My Blogging History

Friday, April 3, 2015

Daily Health Update for Friday, 03 Apr 2015

“To the best of our ability, Life in Motion Chiropractic and Wellness agrees to provide our patients convenient, affordable, and mainstream Chiropractic care. We will not use unnecessary long-term treatment plans and/or therapies.”


www.Chiro-Trust.org






 Mental Attitude: Does IQ Determine How Much Alcohol a Young Man Drinks?

Swedish researchers have found that lower male IQ scores are linked to greater risks for heavy and binge drinking behaviors. The research team separated the nearly 50,000 male study participants into nine groups based on IQ scores from highest to lowest. They found that the risk of heavy drinking increased 20% and the risk of binge drinking increased 9% as they moved each level downwards towards the group with the lowest IQ scores. While it’s believed that many factors may influence an individual's alcohol consumption, those with higher IQ scores may be more likely to make lifestyle choices that would steer them clear of situations that encourage heavy drinking.

Alcoholism: Clinical & Experimental Research, March 2015

Health Alert: Family History of Prostate Cancer May Be Linked to Breast Cancer Risk.

A family history of prostate cancer may be tied to a woman’s risk of breast cancer. Researchers found that women whose father, brother, or son have had prostate cancer may have a 14% greater risk of developing breast cancer when compared with women whose male family members have not had prostate cancer. They also found that women with a family history of both prostate and breast cancer have a 78% greater risk of developing breast cancer when compared with women whose family histories have neither. The findings call attention to the need for women to know their complete family medical history, particularly cancer diagnosed among first-degree relatives, including fathers, brothers, and sons.

Cancer, March 2015

Diet: Could This Olive Oil Compound One Day Fight Cancer?

Oleocanthal, a compound in extra virgin olive oil, has been observed to cause cell death in cancer cells; however, scientists have been unable to determine how it worked. Now, researchers claim that oleocanthal acts by rupturing the lysosomes found in cancer cells, causing cell death within 30 minutes while leaving non-cancerous cells untouched. Study co-author Dr. Paul Breslin notes, "The mechanism of killing cancer cells and sparing healthy cells, lysosomal membrane permeabilization, has been hypothesized as a possible mechanism of effectively killing cancer cells and sparing healthy tissues but has never been realized before. Our realization of this makes this paper of particular therapeutic interest for cancer treatment."

Molecular & Cellular Oncology, January 2015

Exercise: Exercise's Effect on the Brain Could Improve Mobility as We Age.

A small study conducted at Rush University Medical Center in Chicago indicates that staying physically active in adulthood may ward off mobility problems later in life. In a study involving 167 seniors, those with a history of physical exercise had higher mobility scores than their peers who were mostly sedentary during their working years, even in the presence of brain deterioration typically associated with movement difficulty among the elderly.

Neurology, March 2015

Chiropractic: Stretching Can Help Office Workers with Neck and Shoulder Pain.

For office workers with chronic neck and shoulder pain, a recent study found that performing neck and shoulder stretching exercises at least three days a week led to significant improvements in both pain and function.

Clinical Rehabilitation, March 2015

Wellness/Prevention: Benefits From Diet & Exercise.

A healthy diet combined with exercise can lead to many benefits. The Weight-Control Information Network lists the following benefits of exercise: keeps your body energized for work and play, improves ability to manage stress, promotes a positive self-image, improves the fit and look of clothing, tones muscles, and creates a positive example for family and friends.

The Weight-Control Information Network, March 2015


This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.


Thursday, April 2, 2015

Daily Health Update for Thursday, 02 Apr 2015

“To the best of our ability, Life in Motion Chiropractic and Wellness agrees to provide our patients convenient, affordable, and mainstream Chiropractic care. We will not use unnecessary long-term treatment plans and/or therapies.”


www.Chiro-Trust.org







 Mental Attitude: Are Parents to Blame for Narcissistic Kids?

