American Chiropractic Association - chronic 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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My VA Experience with Cognitive Behavioral Therapy for Chronic Pain

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.

Author: Jamie Zeman
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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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Mindfulness-Based Stress Reduction Techniques as a Treatment for Healthcare Provider Burnout

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.

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Research Review: Manipulation and Mobilization for Treating Chronic Low Back Pain: a Systematic Review and Meta-analysis

Spinal manipulation and mobilization for the treatment of back and neck pain have been the topic of several systematic reviews, with some suggesting that the evidence in support of the view that spinal manipulative therapy is superior to other standard treatments for chronic low back pain is sparse. On the other hand, more recent systematic reviews have reported that spinal manipulation and mobilization are “viable” options for treating pain. Despite this degree of variability among studies, manipulation and mobilization are still considered to be effective treatments when compared with other therapies. The purpose of this systematic review was to unravel these differences and inconsistent findings. 

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A Typical Week at the St. Louis VA Medical Center

Part of a series on the chiropractic residency program in the VA health care system

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.

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