Posted On: November 30, 2011
I recently had the opportunity to attend the 2011 Spine Research Institute of San Diego Scientific Conference put on by Dr. Arthur Croft in San Diego. As a chiropractic physician I have attended the majority of these conferences over the past decade and a half to help keep myself abreast of the current literature germane to the practice of chiropractic.
These conferences have focused on the current years literature on the topics of whiplash related disorders, mild traumatic brain injuries and chiropractic management of these conditions. It has been a joy to participate in these conferences and I have learned a lot from them over the years.
This year’s conference had some interesting literature and I am going to review a couple of the papers that I found particularly useful for my practice of both chiropractic and physical therapy.
A paper published by Senna and Machaly in Spine titled: Does Maintained Spinal Manipulation Therapy for Chronic Nonspecific Low Back Pain Result in Better Long Term Outcome, looked at chiropractic maintenance care and it’s effectiveness. The study had a control, a regular treatment group (manipulation twelve times in one month) and a group of patients that got chiropractic maintenance care (twelve manipulations over a month followed by nine months of twice monthly manipulations). All patients had chronic lower back pain lasting at least 6 months. Outcomes were done at various intervals (1,4,7 and 10 months) and included pain and disability scores. Both treatment groups outperformed the control at the one month follow up, but only the maintenance treatment group showed sustained benefit in pain and disability scores at the 10 month mark. Finally a study that shows what chiropractors have know for a long time, that maintenance care helps keep patients out of pain and improves their function. This study was long over due and calls into question the idea that maintenance care is not medically necessary, an opinion proffered by many an insurance carrier. In my opinion if it helps relieve long-term pain and disability it is necessary.
Teasell and his colleagues published a series of papers titled: A research synthesis of therapeutic interventions for whiplash associated disorder in Pain Research and Management. These authors did find some evidence to support chiropractic manipulation in both subacute and chronic whiplash injuries. The authors also found support for exercises with chronic whiplash. These authors were careful to point out that the current evidence is insufficient to determine the true effectiveness of treatment and called for more research in the area. Both of the treatments they mentioned I have employed with my patients for many years and have helped many. My hopes are that eventually the studies will come in, supporting the conservative approach to whiplash related disorders
Overall this year’s conference was a hit. Dr. Croft is to be commended for getting through a ton of literature in a timely manner. My patients will certainly benefit as a result of his hard work and my attendance.
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