Clinical & Research
Leg Pain Location and Neurological Signs Relate to Outcomes
Written by Editor   
Wednesday, June 28, 2017 06:29 AM

Low back pain (LBP) patients with related leg pain and signs of nerve root involvement are considered to have a worse prognosis than patients with LBP alone. However, it is unclear whether leg pain location above or below the knee and the presence of neurological signs are important in primary care patients. The objectives of this study were to explore whether the four Quebec Task Force categories (QTFC) based on the location of pain and on neurological signs have different characteristics at the time of care seeking, whether these QTFC are associated with outcome, and if so whether there is an obvious ranking of the four QTFC on the severity of outcomes.

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Individual Expectation, a Pertinent, Factor in the Treatment of Musculoskeletal Pain
Written by Editor   
Wednesday, June 28, 2017 06:24 AM

Many factors in the treatment of patients with musculoskeletal pain are considered. The current literature suggests expectation is an influential component of clinical outcomes related to musculoskeletal pain for which physical therapists frequently do not account. The purpose of the clinical perspective reported here is to highlight the potential role of expectation in the clinical outcomes associated with the rehabilitation of individuals experiencing musculoskeletal pain. 

Interventions for musculoskeletal pain conditions often address impairments with the implication that pain and function will improve in response to stretching a tight muscle or strengthening a weak muscle. Realistically, the mechanisms through which physical therapy interventions alter musculoskeletal pain are likely multifaceted and dependent upon a variety of factors. The current literature indicates factors other than the correction of physical impairments influence clinical outcomes in the conservative management of patients experiencing musculoskeletal pain.

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Eating Fish May Ease Rheumatoid Arthritis
Written by Editor   
Wednesday, June 28, 2017 06:22 AM

Eating fish -- tuna, salmon, sardines, trout, sole, halibut, poke, and grouper -- may help reduce joint pain and inflammation in rheumatoid arthritis (RA) patients, according to a new study in Arthritis Care & Research.

RA patients who ate baked, steamed, broiled, or raw fish 2 or more times per week had a significantly lower Disease Activity Score in 28 Joints with C-Reactive Protein (DAS28-CRP) -- a score that measures tender and swollen joints, subjective disease activity, and C-reactive protein -- than those who never ate fish or ate it less than once a month. 

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SMT Has an Immediate Effect on Thermal Pain Sensitivity in People With Low Back Pain
Written by Editor   
Wednesday, June 14, 2017 11:28 AM

Current evidence suggests that spinal manipulative therapy (SMT) is effective in the treatment of people with low back pain (LBP). The primary purpose of this study was to assess the immediate effects of SMT on thermal pain perception in people with LBP. A secondary purpose was to determine whether the resulting hypoalgesia was a local effect and whether psychological influences were associated with changes in pain perception.

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Sham Knee Surgery as Good as Knee Surgery?
Written by Editor   
Wednesday, June 14, 2017 11:20 AM

After 2 years of follow-up, arthroscopic partial meniscectomy (APM) was no better than sham surgery for patients with degenerative medial meniscal tears and no evidence of knee osteoarthritis, reported Finnish researchers in Annals of the Rheumatic Diseases.

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New Cervical Spine Guidelines Relevant for Chiropractic Practice
Written by Editor   
Monday, May 29, 2017 09:14 PM

The mission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is to gather and evaluate existing evidence-based practice information; to facilitate the development of new information where existing evidence is lacking; and to distribute and assist in implementation of evidence-based practice information that is relevant to the chiropractic profession.

The Canadian Chiropractic Guideline Initiative (CCGI) has recently published a guideline on neck pain-associated disorders (NAD) and whiplash-associated disorders (WAD) in the Journal of Manipulative and Physiological Therapeutics (JMPT). 

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Are Fitness Trackers Accurate?
Written by Editor   
Monday, May 29, 2017 09:05 PM

Next-generation activity trackers are wrist-worn trackers measuring heart rate with light-emitting diode (LED) reflection from the skin, reflecting tiny changes in skin blood volume. It is easy to understand their convenience, but their accuracy is questionable.  The data supporting that use has been lacking.

