An abstract REPORTS HERE that “mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives.” Research was conducted “to determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.”

The research’s “primary outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52 weeks after randomization. Secondary measures were self-reported disability, global improvement, medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental health scales), and adverse events. Blinded evaluation of neck motion was performed at 4 and 12 weeks.”

The research found that “for pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks, and HEA was superior to medication at 26 weeks. No important differences in pain were found between SMT and HEA at any time point. Results for most of the secondary outcomes were similar to those of the primary outcome.”

The study concludes that “for participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term. However, a few instructional sessions of HEA resulted in similar outcomes at most time points.”

The New York Times REPORTS HERE that “seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication …. the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.”

“One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day.”

“After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.”

“A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.”

Visit us at All Injury Rehab for more information and to set up an appointment.

We all understand the importance of trying to maintain a healthy balance in our lives. The holidays, however, can put our best stress-busters to the test. Make sure to keep your holidays happy and healthy by following our ’10 Tips for a Stress-Free Holiday Season’!

1. Remember the Good-Ol’ Days – Use this time to reminisce about what you enjoyed during previous holidays and focus your attention on capturing the joy of holidays past.

2. Plan for Pleasure – Start with the date of your special event and work backwards through the calendar to organize your days and ensure every item receives attention.

3. Let Others Help – When making your list, check it twice for activities and items you can delegate to someone else. If they’re too busy and you don’t have enough time to complete it, consider dropping the action-item altogether.

4. Set a Budget – Just be sure to stick to it! Otherwise you will have defeated the purpose of creating the budget in the first place and can leave yourself open to feeling disappointed in your efforts.

5. Let Go of Perfection – Be realistic in the expectations of yourself and others. Only Norman Rockwell can fully capture the essence of his holiday season. Find enjoyment in the unique aspects of your family and friends.

6. Be True to You – You are in charge of your happiness. Only you can decide what you will and will not tolerate. Just like with the budget, set your boundaries and stick to them.

7. Treat Yourself Well – Try to schedule at least 12 minutes a day to be nice to you. Use this time to recharge and relax.

8. Reach Out – Holidays can be emotionally charged. Seek support from others who aren’t emotionally invested in your family dynamic. Phone a friend whom you know is ‘pro-you’ and talk to them. You’ll feel recharged again!

9. Reach Out Further – Volunteering at a local homeless shelter, or picking presents for a family in need are just a couple of ways to give so that it brings joy, not obligation. Tending to those less fortunate than you can also help you appreciate what you have a little more.

10. Maintain Your Momentum – ‘Throwing in the towel’ before the turkey is even in the oven can weigh you down. You can easily maximize your merriment by sticking to your year-round exercise and healthy-eating program.

This list of tips is just a sampling of suggestions to help keep your holiday season as stress-free as possible. ‘Tis the season to find pleasure and make memories. Choose what works for you and rejoice in the smallest of progress made.

The new year only offers opportunity. It’s our attitude and our actions that bring to fruition that which manifests as results.

From our Rehab family to yours, Merry Christmas and Happy New Year!!!!

Dynamic Chiropractic – November 20, 2005, Vol. 23, Issue 24

Spondylolisthesis and Chiropractic Care
By Kim Christensen, DC, DACRB, CCSP, CSCS

Although much has been written in the health care literature regarding spondylolisthesis, the clinical decisions required for management remain challenging. This condition, which affects adolescent athletes, adults, and the geriatric population, is not necessarily associated with a pars defect and has a wide range of treatment options – from bracing to spinal manipulation to fusion surgery. So, what is the best and most effective treatment for chiropractic patients with a spondylolisthesis? How can we go beyond symptomatic care to provide long-term support for the spine with spondylolisthesis?

What, Where, Why

Traditionally, spondylolisthesis is defined as an anterior displacement of a vertebral body in relation to the segment immediately below.1 There are several types of spondylolistheses, with the most common being spondylolysis of the pars interarticularis, occurring in the young, and degenerative, which occurs in older patients.2 The vast majority of spondylolistheses are found in the lower lumbar region, with rare occurrences in other spinal regions.

We now understand that most spondylolistheses seen before the age of 50 are due to a break in the pars that occurred during childhood or adolescence (often during athletic activities requiring lumbar extension). When seen after the age of 50, a degenerative cause becomes more likely.

