With the Department of Defense and Veterans Administration seemingly dragging their collective feet with respect to providing access to chiropractic health care services at more of its facilities, perhaps research can spur them to action. Consider findings from "Chiropractic Management for Veterans With Neck Pain: A Retrospective Study of Clinical Outcomes," which appears in the October 2011 issue of the Journal of Manipulative and Physiological Therapeutics. According to the study, patients receiving an average of 8.7 treatments in the form of cervical flexion-distraction spinal manipulation (7 percent of participants), manual spinal manipulative therapy (61 percent) and/or spinal mobilization (44 percent), as well as myofascial release (all participants) improved significantly based on numeric rating scale (measuring pain severity)and Neck Bournemouth Questionnaire scores.
The study, a retrospective chart review, evaluated charts from 54 veterans who received care at the Department of Veterans Affairs Western New York Health Care System chiropractic clinic from Jan. 1 – Dec. 31, 2009. Patients (n = 54) were predominately male, with a mean age of 50.9 years. In addition to the treatment methods outlined above, patients also received "instructions for therapeutic exercises and stretches tailored to the nature of their presentation."
Neck pain was determined to be chronic (duration of at least six months) in almost all cases (89 percent). Researchers evaluated patients' improvement following treatment by way of the NRS and NBQ, with minimum clinically important difference (MCID) between baseline and post-therapy scores set at 30 percent change. Based on the established MCID of 30 percent, two-thirds of the 54 patients exceeded the percentage of improvement for both the NRS and NBQ. Overall, for the numeric rating scale, patients improved an average of 2.6 points (43 percent) from baseline, while for the Neck Bournemouth Questionnaire, average raw-score improvement was 13.9 points, a 33-percent change from baseline scores.
In their conclusion, the study authors note that "[t]here is limited basis for comparison of chiropractic clinical outcomes for neck pain among the veteran patient population," which underscores the importance of this study data for comparison to future research. They also state that "the current study provides the most extensive account to date of chiropractic clinical outcomes for veteran patients with neck pain," again emphasizing the foundational value of their findings.
The complete study on neck pain and clinical outcomes in veterans is available on the JMPT Web site.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