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Reference Values for Human Posture Measurements
Written by Editor   
Tuesday, May 16, 2017 11:26 AM

This study looked at reference values for posture using Postural Assessment Software and concluded that they could be a help in clinical practice.

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Energy Drinks are Tied to Cardiac Changes
Written by Editor   
Tuesday, May 16, 2017 11:18 AM

Evidence continues to accumulate that caution should be utilized when regularly consuming high-volume energy drinks.

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A Qualitative Study of Expectations Over Time Among Chronic Low Back Pain Patients Seeking CAM Therapies
Written by Editor   
Monday, May 01, 2017 07:41 AM

This study used qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies.  It examined how participants’ expectations of treatment changed over the course of a therapy. Expectations tended to shift over the course of treatment to be more inclusive of broader lifestyle factors, the need for long-term pain management strategies and attention to long-term quality of life and wellness. 

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Manipulation Peak Forces Across Spinal Regions for Children
Written by Editor   
Monday, May 01, 2017 07:38 AM
This study created a database of manipulation treatment force variability as a function of the intent of an experienced clinician.
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Scientific Research Needs Oversight
Written by Editor   
Sunday, April 16, 2017 12:38 PM

A recent report encourages improved management of scientific research. It is necessary for all involved in performing, managing, funding, and communicating research to commit to improving practices.

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Nearly 30% of Children in the United States Use CAM
Written by Editor   
Wednesday, April 05, 2017 02:37 PM

News bite:  This study indicates that parents report that 26.6% of children had some form of pain condition during the past year.  21.3% used complementary and alternative medicine (CAM).  Children without painful conditions used CAM only 8.1% of the time.

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Non-Drug Therapies Found Best for Managing Cancer Fatigue
Written by Editor   
Wednesday, April 05, 2017 02:31 PM

News bite:  Exercise and psychological interventions, or a combination of the two, improved cancer-related fatigue (CRF) during and after primary treatment, whereas pharmaceutical interventions did not.

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Time to Redefine the "Disease" of Obesity?
Written by Editor   
Wednesday, April 05, 2017 02:23 PM

News bite:  Some Canadian experts propose a change to the definition of obesity as a disease.  

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Mom's Vitamin E Levels Tied to Child's Risk for Asthma
Written by Editor   
Tuesday, March 21, 2017 07:07 AM

News bite:  Vitamin E plays a part in children's wheezing, but there are eight isotopes of vitamin E, all which have displayed differing effects on health in human studies. Clinicians should be aware that what is currently labeled in our foods and supplements as vitamin E or alpha-tocopherol is actually any of eight different isoforms, and alpha-tocopherol may not actually be the dominant isoform being provided.

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What is the Clinical Compass?
Written by Editor   
Monday, March 06, 2017 12:55 PM

News bite: Learn more about the Clinical Compass, a resource that researches and rates evidence, compiles it in a summary document for the chiropractic profession and other related stakeholders.

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Headache Common Stroke Symptom in Kids
Written by Editor   
Monday, March 06, 2017 12:52 PM
News bite: Do not automatically rule out stroke and other vascular insults in young children presenting with headache. 
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A POLITE Method for Proprioception
Written by Editor   
Monday, March 06, 2017 12:48 PM

News bite: Using the acronym POLITE can help remind the practitioner of the things to cover when planning rehabilitation.

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Mimicking Temporary Fasting May Reduce Metabolic Risk Factors
Written by Editor   
Monday, March 06, 2017 12:44 PM

News bite: A diet that mimics sporadic fasting may reduce body weight and total body fat and improve metabolic markers.

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ACA Applauds ACP Low Back Pain Guidelines
Written by Editor   
Sunday, February 19, 2017 03:01 PM

News Bite:  The chiropractic profession has long advocated for a more conservative approach to treating low back pain.  New guidelines by the American College of Physicians recognizes the value and effectiveness of non-drug approaches, such as spinal manipulation, for acute and chronic low back pain.