Categorical Classification

Classifying spondylolisthesis from a clinical viewpoint is very helpful. One system describes four classical presentations: recent spondylolytic spondylolisthesis (RSS); pre-existing spondylolytic spondylolisthesis – stable (PSS-S); pre-existing spondylolytic spondylolisthesis – unstable (PSS-U); and degenerative spondylolisthesis (DS).3 By placing each patient in one of these four categories, clinical decision-making is simplified and effective treatment can be provided. Another useful approach is the use of an algorithm to assist in determining imaging and treatment options.4

Response to Chiropractic Care

The primarily young athletes who comprise the RSS group have an active stress fracture of the pars, and benefit most from avoidance of hyperextension. Activity restrictions and use of a rigid lumbosacral brace often will produce a successful outcome.5 The most common type of spondylolisthesis seen in chiropractic offices is the stable pre-existing type (PSS-S).

Response to chiropractic care is often excellent. Studies have shown that when a spondylolisthesis is found in an adult, specific side-posture manipulations to the dysfunctional joints are quite effective, and that the prognosis is not significantly different from other patients.6 These researchers reported that the spinal segments most commonly needing adjustment were the ones above or below the spondylolisthetic segment, as well as the sacroiliac joints. Flexion-distraction also has been found to be a successful treatment method, as long as the patient does not demonstrate instability (PSS-U); in unstable patients, the treatment provided little benefit.7

Improving Stability and Control

An important approach to the treatment of patients with spondylolisthesis is to strengthen and re-coordinate the deep support muscles of the lumbar spine. An attempt is made to improve the dynamic stability and segmental control of the spine. These muscles include the multifidus muscles and the internal oblique and transverses abdominus muscles.8 Exercises to train the co-contraction patterns of these muscles often are called “spinal stabilization” exercises. Specific maneuvers include: posterior pelvic tilt; lower abdominal hollowing; and abdominal bracing.

The exercises are started non-weight-bearing while lying supine and/or prone, and then progress to quadruped (on all fours) if the position does not worsen symptoms, and finally to upright sitting and standing positions. They are described as low-resistance, isometric exercises whose focus is on precision of performance and re-learning of function. A 10-week program of supervised exercise sessions designed to progressively incorporate these postures into daily activities was found to reduce back pain and disability levels significantly over more than two years in subjects with spondylolisthesis.9

Postural Correction

Many patients with spondylolisthesis develop postural asymmetries over time. One important factor in treatment is the correction of any loss of the normal upright alignment of the pelvis and spine. While there is no standard “spondylo posture,” it is not unusual to see a change in pelvic alignment (often a forward-flexed pelvis) or in lumbar spinal curve. The lumbar changes can be either a hyperlordosis or (in some cases) a lack of normal lumbar lordosis. Patients will need to be shown corrective exercises specific for the postural imbalances they have developed.

Maintenance and Support

Patients with spondylolisthesis should be taught to perform a general fitness exercise program for the lumbar support muscles on a once-a-week basis. A general and usual recommendation for maintenance exercising is a series of exercises using heavy-duty elastic tubing. These isotonic resistance exercises, performed in an upright (seated) position, will activate all of the stabilizing and major mobility muscles of the lumbar spine.

Another important consideration for long-term support of the spondylolisthetic spine is the use of custom-made orthotics. Since many of these patients have low or absent arches in their feet, the additional support from a pair of custom-made orthotics frequently is necessary. In fact, lower-extremity misalignments such as leg-length discrepancies and pronation problems are often are associated with chronic pelvic and low back symptoms.10

References

Yochum TR, Rowe LJ, eds. Essentials of Skeletal Radiology, 2nd ed. Baltimore: Williams & Wilkins; 1996:327.
Souza TA. Differential Diagnosis for the Chiropractor. Gaithersburg, MD: Aspen Pubs; 1997:132.
Hyland JK. Clinical classification of spondylolisthesis. J Am Chiro Assoc 1993;30(8):67-71.
Yochum TR et al. Natural history of spondylolysis and spondylolisthesis. In: Yochum TR, Rowe LJ, eds. Essentials of Skeletal Radiology, 2nd ed. Baltimore: Williams & Wilkins; 1996:365-367.
Blanda J, Bethem D, Moats W, Lew M. Defects of pars interarticularis in athletes: a protocol for nonoperative treatment. J Spinal Disorders 1993;5:406-411.
Mierau D, Cassidy JD, McGregor M, Kirkaldy-Willis WH. A comparison of the effectiveness of spinal manipulative therapy for low back patients with and without spondylolisthesis. J Manip Physiol Therap 1987;10:49-55.
Cox JM. Chiropractic adjustment results correlated with spondylolisthesis instability. J Man Med 1991;6:67-72.
Richardson C, Jull G. Muscle control-pain control. What exercises would you prescribe? Man Therapy 1995;1:2-10.
O’Sullivan PB, Twomey LT, Allison GT. Evaluation of specific stabilizing exercises in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 1997;2:2959-2967.
Rothbart BA, Estabrook L. Excessive pronation: a major biomechanical determinant in the development of chondromalacia and pelvic lists. J Manip Physiol Therap 1988;11:373-379.
Kim Christensen, DC, DACRB, CCSP, CSCS
Director, Chiropractic Rehabilitation and Wellness Program
PeaceHealth Hospital
Longview, Washington
kchristensen@peacehealth.org

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Click here for more information about Kim Christensen, DC, DACRB, CCSP, CSCS.

