Anthony Delitto, PT, PhD, FAPTA, dean of the School of Health and Rehabilitation Sciences, University of Pittsburgh, will be the keynote speaker at the Interprofessional Collaborative Spine Conference (ICSC), Nov. 8-9 in Pittsburgh, Pa. In his presentation, “Non-Pharmacological Back Pain Management: Collaborative Solutions,” Dr. Delitto will discuss how, in the wake of today’s opioid crisis, there is an elevated value placed on chiropractic, physical therapy and osteopathic therapies. He will review the evidence surrounding non-pharmacological treatments and spinal manipulative therapy for back pain, and how manual therapy providers implement this kind of pain management—including how they educate patients about pain.  

The topic of clinical effectiveness for spinal manipulation and exercise is extremely timely and relevant to today’s healthcare provider. However, there is one aspect of this topic that continues to confuse both clinicians and patients: namely, how to interpret the mixed messages about the clinical effectiveness of manual therapy and exercise for management of low back and neck pain. There have been multiple systematic reviews of the spinal manipulation literature with conflicting conclusions. The same is true of the literature regarding therapeutic exercise. How then does one justify the use of these treatments?

Research evidence suggests following guideline recommendations can improve quality of care and clinical outcomes. However, translating recommendations into clinical care for individuals can be challenging because guidelines, by nature, tend to inform care on a general level. Further complicating guideline adherence is confusion caused by inconsistent terminology and the existence of multiple guidelines for single conditions, among other issues. Inconsistent recommendations within guidelines raises the question, “Is there common ground among guidelines for musculoskeletal conditions?” To answer this question,  researchers identified 11 recommendations that consistently appear within current guidelines. 

Problems involving the hip are some of the most frequently undiagnosed or misdiagnosed conditions. When a patient presents with hip pain, chiropractors immediately consider the most probable culprits—like greater throchanteric pain syndrome and osteoarthritis. But what if the diagnosis is not so straightforward? A new paper by Lee¹ identified the four top undiagnosed causes of hip pain.

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.