Healthspan has been described as the period of life spent in good health, free from diseases and disabilities.(1) The concept of healthspan can be confusing. For example, good health has different meanings to different people. And, because health exists in...
Robert Vining, DC, DHSc
An Evolving Understanding of Chronic Pain: Challenges and Opportunities
A Brief History Not so long ago, our understanding of pain was less complicated. Apart from pain associated with psychological disorders, there was essentially one type, presumed to be caused by injury, dysfunction or irritation of a body part. Pain...
Resources Supporting Person-Centered Care
Person-centered care is respectful of and responsive to individual patient preferences and needs, ensuring patient values guide all clinical decisions.(1) Person-centeredness principles are core elements of chiropractic care. For example, the American Chiropractic Association’s Code of Ethics includes several tenets...
Offering a Choice: A Double Benefit? Paternalism vs. Person Centered Care
Modern healthcare grew from a paternalistic model, which simply put, means providers make healthcare decisions for patients. Paternalism is based on an underlying assumption that providers are the most capable of making decisions that generate the best clinical outcomes. An...
Vertebral Artery Dissection: An Evidence Review
For several decades, high-velocity low-amplitude cervical spine manipulation has been associated with rare instances of vertebrobasilar dissection and stroke. A simplified summary posits one view pointing to case reports and media stories describing instances of stroke after cervical manipulation. The...
Unpacking a Clinical Guideline
High-quality clinical guidelines are summaries of scientific literature designed to assist practitioner and patient decisions about health and healthcare.(1) These guidelines are developed through a systematic process of reviewing and consolidating scientific evidence. Because scientific knowledge evolves over time, guidelines...
Body Language and Person-centered Care
Patient, or person-centered care, has several definitions. Two examples include: “Integrated health care services delivered in a setting and manner that is responsive to the individual and their goals, values and preferences, in a system that empowers patients and providers...
Building Therapeutic Relationships Through Communication
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...
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...