When Work Causes Back Pain

We’re all subject to back problems ­ it’s one of the drawbacks (no pun intended) of walking upright on two legs. Couple that with life’s variety of daily stresses, and it’s all but guaranteed that most people eventually suffer from back pain.

No matter what your occupation is, no doubt it¹s a source of daily or near-daily stress. Work-related factors have long been implicated as potential contributors to back pain, a hypothesis supported by recent research in the journal Spine. Four hundred and eighty-four men and women participated in a 24-year study to determine specific occupational factors related to low back pain (LBP). The study also evaluated whether interactions between psychosocial and physical factors, and between work-related and leisure-related factors, affected LBP. Results showed that:

€ Heavy physical workload and sedentary work (i.e., jobs involving prolonged sitting or limited movement) increased the risk of LBP among men and women.

€ Among women, smoking and the combination of “whole-body vibrations” (a phrase used by researchers to designate jobs involving driving, operating machinery, etc.) and low influence over work conditions increased risk of LBP.

€ Among men, high perceived load outside work (i.e., exercising, household responsibilities and/or repair, etc.) and the combination of poor social relations and overtime increased risk of LBP.

What can you do about back pain? First, be aware of “red flags” ­ factors at work and at home that may increase your risk. Second, schedule regular chiropractic appointments. Your doctor of chiropractic can evaluate any current back pain you might be experiencing and help prevent future back pain from occurring.

Reference:

Thorbjornsson CB, Alfredsson L, Fredriksson K, et al. Physical and psychosocial factors related to low back pain during a 24-year period. Spine, Feb. 1, 2000: Vol. 25, No. 3, pp369-75.

Asking the DoD for a Level Playing Field

While access to chiropractic services within the Department of Defense and Department of Veterans Affairs is by no means inclusive, which explains current legislative efforts to expand access to chiropractic care at both military and veterans health care facilities (H.R. 409 and H.R. 329, respectively), the casual observer might be inclined to believe DCs are treated equally in either system. Not so, according to a letter signed by 15 members of the House of Representatives Committee on Armed Services. The letter, sent to Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, suggests distinct disparities exist, with doctors of chiropractic employed by the DoD getting the short end of the bargain. According to the letter:

“We are informed that pay and job classification disparities have resulted in doctors of chiropractic being compensated at much lower pay scale rates than health care providers with comparable, or even lesser, training, skill sets and health care responsibilities for patients within the military treatment facilities. We also understand that certain institutional biases among certain health care provider officials against doctors of chiropractic have resulted in more difficult access to the active-duty military patient population and  unnecessary restrictions placed upon such doctors of chiropractic in performing their services for the military.”

The letter states that such disparities/biases do not appear to be occurring within the Department of Veteran Affairs (DVA) health care program (according to the letter, DCs within the DVA are Title 38 employees, have an assigned salary grade, a professional standards board and a DC director of the chiropractic program, among other standards and procedures) and urges the DoD “to carefully examine the existing system at the [DVA] for integrating chiropractic into the health programs for veterans and adopt pay, job classification and coordination systems comparable to those under
VHA Directive 2009-059 within DoD’s chiropractic health care program for our active-duty military personnel.”

Two other requests by Committee on Armed Services members who signed the letter: that the DoD consider “having a Doctor of Chiropractic as the chiropractic service leader for each branch of the military, as is done with every other specialty in military medicine.” and that the department “look into any instances of supervision of doctors of chiropractic .. to ensure that there are no instances of bias against such doctors of chiropractic in providing full access to chiropractic care at the military treatment facilities.” The American Chiropractic Association and Association of Chiropractic Colleges both supported the committee’s letter and commented on its significance in an ACA press release:

“I would like to thank congressmen Mike Rogers and Dave Loebsack for spearheading this effort,” said ACA President Dr. Rick McMichael. “The benefit provided by doctors of chiropractic to our brave men and women in uniform is integral to their recovery from injuries and their overall health and well-being. Impeding DCs from providing this care is a disservice to our troops.” “The Association of Chiropractic Colleges applauds this expression of support by members of the House Armed Services Committee for continuing the full integration of the services provided by doctors of chiropractic into the DoD,” said ACC President Dr. Richard Brassard. “We are optimistic that this strong letter will spur positive change.”