If you want to avoid raising a narcissistic child, then the authors of a new study recommend not overvaluing your son or daughter. The researchers found the children whose parents described them as "more special than other children" and who "deserve something extra in life" scored higher on tests of narcissism. Study co-author Dr. Brad Bushman adds, "Children believe it when their parents tell them that they are more special than others. That may not be good for them or for society." Dr. Bushman and his colleagues recommend that parent training interventions could teach parents to express affection toward their children without telling them that they are better than others.

Proceedings of the National Academy of Sciences, March 2015

Health Alert: Nearly Two Out of 3 People with Invasive Cancer Are Surviving 5 Years or More.

The Centers for Disease Control and Prevention (CDC) reports that the overall five-year survival rate for patients following a cancer diagnosis is now just over 60%. While prostate and breast cancer -- the two most common body sites for cancer in the United States -- have high five-year survival rates (97% and 88%, respectively), there's significant room for improvement with lung cancer patients as their five-year survival rate is just 18%.

The Centers for Disease Control and Prevention, March 2015

Diet: Vitamin B1 Deficiency May Affect from 1 in 6 to Nearly 1 in 3 Obese Adults.

Between 15.5% and 29% of obese patients seeking bariatric surgery are thiamine (also known as vitamin B1) deficient. Though important for metabolism, nerve conduction, and muscle contraction, thiamine is not produced by the body and must be derived from food sources. Thiamine deficiency has been associated with weakness, fatigue, psychosis, and nerve damage. While obesity is thought to be a disease of excess nutrition, this finding suggests that it may also be a disease of malnutrition.

Advances in Nutrition, March 2015

Exercise: How to Build a Fitness Support System.

Staying motivated to achieve your health and fitness goals can be easier if you have a strong support system. The American Council on Exercise recommends communicating with a partner or loved one about your goals, finding an accountability buddy to encourage you, and connecting with others who are focused on improving their health.

The American Council on Exercise, March 2015

Chiropractic: Advanced Diagnostic Imaging for Seniors with Back Pain?

While most treatment guidelines generally advise against CT/MRI scans for younger adults with new onset back pain, guidelines for older adults allow for early imaging. However, it's unknown if this improves outcomes or possibly worsens them if such imaging leads to treatments that may have serious adverse effects. To find out, researchers followed 5,239 seniors for the year after their initial visit regarding back pain. Of the group, 349 received either a CT or MRI scan within six weeks of their first appointment. One year later, outcome assessments focused on measuring disability found that early advanced imaging was not associated with better treatment outcomes.

 JAMA, March 2015

Wellness/Prevention: Weight Loss Should Be Part of Cancer Prevention Strategies!

Current research shows that obesity is associated with a higher risk for ovarian and endometrial cancers, as well as postmenopausal breast cancer in women. Though the precise mechanism behind the elevated risk for such cancers is unknown, it's suspected obesity-related changes to a woman's sex hormone levels, insulin resistance, and chronic inflammation may be to blame. Obese women are also at greater risk for cancer recurrence and mortality. Experts recommend that obese women adopt a healthier lifestyle as part of a cancer prevention strategy.

Best Practice & Research, Clinical Obstetrics and Gynaecology, February 2015


This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

Wednesday, April 1, 2015

Daily Health Update for Wednesday, 01 Apr 2015

“To the best of our ability, Life in Motion Chiropractic and Wellness agrees to provide our patients convenient, affordable, and mainstream Chiropractic care. We will not use unnecessary long-term treatment plans and/or therapies.”
www.Chiro-Trust.org





 Mental Attitude: Loneliness & Depression Associated with TV Binge-Watching.

A recent study has found that the more lonely and depressed a person is, the more likely he or she will binge-watch TV. Researchers say that depressed individuals use this activity to move away from negative feelings and those who lack the ability to control themselves are more likely to binge-watch. This is of concern as past research has shown that obesity and other health problems are related to excessive television viewing, suggesting that binge-watching may be more than a harmless addiction.

65th Annual Conference of the International Communication Association, February 2015

Health Alert: Prescription Combo Can Be Fatal for Seniors.

