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Showing posts with label pinched nerve in neck. Show all posts
Showing posts with label pinched nerve in neck. Show all posts

Friday, January 16, 2015

Making The Case for Primary Spine Practitioner Care

Primary Spine Practitioner Care for Back Pain
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

[6] Process of organizing several patients for treatment. The process of deciding which people in a hospital department should get medical treatment first, according to how serious their condition is..

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.

Saturday, April 26, 2014

A Best Evidence Synthesis Regarding the Classification and Treatment of Neck Pain

Endorsed by the United Nations on 30 November 1999 and officially launched on 13 January 2000 at the headquarters of the World Health Organization in Geneva, Switzerland the Bone and Joint Decade (BJD) is an international group of healthcare professionals that address the substantial effect that bone and joint disorders have on society, the healthcare system, and the individual. The goal of the BJD is to “improve the health- related quality of life for people with musculoskeletal disorders throughout the world by raising awareness and promoting positive actions to combat the suffering and costs to society associated with musculoskeletal disorders”.[1] This patient centered organization’s motivation has been the establishment of initiatives capable of delivering best-evidence multi-disciplinary healthcare on a global scale.

This focus was evident with establishment of The Task Force on Neck Pain and Its Associated Disorders in 2000. This fifty (50) member Task Force, with members from nine (9) countries, and representing nineteen (19) clinical and scientific disciplines/specialties was mandated with the task of publishing a report outlining the best current evidence regarding the risk and prognosis of neck pain, its assessment/diagnosis, and the effectiveness and safety of invasive and non-invasive treatment methods for neck pain. During this process they were to also identify problems with the current literature so that future studies could be developed. The goal of this seven year project was to empower the public, especially individuals who suffer from neck pain or at risk of developing it. This collaborative effort that included eight (8) universities in four (4) countries and eleven (11) professional organizations who were nonfinancial sponsors produced a document that has changed approaches and views regarding neck pain as well as its prevention, diagnosis, treatment, and management.[2]

Below is the roster of the 13-member Scientific Secretariat who conducted the screening process of 31,878 research citations on neck pain of which 1,203 articles were found to be relevant. 46% (552) of those were found to be “scientifically admissible” for utilization in this synthesis of best-evidence. Aside from this, various other members of the Task Force also conducted four (4) original research projects during its seven year tenure, two that examined vertebrobasilar stroke, one that compared the outcomes of various forms of neck pain treatment, and another that examined work absenteeism due to neck pain.

As Primary Spine Practitioners, the doctors at Life in Motion Chiropractic and Wellness have found this study to be an invaluable guideline for providing our patients with or triaging them to the most effective treatment available for their neck pain.


Stephen W. Greenhalgh, MA, MLIS
Gabrielle van der Velde, DC, PhD (Candidate)


“In other words, one finds much more information than any individual clinician would be able to find, download, print, read, and digest/assimilate should he/she be devoted to such tasks full-time for years. More specifically, the fact that not only whiplash and nontraumatic disorders but also headaches, arm pain, and generalized symptoms of cervical origin are included in the review is a major strength of this work. Similarly, it’s very useful having both nonsurgical and surgical treatments in the same publication. Moreover, grading treatments according to the likelihood of helpfulness; reporting on prognostic factors and using “suspected etiology” to evaluate treatments are some other examples of the clinical orientation and practicality of this report.”
Department of Rheumatology, Physical Medicine and Rehabilitation, Hôpital Fribourgeois – Freiburger Spital Site de Fribourg – Freiburg, Freiburg, Germany
Service de Rhumatologie, Médecine Physique et Rééducation, 1708, Fribourg, Switzerland



[1] "Background & Goals." THE BONE AND JOINT DECADE. World Health Organization, 13 Jan. 2000. Web. 25 Apr. 2014. <http://bjdonline.org/home/bjd-goals/>.
[2] Haldeman, Scott, Linda Carroll, David Cassidy, Jon Schubert, and Ake Nygren. "The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders - Executive Summary." SPINE 33.4S (2008): S5-S7. Print.