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Current and Prospective Use of Musculoskeletal Diagnostic Ultrasound Imaging at Chiropractic Teaching Institutions: A Worldwide Survey of Diagnostic Imaging Staff
Written by Editor   
Sunday, February 19, 2017 02:53 PM

News Bite:  This study looked at the use of musculoskeletal diagnostic ultrasound imaging at chiropractic educational programs around the world and found that current use of this technology is low, but demonstrate a positive attitude to its use and possible growth in its use.

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Nordic Diet Linked to Lower Stroke Risk
Written by Editor   
Sunday, February 19, 2017 02:49 PM

News Bite:  The Nordic-style diet — which includes cabbages, rye bread, fruit such as apples and pears, root vegetables, oatmeal, and fish — may be protective against some types of stroke

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Common Analgesics May Increase Risk for Hearing Loss
Written by Editor   
Monday, February 06, 2017 12:06 PM

News Bite:  This study reports that prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen modestly increases the risk for hearing loss in older women.

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Clinicians Often Underestimate Harms of Tests and Treatments
Written by Editor   
Monday, February 06, 2017 11:58 AM

News Bite:  Clinicians are likely to underestimate harms and overestimate benefits of tests and treatments.  Harms are correctly estimated 13% of the time and benefits only 11%.  The moral?  The estimates of "harm" and "benefit" that you will encounter are usually NOT correct.

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Low Vitamin D Linked to Increased Headache Risk
Written by Editor   
Monday, February 06, 2017 11:33 AM

News Bite:  Vitamin D may be a component factor in headache a new study demonstrates.

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Evidence-Based Practice and Chiropractic
Written by Editor   
Thursday, January 19, 2017 03:03 PM

News Bite:  The paper reported in this article seeks to present an objective interpretation of the literature reporting EBM or practice and to raise discussion points based on those findings which, if explored, may advance the chiropractic profession in both its academic and clinical activities.  It is hoped that the points raised in this discussion paper will be addressed and the chiropractic profession can continue to grow its areas of best practice, both clinical and academic.

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Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles
Written by Editor   
Thursday, January 19, 2017 02:45 PM

News Bite: Scientists used to believe spinal manipulation was purely a biomechanical treatment option for spinal pain conditions.  The growing basic science suggests that there may be more of a neurophysiological effect following spinal manipulation than previously realized.  This study show that spinal manipulation leads to changes in cortical excitability and that spinal manipulation may therefore be indicated for the patients who have lost tonus of their muscle and/or are recovering from muscle degrading dysfunctions such as stroke or orthopaedic operations and/or may also be of interest to sports performers.

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Infants Born Soon After Mother’s Bariatric Surgery Face Increased Risks
Written by Editor   
Thursday, January 19, 2017 02:11 PM

News Bite: Infants of mothers who had bariatric surgery less than two years prior to delivery were at greater risk for prematurity, NICU admission, and small size for gestational age.

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Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex
Written by Editor   
Thursday, January 19, 2017 02:00 PM

News Bite: The medical establishment has recently been seeking to remove from the chiropractic profession its access to the neurology of the human body. This research may shed some light as to why.  Over the past decade, there has been a growing body of evidence to suggest that neural plastic changes occur following chiropractic spinal manipulation.  With this study, researchers set out to explore which brain sources are responsible.  The study demonstrates that a single session of spinal manipulation of dysfunctional segments in subclinical pain patients alters somatosensory processing at the cortical level, particularly within the prefrontal cortex.

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Tips For A Healthy Spine
Written by Editor   
Thursday, January 19, 2017 11:05 AM

News Bite:  The spine acts as a link between your brain and the body. Despite assertions by the medical community that the spine is different from the nervous system, it is widely noted that there are many conditions that may cause a disruption in the transfer of instructions from the brain to the body, usually  when there are any problems associated with the spine or its protective covering, the vertebrae. It is important to consider the spine and vertebrae together while considering your back care. These tips will help.

