This PSA from the Foundation for Chiropractic Progress discusses how chiropractic care has enabled many people to avoid invasive surgical procedures.
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| Back on the Job - Chiropractic Care |
Monday, January 19, 2015
Thank You for your Trust and Support!!
Just wanted to take a moment and express my sincere thanks
to all of my LinkedIn connections who have taken time out of their day to
endorse my knowledge, skill, and ability with assessing and treating
musculoskeletal pain and dysfunction. I am very humbled and honored to have
your support. Have a great day!!
Friday, January 16, 2015
Making The Case for Primary Spine Practitioner Care
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| Better Option to Back Surgery |
“The American Association of
Medical Colleges has identified musculoskeletal medicine as an area in which
students receive inadequate
preparation for practice in
the real world.[1]
North American medical schools have limited time devoted to musculoskeletal
education. Only 30% to 40% of schools have required instruction in the
musculoskeletal system.[2][3]
Graduates entering practice experience the effects of this lack of instruction;
one survey found that half of family physicians reported inadequate
musculoskeletal training for clinical practice.[4]”[5]
These are not the words of an opinionated
and/or biased chiropractor but those of clinical researchers at the University
of Rochester School of Medicine and Dentistry. They admit that as of November 2014,[5] most primary care physicians graduating
from medical school lack the confidence to assess and treat musculoskeletal
complaints. This fact alone creates a substantial argument for the necessity of
an integrative system of healthcare delivery that incorporates Primary
Spine Practitioner (PSP) trained providers who possess the knowledge,
skill, and ability to triage[6]
patients with musculoskeletal complaints.
PSP trained providers [DC, PT,
MD, NP, PA] can evaluate and manage the majority of patients with
musculoskeletal conditions based upon best available evidence, and in a patient
centered model of care. This portal of entry into the healthcare delivery
system can then streamline the referral process for those patients who need a
level of care beyond that of standard musculoskeletal treatment. Incorporating
this type of provider would alleviate the burden of musculoskeletal complaints
from primary care practices allowing medical doctors to focus on infectious
disease and serious pathology, conditions they ARE TRAINED FOR.
The desire for this integration became evident to us
upon receiving a letter from Excellus Blue Cross/Blue Shield of Rochester dated
29 December 2014. In this letter they outlined a “Waived Copayment Pilot
Program” whose purpose is to “help drive care to spine
pathway trained practitioners so that the program’s value can be measured
and compared to other modalities of treatment for back and neck pain”. This
program will extend until 31 December 2015 and only include Excellus employees
and their covered family members but underlines the fact that a major health insurer
believes PSPs are credible portal of entry providers for patients who
present with musculoskeletal conditions.
[1] Association
of American Medical Colleges. Medical School Objectives Project. Contemporary
issues in medicine: musculoskeletal medicine education. Report VII. 2005.
[2] DiCaprio
MR, Covey A, Bernstein J. Curricular requirements for musculoskeletal medicine
in American medical schools. J Bone Joint Surg Am. 2003 Mar;85(3):565-7.FREE
Full Text
[3] Pinney
SJ, Regan WD. Educating medical students about musculoskeletal problems. Are
community needs reflected in the curricula of Canadian medical schools? J Bone
Joint Surg Am. 2001 Sep;83(9):1317-20.Abstract/FREE
Full Text
[4] Sneiderman
C. Orthopedic practice and training of family physicians: a survey of 302 North
Carolina practitioners. J Fam Pract. 1977 Feb;4(2):267-50.Medline
[5] DiGiovann,
Benedict F., , MD, Richard D. Southgate, , MD, Christopher J. Mooney, , MA,
MPH, Jennifer Y. Chu, , MD, David R. Lambert, , MD, and Regis J. O’Keefe, , MD,
PhD. "Factors Impacting Musculoskeletal Knowledge and Clinical Confidence
in Graduating Medical Students."The Journal of Bone and Joint Surgery E185
96.21 (2014): n. pag. The Journal of Bone and Joint Surgery, Inc.
The Journal of Bone and Joint Surgery, Inc.; STRIATUS Orthopaedic
Communications, 05 Nov. 2014. Web. 17 Jan. 2015. <http://jbjs.org/content/96/21/e185>.
Investigation performed at the Department
of Orthopaedics and Rehabilitation, University of Rochester School of Medicine
and Dentistry, Rochester, New York
Link to the full article:
Saturday, January 10, 2015
Unlock Your Healing Potential with Chiropractic Care
Patient centered and evidence-based chiropractic clinic that assists patients in overcoming their back pain, neck pain, extremity pain or headaches. We educate, motivate, and empower patients via cost effective and clinically effective active care plans that induce high patient satisfaction.
