Chiropractic management of bilateral meralgia paresthetica: a case report.

Objective: The purpose of this report is to describe the course of chiropractic care for an adult male experiencing persistent anterolateral thigh pain due to bilateral meralgia paresthetica.

Clinical Features: A 40-year-old male U.S.

Predictors of Pain Management Strategies in Adults with Low-Back Pain: A Secondary Analysis of Amazon Mechanical Turk Survey Data.

To evaluate the associations between baseline demographics, health conditions, pain management strategies, and health-related quality-of-life (HRQoL) measures with pain management strategies at 3-month follow-up in respondents reporting current low-back pain (LBP). Cohort study of survey data collected from adults with LBP sampled from Amazon Mechanical Turk crowdsourcing panel. Demographics, health conditions, and the Patient-Reported Outcomes Measurement Information System (PROMIS)-10 were included in the baseline survey.

Multimodal Chiropractic Management of a Postsurgical Sternoclavicular Injury Utilizing Gamified Rehabilitation: A Case Report.

Objective: The purpose of this study was to describe how gamification was incorporated into postoperative rehabilitation of a patient recovering from a sternoclavicular dislocation.

Clinical Features: A 23-year-old man sought chiropractic care from an academic chiropractic clinic for persistent right-sided, sternoclavicular joint, moderate-to-severe pain that was exacerbated with shoulder movements and overhead activities. His shoulder was treated previously with reconstructive surgery and a 6-week trial of physical therapy; however, he reported minimal improvement in his pain, and his functional ability was suboptimal.

Nonoperative Management of Lateral Epicondyle Tendinopathy: An Umbrella Review.

Objective: The primary objective of this review was to summarize systematic reviews and meta-analyses reporting on nonoperative management of lateral epicondyle tendinopathy.

Methods: An umbrella review of all published systematic reviews and meta-analyses was performed. Three databases were searched using the key words "tennis elbow," "lateral epicondylitis," "non-operative," and "non-surgical modalities.

Adverse childhood experiences and trauma informed care for chiropractors: a call to awareness and action.

Background: Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.

Imaging Diagnosis and Management of Carpal Trauma and Instability-An Illustrated Guide.

Understanding the subtle signs of carpal instability and other unique injury patterns in the wrist is a critical skill for radiologists. Proper patient management and outcomes are directly dependent on the accurate interpretation of wrist imaging studies. This review will provide a detailed overview of typical imaging features of carpal trauma and instability, management, and complications, using multimodality imaging and original medical illustrations.

Identifying and addressing patient substance use: a survey of chiropractic clinicians.

Background: Chiropractors commonly encounter patients who present for spine pain with parallel substance use. There is currently no widespread training within the chiropractic profession to prepare chiropractors to recognize and address substance use in clinical practice. The purpose of this study was to examine chiropractors' confidence, self-perceptions, and interest in education associated with identifying and addressing patient substance use.

Discrepant Perceptions of Biopsychosocial and Active Care Recommendations Between Doctors of Chiropractic and Midlife and Older Adult Patients: A Descriptive Survey.

Objective: The purpose of this study was to assess perceptions about the inclusion of biopsychosocial and active care recommendations during chiropractic clinical encounters between doctors of chiropractic (DCs) and their midlife and older adult patients and to identify whether there were any discrepancies between their recollections.

Methods: This descriptive cross-sectional survey was part of a mixed-methods research project designed to gather information about the role of electronic health interventions for midlife and older adults who use chiropractic care. For this study, a convenience sample of 29 DCs and 48 chiropractic patients aged 50 years and older from 2 metropolitan areas in the United States completed online surveys between December 2020 and May 2021.

Thoracolumbar fascia mobility and chronic low back pain: Phase 1 of a pilot and feasibility study assessing repeated measures and the influence of paraspinal muscle contraction.

Background: Differential movement, or shear strain (SS), between layers of thoracolumbar fascia is reduced with chronic low back pain. To provide a foundation for clinical research involving SS, this study assessed temporal stability and the effect of paraspinal muscle contraction on SS in persons with chronic low back pain.

Methods: We used ultrasound imaging to measure SS in adults self-reporting low back pain ≥1 year.

Impact of COVID-19 pandemic on nonpharmacological pain management trials in military and veteran healthcare settings: an evaluation informed by implementation science.

The coronavirus disease (COVID-19) pandemic disrupted healthcare and clinical research, including a suite of 11 pragmatic clinical trials (PCTs), across clinics within the Department of Veterans Affairs (VA) and the Department of Defense (DOD). These PCTs were designed to evaluate an array of nonpharmacological treatments and models of care for treatment of patients with pain and co-occurring conditions. The aims of the study are to (a) describe modifications to PCTs and interventions to address the evolving pandemic and (b) describe the application of implementation science methods for evaluation of those PCT modifications.

Intervention Fidelity in Pain Pragmatic Trials for Nonpharmacologic Pain Management: Nuanced Considerations for Determining PRECIS-2 Flexibility in Delivery and Adherence.

Nonpharmacological treatments are considered first-line pain management strategies, but they remain clinically underused. For years, pain-focused pragmatic clinical trials (PCTs) have generated evidence for the enhanced use of nonpharmacological interventions in routine clinical settings to help overcome implementation barriers. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS-2) framework describes the degree of pragmatism across 9 key domains.

Presentation of a Lisfranc Injury to a Chiropractic Clinic: A Case Report.

