The ACA blog provides readers with information to help them advance their knowledge, achieve their professional goals and strive for excellence, while also creating a greater sense of community among chiropractors nationwide through online engagement and information-sharing with their colleagues.

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Choosing Wisely: It’s About Communication, Not Coverage

It’s been one year since the American Chiropractic Association released its Choosing Wisely list, which features recommendations designed to help patients start conversations with their chiropractors about appropriate care. In an era of evidence-based care and shared decision making, patients need this type of information to have meaningful discussions with their doctors that lead to better care and, ultimately, better outcomes.

Author: N. Ray Tuck
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Research Review: Manipulation and Mobilization for Treating Chronic Low Back Pain: a Systematic Review and Meta-analysis

Spinal manipulation and mobilization for the treatment of back and neck pain have been the topic of several systematic reviews, with some suggesting that the evidence in support of the view that spinal manipulative therapy is superior to other standard treatments for chronic low back pain is sparse. On the other hand, more recent systematic reviews have reported that spinal manipulation and mobilization are “viable” options for treating pain. Despite this degree of variability among studies, manipulation and mobilization are still considered to be effective treatments when compared with other therapies. The purpose of this systematic review was to unravel these differences and inconsistent findings. 

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What Does Research Reveal About Chiropractic Costs?

According to ACA Senior Scientific Advisor Christine Goertz, DC, PhD, the most common issues raised by those outside the chiropractic profession relate to the quality and consistency of chiropractic care delivery. The second most commonly asked question invariably pertains to the costs associated with chiropractic care. While there is no definitive answer and more research is needed, Dr. Goertz reveals what the evidence we have to date tells us about the costs associated with chiropractic.

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Research Review: Low-level Laser for Neck Pain vs. Randomised Placebo

When searching for low-risk, cost-effective modalities possessing the ability to aid practitioners in the treatment of non-complicated musculoskeletal complaints, research must lead the way. Often, we see the newest and the latest technology or apparatus put forth as the cure for everything we have been waiting for. Low-level laser (LLLT) has, on the surface, the appearance of the latest and greatest apparatus. But what research is out there backing up claims commonly seen with low-level laser marketing in the healthcare field?

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WHO Collaboration Presents Public Health Opportunities for Chiropractic

The World Health Organization (WHO) held its 71st Assembly May 21-26, 2018 at the United Nations headquarters in Geneva. WHO is the directing and coordinating authority on international health, and uses the annual Assembly to set norms and standards for ethical and evidence-based healthcare policy. I had the honor of attending the Assembly this year as part of the World Federation of Chiropractic (WFC) delegation. Over four days of plenary sessions, committee meetings, and technical briefings, I observed an impressive breadth and depth of operations at WHO—and a chiropractic profession that is primed for more meaningful engagement with the broader public health community.

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An Open Letter to the National Center for Complementary and Integrative Health

In her open letter to the National Center for Complementary and Integrative Healthcare, ACA Senior Scientific Advisor Christine Goertz, DC, PhD, offers suggestions to NCCIH on how to meet some of today's pressing healthcare challenges and, in particular, how complementary and integrative health care can play a role. She writes, "We desperately need a healthcare delivery system 1) that is able to consistently provide evidence-based, patient-centered care to the right individual at the right time, 2) for which the patient care trajectory for chronic conditions begins with the safest, most conservative, effective option available and, 3) that empowers patients and providers with the knowledge and tools they need to make informed decisions that are deeply rooted in disease prevention and health promotion. Much work lies ahead in identifying how CIH practices can best contribute to this effort."

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Research Review: Chiropractic Care and Sensorimotor Function Associated with Falls

Falls are a significant cause of injury, loss of quality of life, and even death in older adults and make up more than 80% of injury-related hospital admissions in individuals over 65 years of age. They are also the leading cause of death due to injury in older adults. The risk of falls increases with lower limb muscle weakness, gait deficits, balance deficits, a recent history of falling, or in individuals over 80 years of age. This study looked at the impact of usual chiropractic care on measures of sensorimotor function associated with the risk of falls in older adults over a 12-week period.
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United States Bone and Joint Initiative: Programs Designed to Advance Knowledge, Improve Care

*Member-Exclusive Content* The United States Bone and Joint Initiative (USBJI) developed in 2011 as a continuation of the work of the United States Bone and Joint Decade, which began in 2002. The American Chiropractic Association (ACA) was an original founding member of the United States Bone and Joint Decade and has held a seat on the board since the beginning. USBJI’s mission is to advocate for and promote multidisciplinary, coordinated and patient-centered care to improve the prevention, diagnosis and treatment of musculoskeletal disorders. To that end, it has launched a number of programs to advance knowledge and improve patient care. 

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Author: John Ventura
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Back Pain Treatment Is Harming Patients: The Lancet Low Back Pain Series

*Member-Exclusive Content* Low back pain (LBP) is by far the most common reason people seek care from chiropractors all over the world. The Lancet, one of the world’s leading medical journals, just published a series of three papers dealing with LBP in a global perspective. The main conclusion from the series is that worldwide easy access to, and overuse of, inappropriate tests and treatments such as imaging, opioids and surgery means patients are not receiving the right care. As a result, patients are harmed and resources are wasted. Jan Hartvigsen, DC, PhD, one of the authors of the series as well as ACA's 2017 Researcher of the Year, provides a summary for members. 

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Research Review: Spinal Manipulation vs. NSAID (Diclofenac) for Acute Low Back Pain

The purpose of this randomized, double-blinded, placebo-controlled, parallel trial was to compare high-velocity low-amplitude spinal manipulation with chemical treatment. In this case, the chemical treatment was diclofenac, a nonsteroidal anti-inflammatory. The trial also included comparison with placebo. Considering the staggering impact of low back pain, the authors of this trial felt there were too few studies comparing spinal manipulation to nonsteroidal anti-inflammatory drugs or placebo. They aimed to test patient satisfaction and function, time off from work, and rescue medication, specifically.

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