Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid.

This is another in what is now a long list of studies showing cost effectiveness of chiropractic care. It looked at the Missouri Medicaid system and estimated adding chiropractic care would annually save the state between $14 and $49 million dollars by providing better outcomes for reduced costs, decrease utilization of surgery, and reduced use and abuse of opioids.
Why do you think some states including Illinois do not cover chiropractic care in their Medicaid programs?
Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid.

MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players.

I ran across this study on asymptomatic elite tennis players with an average age of 17 years old. The study scanned 33 teenagers and only 5 had normal scans! The scans revealed multiple abnormalities in the rest including disc degeneration, joint arthritis, disc bulges, and stress fractures.
Partly due to studies like this and current imaging guidelines, I now order much less imaging than in the past. Unfortunately many doctors rely too heavily on imaging studies. MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players.

Back pain one of leading causes of disability

It is easy for some who have never had a severe or chronic back disorder to think it is not a serious problem, maybe because back disorders do not kill anyone...well at least not directly. The reality is that low back and neck disorders are the 2nd most common cause of disability in the developed countries after ischemic heart disease, according to the Global Burden of Disease Study published in the Lancet.
Does this surprise anyone?How Back Pain Took Over the WorldB

NSAIDs and Heart Attack Risk

A study from the Sept issue of Arthritis and Rheumatology that looked at 7,742 people with osteoarthritis found that those that took NSAID drugs (anti-inflammatory drugs such ibuprofen and aspirin) were at 41 percent increased risk for suffering heart attacks, heart failure and strokes, compared to arthritis patients who did not take NSAIDs. Although many other studies have linked NSAIDs to heart attacks, this was the first to link it to people with osteoarthritis taking NSAID's.
Do you see that this is another reason to try chiropractic or other manual treatments before resorting to drugs?NSAIDs and Heart Attack Risk

Even light activity is healthier than previously thought, new studies show

Two new studies with one from Harvard University show several surprising findings, including that light exercise has even more benefits in decreased mortality than previously thought. As a doctor board certified in rehabilitation I will be sharing these findings with my patients. I am always encouraging them to be more active even when they have very painful conditions because we now know that a little activity can go a long way!
Does this surprise anyone?Even light activity is healthier than previously thought, new studies show

New research shows marathoners have less arthritis than non-runners

Many people have heard that higher mileage running is bad for the knees and increases the chance of arthritis. There has never been any good evidenceto support that contention. A new study from the Journal of Bone and Joint Surgery showed that long term marathoners had half the incidence of knee and hip osteoarthritis as matched controls of non runners.
Does this surprise anyone?
New research shows marathoners have less arthritis than non-runners

Feeling sleep-deprived? Doctors and police officers are too, study says

A newly released study from Indiana's Ball State University says one-third of Americans get less than seven hours of sleep a night. Lack of sleep is associated with numerous mental and physical health problems.
Feeling sleep-deprived? Doctors and police officers are too, study says

JAMA Study: Opioids No Better Than Nonopioids in Improving Pain-Related Function, Intensity for Chronic Back Pain, Hip/Knee OA

Another comparison study showing no differences in long term outcomes using opioids vs non-opioid drugs for chronic back pain, hip/knee osteoarthritis.
I have seen several of these comparison studies showing no better outcomes in the opioid groups. Does this surprise anyone?JAMA Study: Opioids No Better Than Nonopioids in Improving Pain-Related Function, Intensity for Chronic Back Pain, Hip/Knee OA

Using chiropractors to reduce lower back pain

Here is a recent video interview of a professor from Logan Chiropractic College. He notes that the average age of the onset of back disorders is 32 and unfortunately the average age to begin chiropactic care is 47. He also mentions the recent study showing that in a chiropractic treatment group there was a 49% reduction in opioid use.
Using chiropractors to reduce lower back pain

Joint injections of cortisone may not be safe

The extremely common procedure of injection of cortisone into joints has until recently been considered safe if not overused. New evidence is showing that may not be true. A new study in the journal Radiology showed that 8% of patients who had injections in the hips or knees had complications that worsened the state of the joint. Recent studies show little or no benefit. The American Academy of Orthopedic Surgeons do not recommend them.
A Warning From a Doctor Who Has Done Thousands of Steroid Injections for Arthritis

High rate of disabililty after senior patients leave the hospital

We now have overwhelming evidence of the benefits of activity and I spend much time encouraging more activiity for my patients. This Kaiser Health News article references a study showing that one-third of patients age 70 and older leave the hospital more disabled than when they arrived because many times they are restricted from getting out of bed.
Can you imagine how much disability this creates?
‘Fear Of Falling’: How Hospitals Do Even More Harm By Keeping Patients In Bed

Low back pain is number 1 cause of disability worldwide

This Annals of Rheumatic Diseases six year study looked at 117 previous studies and the health and disability data from 187 countries. Overall, out of 291 conditions studied, low back pain was at the top in terms of years lost to disability. The researchers estimate that this problem will increase in the coming decades. As such, the team warns governments and health services to take the issue more seriously than they have in the past.
Do you think this is good advice?
Low back pain is number 1 cause of disability worldwide

Corticosteroid injection for plantar heel pain

t may surprise some, but I treat many non spinal conditions including plantar fasciitis, A recent review of 47 previous studies on cortisone injection for plantar fasciitis ( common cause of heel pain) found that it was no more effective than sham injection (injection of an inert solution).

