An Open Letter to our Medical friends.

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In the past year, many trusted medical establishments including the FDA (1), CDC (2), Joint Commission (3,4), JAMA (5), and The American College of Physicians/ Annals of Internal Medicine (6) have encouraged medical providers to prescribe spinal manipulation as a first line treatment for acute, subacute, and chronic low back pain.

Most recently, The Lancet echoed that endorsement, and provided a unique perspective:

The reduced emphasis on pharmacological care recommends nonpharmacological care as the first treatment option and reserves pharmacological care for patients for whom nonpharmacological care has not worked. These guidelines endorse the use of exercise and a range of other non- pharmacological therapies, including massage, spinal manipulation, and acupuncture.

Gaps between evidence and practice exist, with limited use of recommended first- line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence. (7)

Unfortunately, personal experience skews our perception of each other’s merit, i.e., we primarily see each other’s failures since the successes don’t need to seek additional care. Regardless of our professional degree, we all have failed cases mixed into our many clinical successes. We must not lose sight of the evidence supporting each other’s overwhelming proven value for a given diagnosis. If we judge each other by our successes rather than our failures, we will work toward an integrated model where the patient wins. Together, we will help more patients than either working alone.

We are honored for the opportunity to co-manage your patients.

 

References
1. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017
2. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.
3. The Official Newsletter of The Joint Commission. Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. July 2017 Volume 37 Number 7. Ahead of print in
2018 Comprehensive Accreditation Manual for Hospitals.
4. Joint Commission Online. Revision to Pain Management Standards. http://www.jointcommission.org/assets/1/23/jconline_november_12_14.pdf
5. Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain; Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451-1460.
6. Qaseem A, et al. for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
7. Foster, Nadine EBuchbinder, Rachelle et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, Published Online March 21, 2018 http://dx.doi.org/10.1016/ S0140-6736(18)30489-6

Splenius capitis trigger points

The Splenius capitis muscle is located in the back or the neck. It originates on the ligamentum nuchae and the spinous processes of C7 to T6. It attaches to the occipital bone and the mastoid process of the temporal bone. This muscle functions bilaterally to produce neck extension, and unilaterally to produce rotation of the head to the same side. When trigger points develop in this muscle they will produce restriction in neck movement, as well as pain felt in the neck, but also strongly in the top of the head. Trigger points in this muscle are a common cause of headaches.

Neck Pain Basics

Neck Pain, Posture and Headaches.pngBottom Line: Neck pain is one of the top three reasons people visit our practice. Acute neck pain and cervical radiculopathy can be debilitating. They can keep people out of work, slow down their social life and can even lead to depression.

The bottom line is that Chiropractic has been shown to be more effective than medication, extremely safe and to have high levels of patient satisfaction.

Why it Matters: Top research publications like SPINE, the Annals of Internal Medicine, and the Journal of Manipulative and Physiological Therapeutics have all recently published studies supporting the use of Chiropractic adjustments for neck pain.

Recent research indicates that over 85% percent of patients who had Chiropractic care were found to have statistically and clinically significant improvement in their neck pain and radiculopathy. What about medications? Well, Chiropractic was found to be more effective in both the short and long term that pharmaceuticals.

There is no reason everyone shouldn’t make Chiropractic their first stop to find relief from neck pain. Your weekly Research That Matters handouts will help you educate, entertain, and entice your patients to share the message of Chiropractic with their friends and family.

  • Research has shown Chiropractic care to be extremely safe.
  • Of the nearly 20,000 patients examined by SPINE, none reported complications

    while receiving Chiropractic care.

  • Of people receiving adjustments, 94% reported high levels of patient satisfaction.
  • Similary, those having just received a Chiropractic adjustment reported their pain

    was reduced by up to 75%.

  • Of people receiving Chiropractic adjustments for neck pain, 85% experienced significant improvement.

Neck pain and the trapezius muscle.

The Trapezius muscle is a large diamond shaped muscle located in the back and neck. It is responsible for for a number of shoulder and neck movements and helps maintain proper posture. This muscle is probably the most common muscle that I work on in the clinic. It is frequently strained and develops trigger points easily. The trigger points in the upper portion of this muscle are the most common to be found in the body. Trigger points will refer pain into the upper back, neck, shoulder, and even into the head and temple causing headaches. Chronic trigger points in this muscle are also a frequent cause of a stiff neck.