Clinical guidelines for adults with acute, subacute, and chronic low back pain support conservative management with spinal manipulative therapy (SMT). Research shows SMT is comparable to other noninvasive treatments in reducing low back pain and disability with relatively low risk for adverse events. However, the mechanisms leading to pain relief from SMT are poorly understood. Identifying therapeutic mechanisms of SMT can inform treatment strategies and lead to more effective care. 

Back pain remains a persistent and debilitating problem for many people in the United States and around the world. News that the opioid crisis in America has been fueled in part by the overprescribing of pain medications for low back pain amplifies the need for the chiropractic profession to continue spreading its message about the value of a conservative approach to back pain treatment. To this end, National Chiropractic Health Month (NCHM) goes “Back to Basics” this year by focusing on overall health and injury prevention as key strategies in maintaining spinal health throughout a lifetime—and highlighting the growing body of research supporting a conservative approach to back pain treatment.

It’s pretty difficult to open up a newspaper these days without seeing an article on the devastating public health impact of the opioid epidemic in the United States. While there appears to be general agreement on the scope of the problem, there is less consensus regarding what can be done to solve it. Policy-makers and professional associations taking on this challenge have tended to focus on mortality statistics and/or expert opinion. These are obviously critically important pieces of the puzzle but it is also important to take a patient-centered approach. To facilitate discussion on this important topic, Gallup held a research release event on Sept. 12 in Washington, D.C., titled “Addressing the Opioid Epidemic With Drug-Free Pain Management.”

I’ve had more than a handful of family and friends ask me, “What’s it like working for the VA in St Louis?” and my response is always the same—“It’s great!”  I usually then proceed to give them a rundown of what a typical week looks like as my activities vary from day to day and sometimes from month to month.  An average week is broken down into four different segments: outpatient clinic, interdisciplinary pain rehabilitation (IPR) program, scholarly activities, and clinical rotations. The majority of my time is spent in clinic helping veterans manage their pain and develop healthy habits for self-care. However, the time spent outside the clinic has also been beneficial for personal development and education.