The biopsychosocial model is a widely recommended method of clinical evaluation and management. The model identifies three important areas. “Bio” refers to evaluating/treating biological problems (e.g., pathology), “psych” refers to psychological health, and “social” refers to a person’s relationships with others and the environment. However, some evidence suggests that practitioners, as a group, may not be addressing “social” components of health as much as they could.

The healthcare landscape in the United States is rapidly evolving. Population Spine Health Management and other contemporary practice principles are being implemented by hospital systems and physicians nationwide. Author David J. BenEliyahu, DC, who is an administrator of back pain and chiropractic programs at Mather Hospital/Northwell Health in Port Jefferson, N.Y., believes chiropractors should become versed in these contemporary practice principles and consider implementing them into their practices, which will not only improve outcomes but also enhance the progressive identity of the chiropractic profession.

Chronic pain is a complex condition influencing behaviors, thoughts and mood. With opioid issues coming to light, there has been more emphasis and research into multi-faceted, biopsychosocial models to treatment. Cognitive Behavioral Therapy (CBT) is a type of talk-therapy treatment that focuses on addressing and removing the negative impacts chronic pain has on thoughts and functions. The Office of Mental Health and Suicide Prevention (OMHSP) has implemented a national initiative to disseminate Cognitive Behavioral Therapy for Chronic Pain throughout the Veterans Health Administration to make this treatment widely available to veterans.

Approximately half of pregnant women will experience pelvic girdle pain (PGP) during their pregnancy. PGP is known to lead to pain-related restrictions on physical activity during and after childbirth, and to have a psychological impact on their perceived health, sexual life and general quality of life. The authors of this study aimed to explore the differences in demographics and clinical characteristics at mid-pregnancy and the weekly amount of days with bothersome symptoms throughout the second half of pregnancy in women sub-grouped based on the results of two valid and reliable clinical tests (P4 and ASLR) at 18 weeks of pregnancy. The authors hypothesized that sacroiliac dysfunction and failing force closure diagnosed at mid-pregnancy could be used to predict a course of bothersome symptoms throughout the second half of pregnancy.

Person-centeredness is an approach to health care focused on the person, placing high importance on things such as being respectful and responsive to individual preferences, needs and values. Practitioners who adopt this approach to care report that it can transform the doctor-patient encounter and even re-energize providers. The path to patient-centeredness, however, is not always a natural one for doctors, many of whom report that they must continually work to adopt and refine this style of patient care. Learn what you can do to begin moving toward a more patient-centered approach in your practice.

Is weightlifting safe for adolescents? No, well yes, okay maybe…in the right situations.  That is about as clear as it gets concerning the growing epidemic of adolescent injuries via weightlifting and competitive sports. There is no disputing the facts that plague childhood athletics. A September 2018 systematic review found that injuries increase in proportion to sports specialization. However, few studies have linked the detrimental effects that any single sport has on the progression of spinal degeneration—until now. 

The current opioid epidemic in the United States brings long overdue attention to nonpharmacological approaches to managing pain.  Among the recommended therapies for low back pain by the American College of Physicians, for example, are spinal manipulation, acupuncture, yoga and cognitive behavioral therapy.  While it may be clear why body-based therapies were recommended, the inclusion of a psychological approach, such as cognitive behavioral therapy, may raise some eyebrows. Researchers Margaret Chesney, PhD, and Christine Goertz, DC, PhD, explore how psychological factors play a role in the experience of chronic pain as well as what patients and their providers should know.

Lumbar spinal stenosis (LSS) is caused by age-related degenerative changes in older adults and is a leading cause of pain, disability and loss of independence. LSS is also the most common reason for spinal surgery in older adults. However, most patients are managed non-surgically, despite the fact systematic reviews of non-surgical management suggest unproven benefit for improving walking outcomes. This research review looks at a recent, randomized controlled trial designed to compare the effectiveness of a structured, comprehensive, conservative treatment program with a focus on self-management and improved walking ability to a self-directed program in improving walking ability in patients with neurogenic claudication due to LSS.

Burnout syndrome has been defined as a three-dimensional syndrome characterized by exhaustion, cynicism and inefficiency. It has also been described as the opposite to engagement, which is defined as energy, involvement and efficacy.  One aspect of inefficiency may be a sense of low personal accomplishment – an area often examined in studies on healthcare provider burnout. In her latest ACA Blogs post, VA resident Danielle Aslan, DC, explores how mindfulness-based stress reduction utilized in the VA for patients with chronic pain may also aid healthcare providers.

With up to 10% of the population suffering from carpal tunnel syndrome (CTS), it’s important to keep up with new information about this disabling condition. A significant amount of new data has been published in the past quarter about the management of CTS. This ACA Blogs post by Tim Bertelsman, DC, will equip evidence-based chiropractors with a quick summary of the 10 most significant findings.