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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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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Evidence-based Diagnosis for Low Back Pain

Health professionals from different disciplines use diverse diagnostic methods to inform clinical management for patients with low back pain. One person may diagnose someone as suffering from sacroiliac joint pain while another might classify the same patient with a movement disorder caused by poor muscle coordination. In a given circumstance, either or both individuals could be right or wrong. However, we can’t realistically discern this until we understand the underlying strength of the diagnostic tests we use.

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Collaboration for Low Back Pain Treatment in Older Adults

Part of the Evidence in Action series by Palmer College of Chiropractic

The inclusion of chiropractic practitioners into various collaborative health systems has increased over the past decade. The addition of chiropractic within these multi-disciplinary settings has been embraced by many as a way to manage spinal conditions, such as back and neck pain, using noninvasive therapies. However, taking a patient-centered approach to such integration involving various health care practitioners leads to new questions and challenges and requires novel research to optimize patient outcomes in these settings.

Author: Zac Shannon
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Research Review: Systematic Review and Meta-Analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation

Based on case reports/series and case-control studies, an association between chiropractic neck manipulation (CM) and cervical artery dissection (CAD) has been proposed. However, questions remain as to whether CM is actually a cause of CAD, or if the relationship is the result of other extraneous factors. The purpose of this study was to examine the strength of evidence about whether CM causes CAD by performing a systematic review, meta-analysis and evaluation of the body of evidence as a whole.

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Case Report: A Severe Strain/Sprain and Segmental Dysfunction of the Cervical Spine

*Member-Exclusive Content* This is a case study of a patient with severe cervical sprain/strain and segmental dysfunction following trauma of the cervical and thoracic spine with predisposing multiple levels of disc degeneration and herniation. A 46-year-old male presented himself for examination and treatment. He relayed that the weekend before he had been playing with his nephews in the swimming pool, where they were standing on his shoulders and jumping off into the pool. One of the boys slipped and fell on his head, where he reported that he heard several cracking noises and immediately felt pain in his neck. He had severe muscle spasms from the back of his head down to the middle of his shoulder blades. He could not turn his head to the left, right, nor up or down. He reported the pain worsened upon standing and eating.

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Author: James Cox
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Research Review: Clinical Practice Guideline: Chiropractic Care for Low Back Pain

It is now well known that low back pain (LBP) is the leading cause of disability worldwide and that chiropractors can play a pivotal role in the management of this condition. However, the chiropractic profession can achieve wider acceptance and improved cultural authority, particularly within integrated health care delivery systems, by embracing and integrating current scientific research into our approach to evidence-based health care. It is in this context that this Clinical Practice Guideline (CPG) was developed. The aim of this systematic review was to update and combine three previously published clinical guidelines, while answering this question: “What is the effectiveness of chiropractic care, including spinal manipulation (SMT), for nonspecific low back pain?” 

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