American Chiropractic Association - pain
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Billing for Dry Needling Services (Needle Insertion Without Injection)

Dry needling has become an accepted procedure for the management of myofascial trigger points, offering a viable option to pain medications and surgical intervention. The procedure can also be applied to specific muscle motor points, spinal segments, and other structures including ligaments, tendons and joint capsules for pain relief. In clinical practice it is often used in conjunction with other physical medicine procedures and modalities to manage pain and improve function. 

Author: Anthony Hamm
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Top 4 Most Commonly Missed Hip Diagnoses

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.

 

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Social Factors: A Sometimes-overlooked Opportunity

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.

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Article rating: 4.9

Research Review: Can Pregnancy-related Pelvic Pain Be Predicted?

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.

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Psychological, Social Factors in Chronic Pain: The Impact on Chiropractic Patients

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.

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Article rating: 5.0

Research Review: Non-surgical Treatment vs. Self-directed Care to Improve Walking in Lumbar Spinal Stenosis

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.

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Article rating: 3.5

ACA and APTA Collaborate on Dry Needling Code

Following a successful nine-year collaboration between the American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA), a new CPT® code for dry needling will likely be available to providers sometime in late 2019, paving the way potentially for proper coverage, national standards and a greater understanding of how this relatively new modality helps patients in pain.

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Article rating: 4.0

House-Senate Opioid Bill Contains Provisions Related to Chiropractic

The president is expected to sign the massive legislation.

As the second session of the 115th Congress nears the election, members of the House of Representatives and the Senate recently agreed on a comprehensive legislative package to help end the scourge of opioid addiction.  The opioid issue, which federal and local legislatures across the country have been grappling with for several years, will soon see more federal dollars being focused on ways to help alleviate the destructive force associated with the addiction. 

Author: Jack Dusik
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Research Review: Low-level Laser for Neck Pain vs. Randomised Placebo

When searching for low-risk, cost-effective modalities possessing the ability to aid practitioners in the treatment of non-complicated musculoskeletal complaints, research must lead the way. Often, we see the newest and the latest technology or apparatus put forth as the cure for everything we have been waiting for. Low-level laser (LLLT) has, on the surface, the appearance of the latest and greatest apparatus. But what research is out there backing up claims commonly seen with low-level laser marketing in the healthcare field?

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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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