Combining commonly prescribed antibiotics with a widely used heart medication appears to more than double the risk of sudden death in seniors, finds a new study published in the Canadian Medical Association Journal. Spironolactone (Aldactone) is a common diuretic widely used in the treatment of heart failure. However, investigators have found that when trimethoprim-sulfamethoxazole (Septra, Bactrim) is prescribed to someone on Spironolactone, it can cause blood potassium to rise to potentially life-threatening levels. Over a 17-year period, almost 12,000 people died suddenly after taking this combination of medicines and most of the patients who died were over the age of 85. The authors conclude that pharmacists and physicians must be made aware of this interaction, as it does not appear widely known at present time.

Canadian Medical Association Journal, February 2015

Diet: Toddler Snacks & Meals Have Plenty of Salt & Sugar.

Many prepackaged meals for toddlers contain high levels of salt, and many snacks, desserts, and juices for infants and toddlers contain added sugar. Researcher Dr. Mary Cogswell writes, "It was surprising that more than seven of ten packaged toddler meals contained too much sodium (salt)… Some parents might be surprised that a majority of infant and toddler snacks and sides, such as flavored crackers and rice cakes, contained added sugar. About half the analyzed ready-to-serve mixed grains and fruits products, such as oatmeal and fruit in a jar, contained added sugar." She recommends preparing food for infants and toddlers as a healthier choice over prepackaged foods.

Pediatrics, February 2015

Exercise: You May Want to Take it Easy When Jogging.

After following 1,000 healthy joggers and 4,000 healthy non-joggers for a decade, researchers claim that those who jog 1-2.4 hours per week were 71% less likely to die during the study period than non-joggers. However, they found no mortality benefits when comparing more strenuous joggers to the non-joggers in the study. Study researcher Dr. Jacob Marott adds, "We believe that long-term strenuous endurance exercise may induce pathological structural remodeling of the heart and large arteries."

Journal of the American College of Cardiology, February 2015

Chiropractic: Improvement in Chronic Hypertension Following Cervical Adjustment.

A 55-year-old male with a history of chronic hypertension that did not respond to medical management presented for a trial of chiropractic care. After receiving an upper cervical adjustment using a specific chiropractic protocol, his blood pressure progressively lowered. The findings support the possible use of chiropractic care in the management of unresolved chronic hypertension.

Journal of Upper Cervical Chiropractic Research, January 2015

Wellness/Prevention: Probiotic Pill May Help Diabetics.

Researchers claim that a study involving rats demonstrates that a modified strain of "friendly" human gut bacteria called Lactobacillus appears to have instigated a process that converted cells in the intestinal lining to behave like pancreatic beta cells and release insulin to regulate blood sugar levels. In the study, the rats that received the modified probiotic had blood glucose levels up to 30% lower than rats that did not receive the probiotic. The researchers hope to one day develop a probiotic pill for human use that diabetic patients could take each morning to help manage and possibly cure their condition.

Diabetes, February 2015 


This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

Tuesday, March 24, 2015

Core Strength and Flexibility

This is Part I of what will be a series of posts regarding core strengthening and flexibility. spkDC

Your core is more than the “six-pack” that is envisioned when the subject is discussed. Your core musculature includes the following areas: back, flank, pelvis, and buttocks all of which are responsible for assisting in the stabilization of your spine when you bend, twist, rotate, sit, and stand. So whether you’re a “gym rat” or an “occupational athlete” your core, and your mindful attention to it, is imperative in preventing back and/or neck pain.

Obviously there are various workouts that can improve core strength but some require a certain level of fitness while others, if not executed properly, can result in further injury and/or pain. However, there are exercises which are appropriate no matter what your reluctance or time constraint is. Because let’s face it, any form of physical activity that can enhance your spinal stability is better than none at all.

