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Chiropractic Industry Updates

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Technique Update: Chiropractic Care Reduces Opioid Prescriptions

By Dr. David Graber, Council on Technique and Clinical Excellence Chair

A new systematic review presented at the annual meeting of the American Academy of Pain Medicine revealed that* patients seeing a DC reduced the overall use of opioids. * They found that, “patients who visited a chiropractor for a musculoskeletal pain condition were 49 percent less likely to receive an opioid prescription than their counterparts who went to other healthcare providers.”

Medscape published the article titled, *Chiropractic Care Tied to Significant Reduction in Opioid Scripts*. Leading neurologists, physiatrists and other medical professionals attended the conference to learn, “Chiropractic care for musculoskeletal pain is associated with a significant reduction in opioid prescriptions compared with non-chiropractic care….”

The study covered full-scope chiropractic care, not just spinal manipulation. “Chiropractors provide many of the treatments included in the clinical guidelines for the initial treatment of low back pain, neck pain, and osteoarthritis of the hip, knee, and hand,” so they looked at 62,000 patients in six studies from all available literature on chiropractic use and opioid prescription patterns.

Some of the findings:

  • Fewer chiropractic patients received an opioid prescription.
  • Chiropractic utilization was 11.3 percent to 51.3 percent.
  • Chiropractic patients’ opioid use ranged from 12.3 percent to 57.6 percent vs. non-chiropractic opioid utilization, which ranged from 31.2 percent to 65.9 percent.

What was curious was the comment from Ann E. Hansen, MD, from the University of Washington/Boise VA Medical Center in Idaho, who stated that in regard to chiropractic care and other movement-based therapies, “there is little scientific data to support the specific applications of these modalities.” I wonder if she is ignorant of the research, or does she have willful blindness?

For more information, click here.

Rehab Update: Diaphragm Strength and Thoracic Scoliosis

By Dr. Don DeFabio, Council on Rehabilitation and Performance Chair

Scoliosis as defined must include vertebral rotation. Therefore, if scoliosis is present in the thoracic spine then rib cage rotation will also be present. The prominent “rib hump” that is commonly seen is a reflection of both rib cage rotation *and core weakness.* Greater stabilization of the rib cage can be obtained with exercises to strengthen the diaphragm with abdominal breathing.

Here are the basics for training abdominal breathing:

  1. With inspiration the abdomen pushes out circumferentially (360 degrees) with expansion of the lower ribs and *a quiet upper chest.*
  2. *Hold* for 1-2 seconds
  3. *Slowly breathe out* will a full exhalation drawing the lower ribs down and the abdomen in.
  4. *Hold* for 1-2 seconds
  5. Start with the patient supine with the knees bent, breathing in with the nose to start with a *ratio of 1:2 inhalation to exhalation*. Remember to hold for a few seconds as mentioned above.

There are many options for training abdominal breathing such as *Crocodile* or a *DNS Primal Movement* pattern which are beyond this update.

In conclusion, for your thoracic scoliosis patients, first teach them basic abdominal breathing, then teach them to do it sitting while visualizing lengthening their spine as if they had a helium balloon on their head to assist in reducing their curve, and then have them do it walking, standing or even on a vibration plate. Here is a video on Breathing Progression for more information.

Legislative Update: Access to Treatment of Opioid Addiction Eased for Medicaid Patients

By Jon Bombardieri, ANJC Government Affairs Counsel

New Jersey has continued to make small but critical changes in how it administers its Medicaid program to make it easier for low-income individuals receive effective treatment for substance use disorders.

The state Department of Human Services, which oversees Medicaid, has announced that the program’s 1.7 million patients will no longer need the approval of a doctor in their health insurance company before starting medication-assisted treatment for opiate addiction.

Click here to read more.

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