The Evidence Based Chiropractor Blog

Hundreds of chiropractic marketing and research articles to help you grow.

Jeff Langmaid 8/18/14 Jeff Langmaid 8/18/14

Lumbar DJD: MRI or Standing Radiographs? - by The Evidence Based Chiropractor

Becker Spine recently released a great article on research which examined the differences between convention MRI and standing radiographs for Lumbar DJD. They found- "

•   Lumbar degenerative spondylolisthesis occurred in 98 percent lateral films while occurring only 78 percent of MRIs.
•   Average slip was 10 mm for lateral standing radiographs and 6.6 mm for MRI
•   There were 48 percent of the patients identified with mobile lumbar degenerative spondylolisthesis.
•   Positive predictive value of facet joint effusion for mobile lumbar degenerative spondylolisthesis increased from 52 percent for infusion greater than 1 mm to 100 percent for patients with effusions greater than 3.5 mm.
•   The findings suggest the complete workup of patients with lumbar degenerative spondylolisthesis should include standing radiographs, according to the study authors.

A separate 2005 study examining MRI for adults with low back pain shows most degenerative abnormalities were associated with low back pain and the strongest associations were noted for Modic changes and anterolisthesis. Hypointense disc signal, annular tears, high intensity zones, disc protrusions, endplate changes, zygapophyseal joint degeneration, asymmetry and foraminal stenosis were relatively common."

-The Evidence Based Chiropractor is the fastest growing chiropractic marketing group in the profession. The service, founded and run by Dr. Jeff Langmaid, is dedicated to increasing chiropractic utilization by showcasing research. Marketing to medical doctors through research is proven, cost effective, and can dramatically improve your incoming referrals. Join us. Lets grow chiropractic together.

Jeff Langmaid 8/14/14 Jeff Langmaid 8/14/14

Disc Herniations- Injections or Chiropractic Care? - by The Evidence Based Chiropractor

Research shows chiropractic care to be better than injections for disc herniation's.

Disc herniations (also known as slipped discs, disc bulges, disc extrusions, etc) are a common problem which can lead to disabling pain. Pain down the extremities (arms or legs) is called radicular pain and can stem from a disc herniation which is affecting a nerve root. Radicular pain can result in numbness, tingling, burning, or muscle cramps.

Many people who suffer from a suspected disc herniation visit their primary care physician. Usually, their primary care physician will examine the patient and refer them for a MRI. If the MRI shows a disc herniation the patient is often sent to an orthopedic specialist and injections may be recommended as a treatment option.

Last year over 9 million injections were given in the United States, which is roughly 25,000 per day.

Many patients don't know that injections are only effective about 50% of the time (per Columbia University Neurosurgery Department). Also, they have substantial risks. The Journal of Bone & Joint Surgery found that every injection increases the risk of a vertebral fracture by 21% (in the lumbar spine).

As a matter of a fact, a research article produced in 2013 compared the effectiveness of chiropractic care by spinal manipulation to nerve root injections for symptomatic disc herniation's. They concluded,

“A systematic review of the literature done the next year concluded that spinal manipulation is a very safe and cost-effective option to treat lumbar disc herniation"

and

“Both of the treatment groups had significant decreases in their NRS scores at 1 month with a 60% reduction for the Spinal Manipulative Therapy cohort and a 53% reduction for the Nerve Root Injection group.”

In this study, spinal manipulative therapy, the hallmark of chiropractic care, provided greater relief than the injections!

While many physicians are beginning to embrace the overwhelming research showing the efficacy of chiropractic care, their are still other physicians who are reluctant to provide evidence-based care. If you or someone you know is suffering from a disc herniation, it may be in your best interest to be evaluated by a chiropractic physician.

Jeff Langmaid 8/13/14 Jeff Langmaid 8/13/14

Placebo Outperforms Fibrin Sealant Treatment for Chronic Lumbar Discogenic Pain- by The Evidence Based Chiropractor

A trial was recently presented at the International Spine Invention Society Annual Meeting which looked at fibrin sealant treatment for chronic lumbar discogenic pain. Fibrin sealant treatment is going through trials to determine efficacy and safety which may affect FDA clearances.

While the study did not indicate any potential risks or safety issues, the placebo of saline was found to perform better than the fibrin sealant. For discogenic pain, often annual tears in the annulus fibrosis are present. Fibrin sealant has been investigated as a mechanism to stabilize the disc and reduce pain; although this latest research study shows that the potentially expensive procedure may not provide adequate efficacy. At 26 weeks post treatment 40.7% of the control/placebo group had 50% improvement in VAS scores compared to only 35% of the patients receiving the fibrin sealant.

Previous research has shown chiropractic care, specially flexion-distraction technique, as a viable treatment for discogenic pain due to the reduction in intradiscal pressure.

Jeff Langmaid 7/29/14 Jeff Langmaid 7/29/14

Low Back Pain: Tylenol is No Better Than Placebo - by The Evidence Based Chiropractor

A new research study from the Lancet has shown Tylenol, or more specifically the active ingredient paracetamol, to provide no added relief when compared to placebo for acute low back pain. The study is a double-blinded, randomized-controlled trial, which is one of the highest classes of research.

For many people with acute low back pain; Tylenol is one of the first recommendations from their Primary Care Physician. This study finds that we should question the universal endorsement of paracetamol. Did you know that previous research studies have found chiropractic care to be one of the most safe and effective treatment options available for acute low back pain? Often, primary care providers unfortunately rely on the status quo, which is this case would be the prescription or recommendation of paracetamol for acute low back pain. However, evidence based guidelines indicate that chiropractic care may be a superior option.

Jeff Langmaid 7/23/14 Jeff Langmaid 7/23/14

The Facts on Back Pain and Weather- by The Evidence Based Chiropractor

New research from Australia has found that acute low back pain is not linked to weather conditions. They looked at temperature, humidity, air pressure, wind direction, and precipitation as factors which may lead to an increased likelihood of the onset of back pain.

Back pain currently affects up to 70 million American everyday, and many individuals point to the weather as a reason for why their back is "acting up". While cold, rainy weather may not inspire us to get moving and exercise, it appears as though it does not directly contribute to back pain!