By Kara Shannon, DC, and Robert Vining, DC Effective communication is a known factor in creating a strong therapeutic relationship.1 Therapeutic relationships can facilitate patient adherence to therapy, satisfaction with care and improved outcomes; they have also been associated with reduced...
Robert Vining, DC
Sensitization (Part 2): Management Strategies
By Anna-Marie Schmidt, MM, DC, and Robert Vining, DC, DHSc 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...
Sensitization (Part 1): Characteristics and Implications
By Anna-Marie Schmidt, MM, DC, and Robert Vining, DC, DHSc 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...
Chronic Pain: Screening for Potential Psychological Factors
By Anna-Marie Schmidt MM, DC, and Robert Vining, DC, DHSc 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.1 These factors have the capacity to...
Best Practice Recommendations: Translating Evidence Into Action
By Anna-Marie Schmidt, MM, DC, and Robert Vining, DC, DHSc Research evidence suggests following guideline recommendations can improve quality of care and clinical outcomes.1–3 However, translating recommendations into clinical care for individuals can be challenging because guidelines, by nature, tend...
Social Factors: A Sometimes-overlooked Opportunity
By Anna-Marie Schmidt, MM, DC, and Robert Vining, DC, DHSc The biopsychosocial model is a widely recommended method of clinical evaluation and management.1–5 The model identifies three important areas. “Bio” refers to evaluating/treating biological problems (e.g., pathology), “psych” refers to psychological...
Developing Person-Centeredness: A Continual Process
By Anna-Marie Schmidt, MM, DC, and Robert D. Vining, DC, DHSc Person-centeredness: an approach to health care focused on the person, placing high importance on being respectful and responsive to individual preferences, needs, and values.1 Why is Person-centeredness Important? There are...
Evidence-based Diagnosis for Low Back Pain
Health professionals from different disciplines use diverse diagnostic methods to inform clinical management for patients with low back pain.1 One person may diagnose someone as suffering from sacroiliac joint pain while another might classify the same patient with a movement...
Enhancing a Biopsychosocial Approach
Part of the Evidence in Action series by Palmer College of Chiropractic The concept of caring for the whole patient is not new. As early as the 5th century BC, Hippocrates described the importance of attending to the person behind...
Interpreting “Quality” and “Strength” in a Practice Guideline
Part of the Evidence in Action series by Palmer College of Chiropractic The American College of Physicians (ACP) recently release a clinical practice guideline for noninvasive treatments for low back pain.1 The goal of this guideline is to inform care...
