Outcomes, and Reduce Health Disparities Without Increasing Overall Program Costs.

OBJECTIVE: The purpose of this article is to discuss evidence that supports the resolution of inequities for Medicare beneficiaries who receive chiropractic care. DISCUSSION: Medicare covers necessary examinations, imaging, exercise instruction, and treatments for beneficiaries with back pain when provided by medical doctors, osteopaths, and their associated support staff such as nurse practitioners, physician assistants, clinical nurse specialists, and physical therapists. However, if the same patient with back pain presents to a chiropractor, then the only service that is covered by Medicar…

Adding Chiropractic Treatment to Individual Rehabilitation for Persistent Pelvic Girdle Pain 3 to 6 Months After Delivery: A Pilot Randomized Trial.

OBJECTIVE: The purpose of this study was to investigate the feasibility of conducting a study examining the influence of individualized rehabilitation and chiropractic treatment, compared with individualized rehabilitation alone, in women with persistent dominating 1-sided pelvic girdle pain (PGP) 3 to 6 months after delivery. METHODS: Women were recruited from an outpatient clinic at Stavanger University Hospital, Norway and in a private chiropractic clinic in Stavanger. Those with persistent, dominating 1-sided PGP were included in this pilot study. Those who met inclusion criteria were ran…

The Reduction of Cervical Hyperlordosis and Resolution of Craniocervical Symptoms in an Adolescent Female: A Chiropractic Biophysics Case Report With Long-Term Follow-Up.

Cervical hyperlordosis is a rare condition in the pediatric population. We present a unique case of the application of Chiropractic Biophysics® (CBP®) technique protocols to reduce a hyperlordotic cervical spine corresponding with many craniocervical symptoms, including chronic migraines and neck pain. A 15-year-old female presented with chronic headaches, neck pain, and neck stiffness among other complaints following a martial arts sprain injury several months prior. There were many positive orthopedic tests and limited range of motion. Radiographs revealed a cervical hyperlordosis and a righ…

The perceived barriers and facilitators for chiropractic care in older adults with low back pain; insights from a qualitative exploration in a dutch context.

BACKGROUND: Understanding care seeking behaviour is vital to enabling access to care. In the context of low back pain (LBP), chiropractors offer services to patients of all ages. Currently, geriatric sub-populations tend to be under-investigated, despite the disproportionate effects of LBP on older adults. In the Netherlands, the chiropractic profession is relatively unknown and therefore, generally speaking, is not considered as the first choice for conservative musculoskeletal primary health care. The aim of this paper was to explore the experiences of older adults with LBP, seeking chiropra…

Best Practices for Chiropractic Management of Adult Patients With Mechanical Low Back Pain: A Clinical Practice Guideline for Chiropractors in the United States.

OBJECTIVE: The purpose of this paper was to update the previously published 2016 best-practice recommendations for chiropractic management of adults with mechanical low back pain (LBP) in the United States. METHODS: Two experienced health librarians conducted the literature searches for clinical practice guidelines and other relevant literature, and the investigators performed quality assessment of included studies. PubMed was searched from March 2015 to September 2021. A steering committee of 10 experts in chiropractic research, education, and practice used the most current relevant guidelin…

Functional Limitations in Adults Who Utilize Chiropractic or Osteopathic Manipulation in the United States: Analysis of the 2012 National Health Interview Survey.

OBJECTIVES: The goals of this study were to identify self-reported differences in function, comorbidities, and medical service utilization among adults who reported using chiropractic and/or osteopathic manipulation in the 2012 National Health Interview Survey, and to compare these between older and younger adults. METHODS: We conducted a descriptive study of adults aged 18 or older who were included in the 2012 National Health Interview Survey and the Alternative Medicine Questionnaire. We included those who reported using chiropractic and/or osteopathic manipulation in the past 12 months. R…

Practice patterns in spine radiograph utilization among doctors of chiropractic enrolled in a provider network offering complementary care in the United States.

OBJECTIVE: Nonspecific back pain is associated with high use of diagnostic imaging in primary care, yet current evidence suggests that routine imaging of the spine is unnecessary. The objective of this study is to describe current practice patterns in spine radiograph utilization among doctors of chiropractic enrolled in an American provider network. METHODS: A cross-sectional analysis of administrative claims data from one of the largest providers of complementary health care networks for health plans in the United States was performed. Survey data containing provider demographics were linke…

Aneurysmal bone cyst in a 21-year-old woman presenting with chronic low back pain in a chiropractic office: a case report.

OBJECTIVE: To emphasize the importance of early detection, recognition, appropriate investigation, accurate diagnosis, proper referral, and treatment of an aneurysmal bone cyst (ABC) presenting as chronic low back pain (LBP) in a chiropractic office. CLINICAL FEATURES: A 21-year-old female student presented to the chiropractic office with a 2-year history of severe and progressive LBP. The patient described the LBP as an aching type of pain that was more pronounced during activity and exercises. She also reported weight loss and increased fatigue. INTERVENTION AND OUTCOME: A detailed clinica…

Reliability of spinal displacement analysis of plain X-rays: a review of commonly accepted facts and fallacies with implications for chiropractic education and technique.

BACKGROUND: Current medical, biomechanical, and chiropractic literature indicates that X-ray line drawing analysis for spinal displacement is reliable, with high Interclass Correlation Coefficients (ICCs) found in most studies. Normal sagittal spinal curvatures are being accepted as important clinical outcomes of care; however, just the opposite is taught in many chiropractic college radiology courses. OBJECTIVE: To review the current literature on X-ray line drawing reliability and abnormal static lateral positions. DATA SOURCES: Searches were performed on Medline, Chiro-LARS, MANTIS, and C…

Upper cervical chiropractic management of a patient with headaches, neck pain and a history of traumatic internal carotid artery compromise: a case report.