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A Population-based, Incidence Cohort Study of Mid-back Pain After Traffic Collisions
Written by Editor   
Thursday, January 19, 2017 10:39 AM

News Bite:  This study explores Mid-back pain as a result of traffic-related injury.  About 50 to 80% of individuals involved with these injuries experience Whiplash-Associated Disorders (WAD).  Mid-back pain is one of these symptoms.  In this study the median time-to-first reported recovery was 101 days and about 23% were still not recovered after 1 year.  About half of those with WAD report neck symptoms 1 year after the injury, indicating a prolonged recovery in a substantial proportion of these patients.

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Combining Pain Therapy with Lifestyle: The Role of Personalized Nutrition and Nutritional Supplements
Written by Editor   
Tuesday, January 10, 2017 11:38 AM

News Bite:  In the field of pain therapy the role of nutrition is growing in focus.  This report notes that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment.  

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Survey Reveals a Growing Number of Physicians Willing to Hide Mistakes
Written by Editor   
Tuesday, January 10, 2017 10:48 AM

News Bite:  In a recent survey nearly one-quarter of physicians deemed it acceptable to hide clinical mistakes from patients.  Also, 25% of physicians said that they should not be required to get flu shots, and were nearly evenly split on whether they should be required to undergo random testing for drug abuse.

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Evidence Scant on Nutraceuticals for Neuropathy in Diabetes
Written by Editor   
Tuesday, January 10, 2017 08:38 AM

News Bite:  The only therapeutic strategy shown to prevent development or curtail progression of diabetic neuropathy is tight glucose control.  There are numerous therapeutics for the pain associated with such neuropathy.  Nearly 25% of all diabetic patients are affected by neuropathy.  There is growing interest in nonpharmaceutical approaches to the treatment of both diabetic neuropathy itself and the associated pain.  This article looks at some.

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Emotional Abuse in Childhood May Mean Migraine Later
Written by Editor   
Tuesday, January 10, 2017 08:10 AM

News Bite:  Emotional abuse during childhood precedes onset of migraine in 83% of cases.  Migraineurs also reported significantly higher rates of childhood abuse overall than respondents who reported no migraine. Data continue to amass demonstrating the heartbreaking, wide-ranging negative physical, psychological, and social consequences of childhood abuse and maltreatment. Clinicians treating adults with migraine and other forms of severe headache must recognize that a history of childhood abuse can interfere with treatment.

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Physical Activity Better Than Rest After Youth Concussion
Written by Editor   
Tuesday, January 10, 2017 12:00 AM

News Bite:  The long held practice of complete rest for a youth concussion for weeks or months until fully asymptomatic has been overturned by a newly released study.  Earlier physical activity and more exercise are associated with a lower risk of persistent post concussive symptoms (PPCS).  More exercise, however, is not necessarily a return to full play.

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Helping Patient's Posture
Written by Editor   
Monday, January 09, 2017 09:05 AM

News Bite:  The benefits of improved posture are well known.  Here are three simple tips to help your patients improve their overall posture, and as demonstrated in research, improve their quality of life and health.

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Fish Oil in Pregnancy Linked to Reduced Asthma Risk in Offspring
Written by Editor   
Monday, January 09, 2017 08:49 AM

News Bite:  In a small randomized trial, pregnant women given fish oil supplements bore offspring with a reduced risk of developing persistent wheeze or asthma.

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Clinical Practice Guidelines for the Noninvasive Management of Low Back Pain
Written by Editor   
Saturday, December 24, 2016 07:58 PM

News Bite:  Research indicates that back pain is common, costly, and a considerable proportion of work absenteeism and lost productivity.  This study conducted a systematic review of guidelines on the management of LBP to assess their methodological quality and guide care.