WHAT YOU NEED TO KNOW ABOUT SCIATICA
Taken from our 25 July 14 Spine-Health Powered Newsletter
The term sciatica describes the symptoms of leg pain and
possibly tingling, numbness or weakness that originates in the lower back and
travels through the buttock and down the large sciatic nerve in the back of the
leg. Sciatica (pronounced sigh‐at‐ih‐kah) is not a medical
diagnosis in and of itself ‐ it is
a symptom of an underlying medical condition.
SCIATICA NERVE PAIN
Sciatica is often characterized by one or more of the
following symptoms:
- Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
- Pain that is worse when sitting
- Burning or tingling down the leg (vs. a dull ache)
- Weakness, numbness or difficulty moving the leg or foot
- A sharp pain that may make it difficult to stand up or to walk
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| Sciatica Nerve Inflammation Pattern |
Sciatic pain can vary from infrequent and irritating to
constant and incapacitating. Specific sciatica symptoms also vary widely in
type, location and severity, depending upon the condition causing the sciatica.
While symptoms can be very painful, it is rare that
permanent sciatic nerve damage (tissue damage) will result.
THE SCIATIC NERVE AND SCIATICA
The sciatic nerve is the largest single nerve in the body
and is composed of individual nerve roots that start by branching out from the
spine in the lower back and combine to form the "sciatic nerve." When
it is irritated, sciatica symptoms occur.
- The sciatic nerve starts in the lower back at lumbar segment 3 (L3).
- At each level of the lower spine a nerve root exits from the inside of the spine and then comes together to make up the large sciatic nerve.
- The sciatic nerve runs from the lower back, down the back of each leg
- Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg [e.g. the buttock, thigh, calf, foot, toes]
The sciatica symptoms (e.g., leg pain, numbness, tingling,
weakness, possibly symptoms that radiate into the foot) are different depending
on where the nerve is pinched. For example, a lumbar segment 5 (L5) nerve
impingement can cause weakness in extension of the big toe and potentially in
the ankle.
THE COURSE OF SCIATICA PAIN
The incidence of sciatica increases in middle age. Rarely
occurring before age 20, the probability of experiencing sciatic pain peaks in
the 50's and then declines.
Often, a particular event or injury does not cause
sciatica, but rather it tends to develop over time. The vast majority of people
who experience sciatica get better within a few weeks or months and find painrelief with non-surgical sciatica treatment. For others, however, sciatica pain
from a pinched nerve can be severe and debilitating.
There are a few symptoms that may require immediate
medical, and possibly surgical, intervention, such as progressive neurological
symptoms (e.g. leg weakness) and/or bowel or bladder dysfunction (Cauda Equina
Syndrome).
Because sciatica is caused by an underlying medical
condition, treatment is focused on relieving the underlying causes of symptoms.
Treatment is usually self-care and/or non-surgical, but for severe or
intractable cases surgery may be an option.
MOST COMMON CAUSES OF SCIATICA
- Lumbar herniated disc (also referred to as a slipped, ruptured, bulging, or protruding disc, or a pinched nerve) occurs when the soft inner core of the disc leaks out through the outer core and irritates the nerve root. Sciatica is the most common symptom of a lumbar herniated disc.
- Degenerative disc disease is diagnosed when a weakened disc results in excessive micro-motion at that spinal level, and inflammatory proteins from inside the disc become exposed and irritate the area (including the nerve roots).
- Isthmic spondylolisthesis. This condition occurs when a small stress fracture allows one vertebral body to slip forward on another (e.g. the L5 vertebra slips over the S1 vertebra). The combination of disc space collapse, the fracture, and the vertebral body slipping forward, can cause the nerve to get pinched and cause sciatica.
- Lumbar spinal stenosis is related to natural aging in the spine and is relatively common in adults over age 60. The condition typically results from a combination of one or more of the following: enlarged facet joints, overgrowth of soft tissue, and a bulging disc placing pressure on the nerve roots, causing sciatica pain.
- Piriformis syndrome. The sciatic nerve can get irritated as it runs under the piriformis muscle in the buttock. If the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica- type pain.
- Sacroiliac joint dysfunction. Irritation of the sacroiliac joint - located at the bottom of the spine - can also irritate the L5 nerve, which lies on top of the sacroiliac joint, causing sciatica- type pain.
Click here to read the full article: http://www.spine-health.com/ conditions/sciatica/what-you-need-know-about-sciatica
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