No inanimate device or solitary treatment to date is the be all end all cure for low back pain, an issue which ranks second to respiratory infection for primary care visits. That being said, when it comes to musculoskeletal pain, no website or anecdotal opinion is a reasonable substitute for an objective examination by a musculoskeletal specialist to determine the cause and subsequent treatment for your low back pain. Ignoring pain that hasn't gotten better or become worse after 72+ hours will only amplify the issue and altering your body mechanics to decrease its provocation can cause additional problems.  

Studies have shown that regular stretching AND strengthening of core musculature can help you avoid back pain and/or ease chronic pain. The objective of regular core “mindfulness” is to hone conscious control over the position and movement of your body’s center, an area known in traditional Chinese medicine as the “dan-tien” [don-tee-en]. You should think of your core as the “conjunction junction” between your torso and lower extremities (thighs, legs, and feet).


All bodily propulsion either originates or is transferred through the core via the kinetic chain. Muscle weakness/tightness within the chain (i.e. back, flank, pelvis, buttocks) can/will decrease the strength/stability of your movements and set in motion joint misalignments and/or adverse limb placement thereby perpetuating injury over time (“the straw that broke the camel’s back”).

Core strength and flexibility is the key to ambulatory power, balance, and stability which is vital to injury prevention. Your core affects just about everything you do whether it be taking a walk, rising from your chair, putting on your shoes, turning to back your car down the driveway, or simply standing still and a weak inflexible core can make on the job tasks, hobbies, sports, or housework quite unpleasant.

Aside from maintaining a healthy back, core strength and flexibility will help you feel, think, and look better:


  • Regular exercise has been shown to ease depression and improve mood which in turn will help you not gain weight or regain pounds you've lost
  • In older adults, regular exercise improves functional abilities which in turn help to maintain/boost bone density, prevent falls, and sharpen mental function

  • Regular Exercise = ↓ Risks ForEarly Death [i.e. heart disease, stroke, type 2 diabetes, high blood pressure, metabolic syndrome, etc.]

  • Some people [under a medical doctor’s supervision] may be able to cut back on certain medications which can eliminate/ease unwanted side effects as well as save you money

Thursday, March 19, 2015

Inversion Tables

I am constantly asked by patients what my professional opinion is regarding inversion tables. In most cases I share my cursory exploration of the subject and advise that they do their homework before buying one. Having been asked this question again only three days ago I felt it only right to review what research literature I could find on the subject so as to provide people with a more detailed point of reference.

My search for credible, unbiased literature revealed a surprisingly scant wealth of resources on the subject. There are plenty of sites with opinion pieces, organizational advocacy, and even consumer testimonials regarding personal experience with inversion (i.e. Spine-Health) but very little medical evidence for or against its use. In fact I could only find two websites where the authors cited medical research to substantiate their advocacy, or lack thereof, for inversion table use in the treatment of musculoskeletal pain.

Edward R. Laskowski, M.D., co-director of the Mayo Clinic Sports Medicine Center and a professor at College of Medicine, Mayo Clinic, published a brief article regarding the subject where he opened his commentary by stating, “Inversion therapy doesn't provide lasting relief from back pain, and it's not safe for everyone”. He went on to describe the effects of inversion and ended by citing its contraindications for use.[1]

Kevin Macpherson, M.Ed., ATC, currently employed by Pivotal Health Solutions, published an article where he cites eight relevant publications and ends his commentary by stating, “If more health-care providers were educated on the benefits of inversion, many patients could receive the lifelong benefits of this therapy and the cost savings to both patients and practitioner can be substantial, as we start to equalize gravity’s negative effects one patient at a time”.[2]

However, several of the research studies cited are more than twenty (20) years old and the sample sizes were small (60 subjects or less) which isn't a true random sampling of the general population. This in no way means the findings of these researchers is not legitimate but is dated and cannot accurately formulate a conclusive argument for or against the use of inversion tables.[3], [4], [5], [6], [7], [8], [9], [10], [11] Dr. Laskowski’s article did however include two literature reviews in which the authors searched medical databases for studies involving treatment methods for low back pain.