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Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease
Written by Editor   
Tuesday, December 20, 2016 12:00 AM

News Bite:  Want to cut your risk of coronary artery disease nearly in half regardless of your genetic predisposition to it?  Research indicates that having three out of four of the following will do it:  no current smoking; no obesity; regular physical activity; healthy diet.  If we help our patients toward these goals statistics indicate that a substantial reduction in coronary artery disease would result.

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Effects of Motor Control Exercise Vs Muscle Stretching Exercise on Reducing Compensatory Lumbopelvic Motions and Low Back Pain
Written by Editor   
Monday, December 19, 2016 05:14 PM

News Bite: It seems that six weeks of motor control exercise is superior to stretching exercise for reducing compensatory pelvic motion during active prone knee flection and the intensity of low back pain.

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Conservative Management of Uncomplicated Mechanical Neck Pain in a Military Aviator
Written by Editor   
Friday, December 16, 2016 12:00 AM

News Bite: Fighter jet military personnel frequently suffer mechanical neck pain.  Military guidelines call for manipulative therapy, but published studies describing manipulative therapy for fighter jet aviators are scarce.  This report discusses the treatment and resolution of the mechanical neck pain of an F/A 18 instructor pilot.

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Back to Basics in Acute Migraine Treatment
Written by Editor   
Tuesday, December 13, 2016 12:00 AM
News Bite: The effective management of migraine requires a careful assessment and diagnosis.  Avoid medication overuse and incorporate nonpharmacologic therapies.  Always remain open to the possibility of an incorrect diagnosis.
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Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Sickness Absence
Written by Editor   
Friday, December 09, 2016 12:00 AM

News Bite: This study found that the use of pain medication, not necessarily the intensity of the pain, was associated with long-term sickness absence.

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Cost Analysis Related to Dose-response of SMT for Chronic Low Back Pain
Written by Editor   
Wednesday, December 07, 2016 12:00 AM

News Bite: This study in examining the incremental costs and benefits of different doses of SMT for chronic LBP found that while all patients receiving SMT had more pain-free and disability-free days compared with the control group, those who received a dose of 12 SMT treatments over a six week period demonstrated a statistically significant number of pain-free and disability-free days.  Care of chronic LBP with SMT did not increase the costs of treatment plus lost productivity.

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The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline
Written by Editor   
Tuesday, December 06, 2016 12:00 AM

News Bite: A new clinical guideline for neck pain that replaces two prior guidelines is summarized. 

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Does Cervical Spine Manipulation Reduce Pain in People with Degenerative Cervical Radiculopathy?
Written by Editor   
Friday, December 02, 2016 12:00 AM
News Bite: Cervical radiculopathy, compression of a cervical nerve root, is a term used to describe neck pain with associated pain radiating into the arm.  In China the prevalence of cervical spondylosis was about 17% with 60 to 70% of them experiencing radiculopathy.  This study looked at three randomized control trials and a moderate level evidence to support the immediate effectiveness of cervical spine manipulation in treating people with cervical radiculopathy.   
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ER Not Used for Most Sports Injuries
Written by Editor   
Thursday, December 01, 2016 12:00 AM

News Bite: Half of all sports and recreation injuries are seen in the doctor's office and not in the ER.  Males are injured more frequently and sprain/strain are the most common.  Girls get injured more frequently then boys playing the same sport. Contact is the most common cause of injury.

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Estimating the Risk of Chronic Pain for Patients with Acute Low Back Pain
Written by Editor   
Wednesday, November 30, 2016 12:00 AM

News Bite: A five question prognostic model for patients with acute LBP may be a useful tool for estimating risk of chronic LBP.

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'Medical Food' May Slow Brain Atrophy in Alzheimer's
Written by Editor   
Tuesday, November 29, 2016 12:00 AM

News Bite: Nutrition has been demonstrated to result in lower rates of brain atrophy in Alzheimer's patients.  Worldwide between 5 to 30% of adults over 65 have elevated levels of homocysteine. Such condition results in being twice as likely to have dementia, heart attack, and stroke.  B Vitamin supplementation is commonly used to manage this condition.

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