Objective: The purpose of this report is to describe the presentation of a patient with a previously undiagnosed Lisfranc injury to a chiropractic practice.

Clinical Features: A 56-year-old woman presented to a chiropractic clinic with traumatic right midfoot pain 6 months after her injury. She previously jumped out of bed, landing with her ankle inverted and causing severe pain.

A Brief Review of Chiropractic Educational Programs and Recommendations for Celebrating Education on Chiropractic Day.

Objective: The purpose of this article is to provide an overview of the growth of chiropractic education globally and a chronological list of current training programs. Another purpose is to provide exemplars of enduring programs and offer suggestions for how chiropractic practitioners may celebrate education on Chiropractic Day, which is September 18.

Discussion: Chiropractic education has transformed considerably over the past 125 years, and there are now 52 programs globally.

Effect of lavender and rosemary aromatherapy on test anxiety in chiropractic students.

Objective: Test anxiety is a debilitating disorder that can impair cognitive performance and affect academic success. Aromatherapy is commonly used for relaxation therapy. The primary aim of the study was to determine if nasal inhaler aromatherapy, utilizing a blend of rosemary and lavender essential oils, could be a useful strategy to reduce testing anxiety in students.

Thoracolumbar fascia mobility and chronic low back pain: Phase 2 of a pilot and feasibility study including multimodal chiropractic care.

Background: Thoracolumbar fascia mobility observed with ultrasound imaging and calculated as shear strain is lower in persons with chronic low back pain. This pilot and feasibility trial assessed thoracolumbar shear strain in persons with chronic low back pain following spinal manipulation and over an 8-week course of multimodal chiropractic care.

Methods: Adults self-reporting chronic low back pain ≥ 1 year participated between September 2019 and April 2021 in a trial using ultrasound imaging to measure thoracolumbar shear strain.

In vivo measurement of intradiscal pressure changes related to thrust and non-thrust spinal manipulation in an animal model: a pilot study.

Background: The intervertebral disc is a known back pain generator and is frequently the focus of spinal manipulative therapy evaluation and treatment. The majority of our current knowledge regarding intradiscal pressure (IDP) changes related to spinal manual therapy involves cadaveric studies with their inherent limitations. Additional in vivo animal models are needed to investigate intervertebral disc physiological and molecular mechanisms related to spinal manipulation and spinal mobilization treatment for low back disorders.

Qualitative Analysis of Illness Representations and Coping Perceptions Among Older Adults With Chronic Spinal Disability: "A Thought in the Back of My Mind".

Objective: The purpose of this study was to explore older adults' illness representations, their beliefs about health, and their coping perceptions of chronic spinal disability.

Methods: This qualitative descriptive study used structured interviews that were completed during a randomized trial of non-pharmacological management of spine-related disability with chiropractic spinal manipulative therapy and exercise. Dual coders conducted a descriptive thematic analysis of 50 randomly selected transcripts supported by qualitative data management software.

Three Patterns of Spinal Manipulative Therapy for Back Pain and Their Association With Imaging Studies, Injection Procedures, and Surgery: A Cohort Study of Insurance Claims.

Objective: The purpose of this study was to evaluate the relationship between procedures and care patterns in back pain episodes by analyzing health insurance claims.

Methods: We performed a retrospective cohort study of insurance claims data from a single Fortune 500 company. The 3 care patterns we analyzed were initial spinal manipulative therapy, delayed spinal manipulative therapy, and no spinal manipulative therapy.

Guideline-concordant utilization of magnetic resonance imaging in adults receiving chiropractic manipulative therapy vs other care for radicular low back pain: a retrospective cohort study.

Background: Lumbar magnetic resonance imaging (LMRI) is often performed early in the course of care, which can be discordant with guidelines for non-serious low back pain. Our primary hypothesis was that adults receiving chiropractic spinal manipulative therapy (CSMT) for incident radicular low back pain (rLBP) would have reduced odds of early LMRI over 6-weeks' follow-up compared to those receiving other care (a range of medical care, excluding CSMT). As a secondary hypothesis, CSMT recipients were also expected to have reduced odds of LMRI over 6-months' and 1-years' follow-up.

Cauda Equina Syndrome Following Lumbar Disc Herniation at L5-S1: A Case Report.

Objective: The purpose of this article is to describe a patient presenting to a chiropractic clinic with rapidly progressing cauda equina symptoms.

Clinical Features: A 30-year-old woman presented to a chiropractic clinic with the onset of saddle distribution sensory loss and urinary retention. The patient had worsening symptoms 48 hours following evaluation at local emergency and radiology departments.

Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems.

Introduction: Pragmatic clinical trials (PCTs) can overcome implementation challenges for bringing evidence-based therapies to people living with pain and co-occurring conditions, providing actionable information for patients, providers, health systems, and policy makers. All studies, including those conducted within health systems that have a history of advancing equitable care, should make efforts to address justice and equity.

Methods: Drawing from collective experience within pragmatic pain clinical trials networks, and synthesizing relevant literature, our multidisciplinary working group examined challenges related to integrating justice and equity into pragmatic pain management research conducted in large, integrated health systems.

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a single-arm, pragmatic, pilot trial of multimodal chiropractic care for U.S. veterans with chronic low back pain.

Background: Over 25% of veterans seeking care at U.S. Veterans Health Administration facilities have chronic low back pain (LBP), with high rates of mental health comorbidities.