In addition to Reps. Rogers (R-AL) and Loebsack (D-IA), other letter signees included Reps. Todd Aiken (R-Mo.), Robert E. Andrews (D-N.J.), Roscoe G. Bartlett (R-Md.), Madeleine Z. Bordallo (D-Guam), Hank Johnson (D-Ga.), Walter B. Jones (R-N.C.), Larry Kissell (D-N.C.), Frank A. LoBiondo (R-N.J.), Silvestre Reyes (D-Texas), Tim Ryan (D-Ohio), Jon Runyan (R-N.J.), Bobby Schilling (R-Ill.) and Niki Tsongas (D-Mass.).

H.R. 409, the Chiropractic Health Parity for Military Beneficiaries Act (introduced by Rep. Rogers), would require that the Secretary of Defense develop a plan to expand the chiropractic benefit within the DoD to apply to any beneficiary covered under TRICARE, rather than only active-duty service members. H.R. 329, the Chiropractic Care to All Veterans Act [introduced by Rep. Robert Filner (D-Calif.)], would require that the VA staff a chiropractic physician at all major VA medical facilities no later than 2014. Both pieces of legislation are currently in congressional subcommitee; for the latest on either bill, visit www.govtrack.us.

Visit us at All Injury Rehab for more information and to set up an appointment.

Back pain can arise from a variety of conditions. The chief among them are:

• Pinched Nerves
• Slipped Discs
• Ruptured Discs
• Scoliosis
• Arthritis
• Muscle Pain

A chiropractor can pinpoint the cause of the back pain. He or she can make the necessary spinal adjustments to relieve the problem. In some cases, a chiropractor will recommend that you seek medical attention for your situation.

The 1994 Federal Agency for Health Policy and Research (AHCPR) guidelines for low-back pain concluded that spinal manipulation, chiropractic’s primary treatment technique, is one of only three treatments whose effectiveness is substantiated by rigorous research.

According to a 1992 RAND Corp. study, patients see a chiropractor primarily for low back pain and neck pain. Because back pain is so pervasive in our society, a recent study published in the British Medical Journal pointing out that back pain doesn’t go away that easily confirmed what chiropractors have always known. Only 25 percent of low back pain sufferers had fully recovered 12 months after their first visit to a general practitioner, the study said. This low number is in conflict with the commonly-held notion that low back pain episodes go away by themselves after a month. Doctors of chiropractic have long understood the cyclic nature of low back pain.

In 1999, Blue Cross/Blue Shield of Kansas in August 1999, presented a study aimed at determining the cost and effectiveness of treating back pain with chiropractic compared with other techniques. The results showed that 38 percent of the patients chose to seek chiropractic care rather than medical care. The results showed that chiropractic was more cost-effective than anesthesiology; neurosurgery; neurology; registered physical therapy; orthopedic reconstructive surgery; physical medicine and rehabilitation; and rheumatology. The study also showed that most of the chiropractic expenses 89%, were related directly to patient care, while only 45 percent of the medical costs were related to treatment of the condition with remainder of the costs being for diagnostic procedures. The study had excluded any costs for hospitalization, surgery, or any fees paid to orthopedists or neurosurgeons for costs associated with surgery. Without these additional costs being included in the study, the costs related to medical care were reported much lower than they actually were, and the savings from chiropractic care was actually much larger.

Chiropractors points out this study as vindication of their long-held view, “Patients suffering from back problems are in much better, and cost effective hands with chiropractic care.”

Satisfied Customers
A research journal, the “Journal of Manipulative and Physiological Therapeutics” published a study that showed high levels of patient satisfaction for those who went to chiropractors with what was classified as severe to moderate pain in either the back or neck. A total of 369 patients were sampled who had gone to chiropractors with these problems. These individuals were asked to complete surveys tracking all kinds of information from the type and severity of their problem to their level of satisfaction with care.

The results showed a very positive response from the study group in both the results they felt and their overall level of satisfaction with their care. The results of the published study summed it up best; “Based on the results of this survey, it seems that patients suffering from back and or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments. Moreover, the patients surveyed demonstrated a high degree of satisfaction with the care they received. Numerous other studies have demonstrated that chiropractic is as effective, if not more effective than conventional medical management of such complaints.”

Preventing Low-Back Pain

• Exercise regularly
• Keep objects close to the body when lifting them.
• Place a pillow or rolled-up towel behind the small of the back when driving long distances.
• Put work tables at a comfortable height.
• Use a chair with good lower-back support.
• Wear comfortable, low-heeled shoes.
• Wear a lumbar corset if you lift things frequently at work.
• When you sit for a long time, rest your feet on a low stool.