The first, published in 2006 in Spine, examined traction therapy for low back pain with or without sciatica. In this review the authors selected studies regarding “randomized controlled trials (RCTs) involving any type of traction”, albeit inversion tables ARE a form of traction this was not the solitary focus of this review. The authors ultimately concluded that “intermittent or continuous traction” is not a recommended standalone treatment for low back pain but that “the literature allows no firm negative conclusion that traction, in a generalized sense, is not an effective treatment for patients with LBP”.

The second, published in 2007 in the Annals of Internal Medicine, examined treatment methods that ranged from acupuncture to yoga but did not primarily examine the benefits and/or risks involved with inversion tables. The authors conclude that cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation exhibited moderate clinical effectiveness for the treatment of chronic or subacute low back pain. [12]

Ultimately I did find one [unbiased][13] research article that exclusively examined the use of inversion therapy in the treatment of low back pain. Although cited in Mr. Macpherson’s article 2 it must have been an ad hoc addition by the website because this study was conducted three (3) years after the publication of his commentary. This was a pilot randomized trial conducted at the Regional Neurosciences Centre, Newcastle Upon Tyne in the United Kingdom that examined “the effect of inversion therapy in patients with single level lumbar discogenic disease, who had been listed for surgery”. Although only a small sample size (24 participants) was observed it examined the use of physiotherapy in the treatment of sciatica with and without the use of an inversion device. From a clinical standpoint the outcome measures used in this trial are right on the mark as well as their use of surgery avoidance as a sign of treatment success. The authors concluded that a larger multi-center randomized trial needs to be conducted because it was shown that “intermittent traction with an inversion device [plus physiotherapy] resulted in a significant reduction in the need for surgery”.[14]

So what does all of this mean for you, the consumer? Before commencing any form of treatment due to a spine related disorder you should first consult a licensed medical professional who is specifically trained to differentially diagnosis your symptoms. Internet websites and anecdotal advice from friends and family is not a proper substitute for professional determination of your pain and effective treatment protocol(s). In fact when it comes to inversion therapy there are several contraindications to its use such as deconditioned musculature (spinal instability, spinal injury), eye conditions (detached retina, glaucoma, infection), circulatory problems (clotting issues, heart condition, high blood pressure, atrial fibrillation), fracture, hernia, implanted device(s), middle ear infection, osteoporosis, or pregnancy and only a professional medical consult will help determine if this form of treatment is right for you.[15] You should also keep in mind that no solitary intervention, as stated in the research presented here, is an effective form of treatment for musculoskeletal pain and dysfunction.

“Inversion tables are more or less like traction. I tell patients that want to try an inversion table to make sure they have another person in attendance to help them on and off the table. The same is true with traction. It may help, it may not. Generally, you will know the first time it is used.”[16]
Center for Spine Health, Cleveland Clinic



