Sep 22

Chiropractic Research And Access Are Important For Spine Patient Care

The “knowers” will control spinal manipulation once said Scott Haldeman DC MD. So true! And patients should expect their spinal manipulation therapy (SMT) providers to be such knowers! 90% of spinal manipulation is delivered by chiropractors. (1) Chiropractors know SMT. A review of their application of SMT according to the RAND/UCLA Appropriateness Method reported that they appropriately used SMT in treating 84% of their chronic low back pain and 86% of their chronic neck pain patients. (2) According to an analysis of published research, research support for chiropractic SMT was cited more than average in a multitude of research areas from medicine, veterinary, neurosciences, biochemistry, genetics and molecular biology, to social sciences. (3) Chiropractors know they can provide relieving SMT, affordably too, when patients can get to them. A recent study of older adult spine pain patients’ reduced access to chiropractic resulted in an increase the number of visits to primary care physicians for spine pain, rate of spinal surgery, and cost of care (an additional cost of $114,967 per 1000 beneficiaries on medical services). (4) Luckily in our area, your chiropractor is available to you, knows the proper tests to evaluate your condition to set up a treatment plan to manage your spine pain. Many tests like manual palpation are available to back pain specialists to evaluate low back pain in adults. For example, the gluteal muscle palpation test for tenderness stands out for its validity in differentiating low back pain patients with and without radiculopathy. (5) Chiropractors like yours truly are knowers who understand the examination, diagnosis, and appropriate treatment of back and neck pain!

TIP OF THE MONTH: Breathe

Just breathe. Do you think about breathing? Not many people do, but researchers are! They are studying breathing, its different modes and its pain-relieving qualities. Compared to uncontrolled breathing patterns, slow deep breathing reduced visceral pain intensity. (6) It was found to better ease pain when it was slow paced with a longer expiration than inspiration. (7) One study proposed pursed-lips breathing and found that it was more calming, pleasant, and sense-of-control delivering, good for handling emotional responses. (8) Interesting! Your chiropractor most appreciated the study of breathing’s effect on chronic neck pain patients’ muscle activity which prompted researchers to recommend breathing as a part of neck pain treatment plans. (9) Just breathe! You do anyway, so maybe just pay a little more attention to howyou breathe to boost your pain relief.

Listen to this PODCAST with Dr. Lee Hazen and Cheri Hazen on The Back Doctors Podcast with Dr. Michael Johnson as they discuss the inclusion of basic breathing instruction along with spinal manipulation in their use of the Cox® Technic System of Spinal Pain Management.

Thank you for your trust in our chiropractic care. See you soon!

References for HEALTHY NEWS – September 2021

  1. Anderson BR, McClellan WS, Long CR. Risk of Treatment Escalation in Recipients vs Nonrecipients of Spinal Manipulation for Musculoskeletal Cervical Spine Disorders: An Analysis of Insurance Claims. J Manipulative Physiol Ther. 2021 Aug 5:S0161-4754(21)00035-X. doi: 10.1016/j.jmpt.2021.03.001. Epub ahead of print. PMID: 34366149.
  2. Coulter ID, Herman PM, Kommareddi M, Hurwitz EL, Shekelle PG. Measuring the Appropriateness of Spinal Manipulation for Chronic Low Back and Chronic Neck Pain in Chiropractic Patients. Spine (Phila Pa 1976). 2021 Oct 1;46(19):1344-1353. doi: 10.1097/BRS.0000000000004009. PMID: 34517404; PMCID: PMC8438222.
  3. Thelwall M. Alternative medicines worth researching? Citation analyses of acupuncture, chiropractic, homeopathy, and osteopathy 1996-2017. Scientometrics. 2021 Sep 3:1-17. doi: 10.1007/s11192-021-04145-0. Epub ahead of print. PMID: 34493881; PMCID: PMC8414961.
  4. Davis M, Yakusheva O, Liu H, Anderson B, Bynum J: The Effect of Reduced Access to Chiropractic Care on Medical Service Use for Spine Conditions Among Older Adults. J Manipulative Physiol Ther 2021:S0161-4754(21)00071-3
  5. Nolet PS, Yu H, Côté P, Meyer AL, Kristman VL, Sutton D, Murnaghan K, Lemeunier N. Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review. Chiropr Man Therap. 2021 Aug 26;29(1):33. doi: 10.1186/s12998-021-00384-3. PMID: 34446040; PMCID: PMC8390263.
  6. Gholamrezaei A, Van Diest I, Aziz Q, Pauwels A, Tack J, Vlaeyen JWS, Van Oudenhove L. Effect of slow, deep breathing on visceral pain perception and its underlying psychophysiological mechanisms. Neurogastroenterol Motil. 2021 Aug 11:e14242. doi: 10.1111/nmo.14242. Epub ahead of print. PMID: 34378834.
  7. Jafari H, Gholamrezaei A, Franssen M, Van Oudenhove L, Aziz Q, Van den Bergh O, Vlaeyen JWS, Van Diest I. Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms. J Pain. 2020 Sep-Oct;21(9-10):1018-1030. doi: 10.1016/j.jpain.2019.12.010. Epub 2020 Jan 22. PMID: 31978501.
  8. Gholamrezaei A, Van Diest I, Aziz Q, Vlaeyen JWS, Van Oudenhove L. Psychophysiological responses to various slow, deep breathing techniques. Psychophysiology. 2021 Feb;58(2):e13712. doi: 10.1111/psyp.13712. Epub 2020 Oct 27. PMID: 33111377.
  9. Borisut S, Tantisuwat A, Gaogasigam C. The study of respiratory muscles activation during respiratory muscle strength effort in adult females with chronic neck pain. J Phys Ther Sci. 2021 Sep;33(9):689-694. doi: 10.1589/jpts.33.689. Epub 2021 Sep 1. PMID: 34539075; PMCID: PMC8436045.