Over the years, scientific evidence has been published that may improve the physician's ability to differentially diagnose various spinal pathologies but clinical diagnosis of mechanical back pain has not seen many new developments. Clinicians continue to rely on orthopedic tests and palpation skills as the primary tools to determine the origin of the pain. Based on the results of these tests, the clinician then decides if additional testing is needed and/or selects the treatments that are most appropriate for the patient's condition.   [full article]

Smoking is on the decline in the United States with about 20% of American adults reporting that they currently smoke and although it has declined in adults, it is increasing in certain groups including adolescents and females. Still, tobacco use in general remains the most preventable cause of death in the United States leading to over 400,000 deaths and billions of dollars in medical expenses. The Centers for Disease Control and Prevention (CDC) stated that it should be the goal of every health care provider to ascertain the use status of their patients and advise them to make a quit attempt.   [full article]

The chiropractic profession relies largely upon specialized manual therapy procedures (adjustment/manipulation) as a means of patient care. The methods of delivering chiropractic adjustments are not homogeneous and often require complex motor skills. These manipulative procedures involve biomechanical variables such as velocity, amplitude and the line of drive of force. Consideration of these variables is important in order to render them therapeutically safe and functionally effective. Learning these techniques in private practice or in chiropractic colleges is a process that involves significant repetition. These teaching methods have potentially damaging effects. Doctors or students learning new manipulative procedures are initially at greater risk in the skill acquisition phase, when the neuromuscular system is adapting to the new skills associated with the manipulative procedure. Epidemiological studies demonstrate that work related musculoskeletal disorders are common among health providers. Chiropractors also risk injuries of various types related to their work. Some DC's are forced to leave practice due to injury sustained in practice. Thus, an emphasis needs to be placed upon safety to ensure practice longevity.   [full article]

Evidence-based practice is a combination of the judicious use of the best external evidence, doctor's expertise and patient's wishes and desires. External evidence means retrieving and evaluating published scientific studies. The first part in finding the evidence is to formulate a searchable question that one will use when searching an appropriate database.   [full article]

Falls in older adults are becoming an increasingly important issue for the public, for health care providers, and for society in general. Each year, approximately one-third of community-dwelling adults aged 65 or older experience a fall. Falls cause two thirds of all unintentional injury deaths in older adults. Of those older adults hospitalized due to falls, 40-50% lose their independence and enter a nursing home as a result. According to a 2005 study, the direct medical costs of falls are estimated to be $6-8 billion per year. Furthermore, not only is the population of older adults growing rapidly, but fall death rates are on the rise for both men and women.   [full article]

Traction as a therapeutic intervention in the treatment of low back pain has existed for many years. Its use has progressed from simple static traction to intermittent motorized traction. A recent systematic review found only seven randomized controlled trials for intermittent motorized traction and six reported no difference between the traction groups and the control groups. The most recent incarnation of traction has been a form of intermittent motorized traction commonly referred to as spinal decompression therapy. Developers and manufacturers of the equipment and often physicians as well consider it to be a unique form of traction.   [full article]

This series of reviews of the scientific literature explores Wellness risk factors, diagnostic strategies and treatment options for a variety of conditions. Data was gathered from the MEDLINE, MANTIS and CINAHL databases with an effective date listed on each review as the "as of" date. A variety of search strategies were used such as "prevention AND condition", "diagnosis AND condition", "therapy AND condition" as well as searching the specific condition under review.   [full article]

According to the new 2006 US Preventive Services Task Force (USPSTF) guidelines clinicians should discuss the potential benefits and risks associated with aspirin therapy with patients who have an increased risk of cardio-vascular disease (CVD).   [full article]