[1] Laskowski, Edward R. "Diseases and Conditions - Back Pain." Inversion Therapy: Can It Relieve Back Pain? Mayo Foundation for Medical Education and Research, 09 June 2014. Web. 17 Mar. 2015. <http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/inversion-therapy/faq-20057951>.
[2] Macpherson, Kevin. "Inversion Therapy." Canadian Chiropractor. Annex Business Media, 30 Apr. 2009. Web. 17 Mar. 2015. <http://www.canadianchiropractor.ca/techniques/inversion-therapy-1461>.
[3] Haskvitz EM, et al. Blood pressure response to inversion traction. Physical Therapy. 1986;66:1364.
[4] Lamarr JD, et al. Intraocular pressure response to inversion. American Journal of Optometry & Physiological Optics. 1984;61:679.
[5] Klatz RM; Goldman RM; Pinchuk BG; Nelson KE; Tarr RS: The effects of gravity inversion procedures on systemic blood pressure, intraocular pressure and anteriol retinal pressure. J Am Osteopathic Assoc. 1983 Jul; 82(11) 853-857.
[6] Goldman RM; Tarr RS; Pinchuk BG; Kappler RE: The Physician and Sports Medicine. March 1985.
[7] Nachemson A and Elfstrom G: Intravital Dynamic Pressure Measurements in Lumbar Discs. Scandinavian Journal of Rehab Medicine, supplement, 1970.
[8] Kane M, et al.: Effects of Gravity-facilitated Traction on Intervertebral Dimensions of the Lumbar Spine. Journal of Orthopedic and Sports Phys Ther. 281-288, Mar 85.
[9] Nosse L.: Inverted Spinal Traction. Arch Phys Med Rehabil 59: 367-370, Aug 78.
[10] Dimberg L, et al: Effects of gravity-facilitated traction of the lumbar spine in persons with chronic low back pain at the workplace.
[11] Sheffield F.: Adaptation of Tilt Table for Lumbar Traction. Arch Phys Med Rehabil 45: 469-472, 1964.
[12] Chou R. Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine. 2007;147:492.
[13] I did find another study published in the Journal of the Canadian Chiropractic Association but found it hard to believe no outcome bias existed when the study was funded by the manufacturer of the inversion device being used in the research.
[14] Prasad KS, et al. Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial. Disability and Rehabilitation. 2012;34(17):1473-80
[15] Spinasanta, Susan. "Low Back Pain and Sciatica Treatment | Inversion Therapy." SpineUniverse. Vertical Health, LLC, 17 Apr. 2014. Web. 17 Mar. 2015. <http://www.spineuniverse.com/conditions/back-pain/low-back-pain/turning-back-pain-sciatica-upside-down>.
[16] Wilson, Fredrick. "Osteopathic Manipulation for Back&Pelvic Pain." My.clevelandclinic.org. Cleveland Clinic, 14 Jan. 2011. Web. 18 Mar. 2015. . This is was taken from "Online Health Chat" hosted by the Cleveland Clinic where members of the general public were able to have a Q&A session with Fredrick Wilson, DO.

Wednesday, March 11, 2015

Efficient Spine Care in the United States


Back and/or neck pain are a prevalent issue in society today and it is estimated that 149 million work days are lost every year in the United States at a cost of $100-200 billion [i.e. lost wages and decreased productivity] due to low back pain alone.[1],[2], [3] The World Health Organization reports that currently the primary treatment for low back pain is analgesic medication and that the causes for its provocation are rarely addressed.[4] This ineffectual treatment protocol isn't necessarily the fault of the rendering primary care physician due to their “inadequate preparation for practice in the real world” with regards to musculoskeletal medicine.[5] In November 2014, DiGiovann, et al reported that North American medical schools have limited time devoted to musculoskeletal education and cite that only 30% to 40% of schools have required instruction in the musculoskeletal system.[6],[7],[8] This is unfathomable when the average total health expenditure per person with back and/or neck pain in the United States is 73% greater than for individuals in other countries.[9],[10] The time has come for a truly unbiased and integrative approach to the treatment of low back and neck pain a fact that has been evident within the medical community since 1999.[11]

In July 2011, Murphy et al published a commentary expressing the need for the implementation of a primary spine practitioner (PSP) to effectively triage patients experiencing spine related disorders (SRDs), conditions that include back pain, neck pain, many types of headache, radiculopathy, and other symptoms directly related to the spine. They state that the PSP “would function as the first contact for patients with SRDs, i.e. the first practitioner that a patient consults when he or she develops a spine problem and could also function as a resource for traditional PCPs (family practice physicians, general internal medicine physicians, pediatric, obstetrical/ gynecological physicians, primary care nurse practitioners or physician’s assistants) to refer patients who present with SRDs”. This implementation exhibits potential benefits to SRD patients (i.e. faster recovery, cost savings, iatrogenic[12] disability avoidance, increased productivity, decreased likelihood of becoming a chronic pain sufferer, high patient satisfaction, focus on prevention), our society ( i.e. knowledgeable care coordinator, SRDs as a public health initiative, improved worker productivity, less long term disability), and the overall healthcare system (i.e. controlling costs, unburdening traditional PCPs, more strategic specialist referrals, disruptive innovation, standardization of care, new evidence and technologies). [13]

Candidates for the role of PSP within our current system would be currently licensed healthcare providers (i.e. chiropractor, physician, physical therapist, nurse practitioner) who would receive additional training based on a spine care pathway which has already been implemented in hospital systems, accountable care organizations, patient centered medical homes,  and privately operated PCP and specialty groups.

