Effective communication is a known factor in creating a strong therapeutic relationship. Therapeutic relationships can facilitate patient adherence to therapy, satisfaction with care and improved outcomes; they have also been associated with reduced malpractice claims. This article addresses aspects of communication which are key to building therapeutic relationships in chiropractic practic

While the majority of musculoskeletal cases respond quickly and favorably to conservative care, some conditions are less cooperative. When a patient is not meeting outcome goals, evidence-based chiropractors must be willing to abandon their familiar recipe, and “do something different.” In a value-based healthcare model, there’s a vast difference between merely treating someone vs. delivering best practices. The essential step for improving clinical outcomes is to provide the most effective care for every patient on every visit—including those cases that challenge us.

Chronic pain symptoms can be quite different from acute pain symptoms.¹ One possible reason is sensitization, a process whereby neurons become more responsive to pain signals and/or translate non-painful stimuli into pain. Part 1 of this series described general neuro-adaptive processes leading to sensitization and clinical diagnostic criteria. Here in Part 2, management strategies for persons with sensitization are described.

Practitioners use symptoms to guide clinical evaluation and treatment. For example, chest pain on exertion suggests possible need for cardiac evaluation. Pain is a symptom we are trained to explore by asking questions such as, “How severe is your pain?” and “Where is the pain located?” We ask these questions because the answers help point us in the direction of a diagnosis. However, pain symptoms are sometimes unreliable. For people experiencing chronic pain, symptom characteristics may not match patterns found in acute cases. The physiological basis for this alternate pain experience can be the result of peripheral or central sensitization. 

Our review of the top 10 blog posts on ACA Blogs in 2019 provides plenty of evidence that readers are most interested in topics that will help them better care for their patients as well as information on new developments in health care policy. Thanks to all who engaged with ACA Blogs over the past year. If you missed any of our top 10 posts of the year, here we provide a list so you can catch up! 

Postdoctoral training programs are very common in the sciences and healthcare disciplines. They typically focus on developing skills and experience in areas outside the realm of patient care, such as research, health policy, health administration and teaching, among others. Expanding the number of early-career chiropractors engaging in various postdoctoral training programs is an important underpinning for the continued development of the profession. Meet five doctors of chiropractic who have completed or are currently in one of four different, but related postdoctoral programs conducted by a Yale School of Medicine/VA Connecticut partnership

In the wake of the national opioid crisis in the United States, primary care clinics are beginning to recognize the importance of non-pharmacologic care for patients with common musculoskeletal conditions such as low back pain. Integrating chiropractic care into healthcare clinics is an important step toward offering these more holistic approaches to pain management. However, clinics in lower-income neighborhoods often face financial and other barriers to offering this type of care. ACA member Eric Roseen, DC, MSc, is embarking on a research study to find new approaches to creating patient access. 

Chronic pain symptoms and the ability to manage and cope with them can be strongly influenced by what are generally referred to as psychological factors. These factors have the capacity to substantially hinder clinical improvement, cause symptom aggravation and reduce self-management capacity. Though these concepts are well-supported in the scientific literature, they are not inherently usable. Practical methods of revealing relevant psychological factors are needed. To explore whether psychological factors are clinically relevant, clinicians can ask questions during the consultation and/or use one of several screening questionnaires.

ICSC presenter Carolina Cancelliere, DC, PhD, is a clinical epidemiologist who serves as research chair in knowledge translation for the Canadian Chiropractic Research Foundation and as a faculty member in health sciences at Ontario Tech University. She and her team are working to demonstrate how chiropractic care can be applied to help patients suffering from disabilities related to spinal disorders. At ICSC, she will participate in the session “Translating Spinal Care Research into Practice." In this ACA Blogs post, she answers questions about her upcoming presentation.

The Interprofessional Collaborative Spine Conference (ICSC) will bring together members of the chiropractic, osteopathic medicine and physical therapy professions to tackle topics related to manual therapy and its use—amid the opioid epidemic—in treating low back pain and other conditions. In his presentation, “Implementation Science/Knowledge Translation Session: Osteopathic Perspective,” Michael Seffinger, DO, a professor at the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, unpacks the sometimes conflicting and sometimes incomplete evidence using his osteopathic lens.