OBJECTIVE: This case describes the upper cervical chiropractic management of a patient with neck pain and headaches with a history of cervical artery compromise following a motor vehicle accident. BACKGROUND: A 54-year-old male with neck pain and headaches was seen in a chiropractic office. Eight months prior to his initial visit, the patient was involved in a motor vehicle accident (MVA) which resulted in partial dissection of his left internal carotid artery. The patient reported severe cervicalgia, headaches and painful restricted cervical motion. Physical exam and cervical imaging assesse…

What are the effects of diagnostic imaging on clinical outcomes in patients with low back pain presenting for chiropractic care: a matched observational study.

BACKGROUND: Evidence suggests that diagnostic imaging for low back pain does not improve care in the absence of suspicion of serious pathology. However, the effect of imaging use on clinical outcomes has not been investigated in patients presenting to chiropractors. The aim of this study was to determine if diagnostic imaging affects clinical outcomes in patients with low back pain presenting for chiropractic care. METHODS: A matched observational study using prospective longitudinal observational data with one year follow up was performed in primary care chiropractic clinics in Denmark. Data…

Correction of a double spondylolisthesis of the lumbar spine utilizing Chiropractic BioPhysics® technique: a case report with 1 year follow-up.

[Purpose] To report on the reduction of a double lumbar spine spondylolisthesis by use of Chiropractic BioPhysics® technique. [Participant and Methods] A 57 year-old male presented with severe chronic low back pains and sciatica. After playing hockey for 50 years, he was unable to continue and was forced to retire. Lumbar radiography showed an L3 retrolisthesis of -5.3 mm and an L4 anterolisthesis of 5.4 mm. Chiropractic BioPhysics technique including mirror image lumbar spine drop-table adjustments, corrective exercises and a unique pelvic extension traction was performed 50 times over 7-mont…

An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment.

BackgroundA close collaboration between surgeons and non-surgical spine experts is crucial for optimal care of low back pain (LBP) patients. The affiliation of a chiropractic teaching clinic to a university hospital with a large spine division in Zurich, Switzerland, enables such collaboration. The aim of this study was to describe the trajectories and outcomes of patients with chronic LBP referred from the spine surgery division to the chiropractic teaching clinic.MethodsThe patients filled in an 11-point numeric rating scale (NRS) for pain intensity and the Bournemouth Questionnaire (BQ) (bi…

Development of a Clinical Decision Aid for Chiropractic Management of Common Conditions Causing Low Back Pain in Veterans: Results of a Consensus Process.

ObjectiveThe purpose of this study was to develop a clinical decision aid for chiropractic management of common conditions causing low back pain (LBP) in veterans receiving treatment in US Veterans Affairs (VA) health care facilities.MethodsA consensus study using an online, modified Delphi technique and Research Electronic Data Capture web application was conducted among VA doctors of chiropractic. Investigators reviewed the scientific literature pertaining to diagnosis and treatment of nonsurgical, neuromusculoskeletal LBP. Thirty seed statements summarizing evidence for chiropractic managem…

Воздействие хиропрактических манипуляций на поврежденный эпителий барьер и его механизм специализированных посредников по восстановлению в модели селезенки-дефицита.

ЦЕЛЬ: Изучение влияния дефицита селезенки на эпителиальный барьер иеджунума и легких в крысиной модели селезенки, а также воздействия и потенциального специализированного механизма содействия восстановлению (СМП) хиропрактических манипуляций. МЕТОДЫ: Three- недельные крысы Sprague-Dawley были произвольно разделены на обычную контрольную группу (n = 6), группа селезенки (n = 5) и хиропрактической группой (n = 6). В группе селезенок и хиропрактической группе была создана модель селезенки. Кроме того, хиропрактические манипуляции осуществлялись в хиропрактической группе. Four Спустя несколько нед

Совпадение в аннотации оригинала
OBJECTIVE: To investigate the influence of spleen deficiency on the epithelial barrier of jejunum and lungs in a rat model of spleen-deficiency and the effect and potential specialized pro-resolving mediators (SPMs) mechanism of chiropractic manipulation. METHODS: Three-week-old male Sprague-Dawley rats were divided randomly into normal control group (n = 6…

Recruitment methods and costs for a randomized, placebo-controlled trial of chiropractic care for lumbar spinal stenosis: a single-site pilot study.

OBJECTIVE: The purpose of this article is to describe the methods for recruitment in a clinical trial on chiropractic care for lumbar spinal stenosis. METHODS: This randomized, placebo-controlled pilot study investigated the efficacy of different amounts of total treatment dosage over 6 weeks in 60 volunteer subjects with lumbar spinal stenosis. Subjects were recruited for this study through several media venues, focusing on successful and cost-effective strategies. Included in our efforts were radio advertising, newspaper advertising, direct mail, and various other low-cost initiatives. RES…

Longer-term chiropractic care outcomes for US active-duty military personnel with low back pain: secondary analysis of a pragmatic clinical trial.

BACKGROUND: Few trials have directly evaluated outcomes of adding chiropractic care to usual medical care, and prior work has been limited to short-term follow-up. The objective of this work is to address these gaps by evaluating outcomes from the addition of chiropractic care to usual medical care in active-duty U.S. military members with low back pain (LBP) over 52 weeks. METHODS: A multi-site, pragmatic clinical trial allocated 750 U.S. active-duty military personnel with LBP to usual medical care plus chiropractic care or usual medical care alone with the primary endpoint at 12 weeks. The …