The effectiveness of integrative care for SRDs has not only been clinically demonstrated but has been mandated by a renowned medical center’s health plan:

- A 2013 study of Washington state workers who had recently filed worker’s compensation claims due to back injury found a 41.2 percent decrease in lumbar spine surgeries when the claimant consulted a chiropractor first.[14]

- Priority Health a major health plan in Western Michigan found that when they required spine patients who were heading for a non-urgent surgical consultation to first consult a physiatrist, surgical referrals decreased 48 percent, spine surgeries decreased 25 percent, and surgical costs dropped 25.1 percent.[15]

- University of Pittsburgh Medical Center Health Plan requires that patients with chronic back pain undergo a minimum of three months of chiropractic and/or physical therapy before any spine surgery is approved.[16]

So why am I so adamant about this subject? In September 2013, Spine Care Partners in conjunction with Lifetime Health Medical Group and Excellus BlueCross BlueShield commenced the inaugural spine care pathway training which was conducted at Excellus’ corporate headquarters in Rochester, NY. Dr. Fralick and I had the honor of being part of that inaugural class and have experienced first-hand the benefits this evidence based and patient centered program exhibits. Everything the Murphy et al commentary envisioned, at least in regard to SRD patient benefits, has become a reality for the patients who have sought care in our office.

The desire for this integration on a community level 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.

So I urge all of you who are reading this to share this information with your healthcare providers and encourage them to seek out these practitioners in your community and integrate them into their treatment plans for spine related disorders.   




[1] Guo HR, Tanaka S, Halperin WE, Cameron LL. Back pain prevalence in US industry and estimates of lost workdays. Am J Public Health, 1999, 89(7):1029-1035.
[2] Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am, 2006, 88(suppl 2):21-24.
[3] Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin, 2007, 25(2):353-371
[4] Duthey, Beatrice, PhD. "Background Paper 6.24 - Low Back Pain." Priority Medicines for Europe and the World 2013 Update. Background Paper 6 - Priority Diseases and Reasons for Inclusion. BP 6.13 to 6.24 (part 2). World Health Organization, 15 Mar. 2013. Web. 11 Mar. 2015. <http://www.who.int/medicines/areas/priority_medicines/BP6_24LBP.pdf>.
[5] Association of American Medical Colleges. Medical School Objectives Project. Contemporary issues in medicine: musculoskeletal medicine education. Report VII. 2005.
[6] 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>.
[7] 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
[8] 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
[9] Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingsworth W, Sullivan SD. Expenditures and
health status among adults with back and neck problems. JAMA, 2008;299(6):656-664.
[10] Rosner, Anthony. "Going About Spine Care the Wrong Way - Spine Care "bass-ackwards."" Dynamic
Chiropractic - News, Articles, Research & Information for Chiropractors. MPA Media, 01 Jan. 2014. Web.
[12] of or relating to illness caused by medical examination or treatment.
[13] Murphy et al. The establishment of a primary spine care practitioner and its benefits to health care reform
in the United States. Chiropractic & Manual Therapies 2011, 19:17 http://chiromt.com/content/19/1/17
[14] Keeney B, Fulton-Kehoe D, Turner J. Wickizer TM, Chan KC, Franklin GM. Early predictors of spine
surgery after occupational back injury: results from a prospective study of workers in Washington
State. Spine, 2013;38(11):953-964.
[15] Fox J, Haig AJ, Todey B, Challa S.. The effect of required physiatrist consultation on surgery rates for back
pain. Spine, 2013;38(3):e178-e184.
[16] "DC Receives Federal Grant to Study Nonsurgical Alternatives to Surgery for Spinal Stenosis: Interview
With Michael Schneider, DC, PhD." Health Insights Today, March 2013.