Has anyone had a treatment that was successful for this condition?

Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis

Physical Therapy, Chiropractic Back Care Cut Opioid Use, Costs

A recent study in Journal of the American Medical Association Network Open concluded that adding increased chiropractic and physical therapy coverage and other non drug services to insurance plans gave better outcomes, decreased costs, and reduced opioid use.

Physical Therapy, Chiropractic Back Care Cut Opioid Use, Costs

9 Risk Factors for Developing Sciatica

I have had many patients with more severe sciatica (leg pain from a pinched nerve in the low back) tell me with a straiight face they wished someone would cut their leg off! It can be more severe than back pain because it is a form of nerve pain.
You can decrease your risk of sciatica by working on the nine factors discussed in this article.

9 Risk Factors for Developing Sciatica

The problem with MRIs for low back pain

It seems to make sense that more medical testing gives better results, yet studies have shown that imaging for low back pain does not improve one’s pain, function, or quality of life. One of the big negatives with imaging is that there is a high amount of false negatives, which are incidental findings that do not cause symptoms, and this many times leads to unneeded further testing and failed treatments including surgeries.
So it is counter-intuitive but sometimes less testing is better.
The problem with MRIs for low back pain

Depression and anxiety: Exercise eases symptoms

Good article from Mayo Clinic on how exercise can help with depression and anxiety. I am board certified in rehabilitation and continually discuss the benefits of activity and exercise with my patients. Did you know that exercise has been shown to be as effective as drug therapy for mild and moderate depression, and it can help with anxiety syndromes? Only 30 minutes 5 times per week can have significant benefits and even 10-15 minutes per day can be beneficial. It does not have to be structured....taking the stairs instead of an elevator or escalator is exercise.Depression and anxiety: Exercise eases symptoms

VA Study Finds Chiropractic Linked to Lower Opiate Usage

A recent Veteran's Administration study published in the Pain Medicine Journal found that veterans who received chiropractic treatment had a significantly lower usage of opiates after their chiropractic visits compared to non-chiropractic patients.
Opioids can sometimes be beneficial, but in some cases other treatments can be more appropriate. Do you think it would be beneficial to get veterans better access to chiropractic and other non drug treatments?

VA Study Finds Chiropractic Linked to Lower Opiate Usage

Medicare: Patient Access to Chiropractic

Medicare has always only had partial coverage for chiropractic services. Last week a bipartisan bill was been introduced in the House of Representatives named The Chiropractic Medicare Coverage Modernization Act of 2019 (H.R. 3654), and it would allow Medicare beneficiaries access to all of the chiropractic profession’s non-drug approaches to pain management.
If you think this would be beneficial for Medicare beneficiaries, please follow the link below to send a letter of support to your representative.
https://www.acatoday.org/…/Legi…/Medicare/HR3654-Take-Action

For chiropractor George Billauer, the soccer stars have aligned

Story about Dr. George Billauer who has been the team chiropractor for the US soccer team for 27 years and has also worked with professional baseball and hockey teams and professional boxers.
Do you see chiropractic care as beneficial for sports teams?
For chiropractor George Billauer, the soccer stars have aligned

Barry Marshall, from Quack to Nobel Prize

Medical breakthroughs are often discovered by doctors who were initially ridiculed by other doctors. In 1982 Dr. Barry Marshall presented at the Australian Gastroenterological Society claiming that stomach ulcers were caused by infection, and could not finish as he was laughed off stage. Research over the next 10 years proved that hypothesis to be correct and in 2005 Dr. Marshall was awarded the Nobel Prize for the discovery.
Barry Marshall, from Quack to Nobel Prize

To Combat Opioids, Missouri Medicaid Opens Access to Chiropractic

Missouri has announced that access to chiropractic services and other non-drug pain treatments will now be made available in the state's Medicaid program to help diminish the use of opioids and provide relief for those suffering from chronic pain. 
Illinois cut out coverage of chiropractic services a number of years ago. Do you think it might be a good idea to reinstate chiropractic coverage here in Illinois?To Combat Opioids, Missouri Medicaid Opens Access to Chiropractic

Price Of A Brace Brings Soccer Player To His Knees

Doctor's offices typically mark up braces and other medical equipment 3-4 times. This article from Kaiser Health News recommends checking online for prices because many times one can get the same product for up to hundreds of dollars less. 
Has anyone found that they significantly overpaid for medical equipment at a doctors office?Price Of A Brace Brings Soccer Player To His Knees