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: Separating Facts from Fears

It has been just over a year since many in the chiropractic profession first learned that the American Chiropractic Association (ACA) joined more than 80 medical specialty society partners to participate in an initiative that is sponsored by the American Board of Internal Medicine Foundation. This initiative’s mission is to “promote conversations between clinicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” It is called the Choosing Wisely campaign1 and it has generated more spirited discussion among doctors of chiropractic than I can recall since release of the Mercy Conference Proceedings in 1993.

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Engaging the Community Through Diversity in Research

An Introduction to Diverse Needs

While a chiropractic student, I traveled with a group of medical providers to a community in Ghana to provide supplies, assist with health screens in remote villages, and work in a local hospital within a variety of departments. During my time there, I interviewed different community members employed by the hospital or by non-governmental organizations working with the hospital about their perceived health burdens and openness to chiropractic. Unexpectedly, interviewees expressed that while they practiced a Western medicine model, there was some uncertainty on how much that body of knowledge applied to them since they felt so underrepresented in the studies that contributed to that knowledge. The patients and study participants described were rarely people that came from similar geography, cultures, and lifestyles or had physical characteristics they identified with. 

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Research Review: Chiropractic Care and Risk for Acute Lumbar Disc Herniation: a Population-based Self-controlled Case Series Study

The objective of this study was to compare the associations between primary care physician and chiropractic care in relation to acute lumbar disc herniation (LDH) with early surgery. The clinical picture of LDH in the early stages (i.e. the prodromal phase), in which low back pain progresses to radicular leg pain and possible neurologic signs, is often uncertain and can be a confusing time for both patients and clinicians. Thus, making a diagnosis of LDH during the early course of symptoms is often very difficult. The study's hypothesis was that chiropractic care could only be thought to increase the risk for acute LDH if the measured association between chiropractic visits and acute LDH exceeded the association between PCP visits and acute LDH.

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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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