Visit us at All Injury Rehab for more information and to set up an appointment.

High-Risk Moments for Your Low Back
How to Avoid Injury and Pain
By Marc Heller, DC

What are the high-risk times and events for your lower back? Why can you get into more trouble doing something as simple as picking up a loaf of bread from the trunk of the car, rather than doing something more challenging? What simple steps can you take to avoid injury and pain? Let’s get the answers to these questions and more.
Two Critical Moments

When it comes to your lower back and injury risk, there are two critical times when you need to be especially careful. One is first thing in the morning. Your back is actually swollen at that time. You are substantially taller, and the discs have extra fluid in them. A careless forward bend or twist first thing in the morning can do substantial damage to your discs or other back structures. It doesn’t seem fair that such a simple thing, bending and twisting, something you have done thousands of times before, can suddenly cause big problems.

The other critical time is after you have been sitting. Long car drives or airplane trips are especially challenging. In this case, the culprit is something called “creep.” This means that your ligaments and tendons lengthen into the position that you have been in. Think of sitting as a bent-forward position, as your legs are forward. The ligaments and tendons do not provide protection properly when they have been lengthened by creep. When you first get up from sitting, you are at risk. The longer you have been sitting, the higher the risk. If you sit more upright, with good lumbar support, you will have somewhat less risk.

Here are some common events that can contribute to lower back pain. Keep in mind that in all of these scenarios, your back was already vulnerable.

Scenario #1: You didn’t sleep well last night, perhaps from sleeping in an unfamiliar bed after travel, after sitting too long. You get up, feel stiff, but ignore it. You sit down in a soft chair to enjoy your morning hot drink. You get up and get a sudden sharp stab in the back.

Scenario #2: You get up from sleeping, and sit at your laptop, and get entranced by a video or article. You end up sitting far longer than you planned. You get up, and can’t completely straighten up.

Scenario #3: You get up from sleeping, drink your morning coffee, which wakes up your gut, and you go to bathroom to empty your bowel. You are a bit constipated, and have to strain. When you get up from the toilet, your back spasms.

Overnight sleeping, even a good sleep on your favorite bed, leaves your back somewhat swollen. Swollen may be an exaggeration, but the reality is that there is extra fluid in all of your joints.

If you have a good back, none of this matters. If you have a vulnerable back, it all matters. Ideally, when you get up, you should do some kind of activity that warms up and “wrings out” the excessive fluids. A short walk, some simple movements, can make a real difference. Sitting down at the computer, sitting on the toilet, etc., can get you in trouble.

So, who has a good back versus a bad back? Unfortunately, most of us have bad backs, at least in the sense that they can be subject to injury and pain at any time. In fact, studies suggest that as many as eight in 10 people experience low back pain during their lifetime. That’s a lot of back pain already happening or waiting to happen. And as you can tell from the above discussion, some of the scenarios whereby people experience back pain are all too common.

How to Avoid Injury and Pain

Don’t bend over immediately after sitting. Sitting, even in good posture, puts you at risk. The longer you sit and the worse the seat, the more at risk you are. Airlines are very risky; it’s hard to get up and move around because of the tight quarters, and the minute the plane stops, you bend over and get stuff from under the seat, or reach up, and twist and lift to get your bag from the overhead compartment. After a long sit, give yourself at least a few seconds of backward bending and/or moving around to reset your spine. Then you can carefully, using your hips rather than your back, bend over to pick up something.

When you sit, don’t slump. Slumping reinforces the risks, makes it more likely for something bad to happen to your discs or joints or muscles. So, sit up straight, and keep your back in neutral. Neutral means that you keep a bit of a lordosis in your lower back, keep the lumbar spine from slumping forward, stay more upright. This simple action can make a huge difference. Like any habit, this will require you to “Just Do It” for a few weeks.

Talk to your doctor about these and other high-risk moments for your lower back and what you can do to relieve low back pain or avoid the pain altogether. And make sure to review “Self-Care for Back Pain” in the May 2010 issue, which provides information on exercises your doctor may prescribe if you are experiencing back pain.

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Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore. He is a nationally recognized expert in treating tailbone, sacroiliac and lower back pain.

Page printed from:
http://www.toyourhealth.com/mpacms/tyh/article.php?id=1306&no_paginate=true&no_b=true

Visit us at All Injury Rehab for more information and to set up an appointment.

Texas Journal of Chiropractic
Texas Chiropractic Association
US House Passes Expanding Chiropractic to ALL Major VA Medical Centers
Published 05/25/2010 – 11:34 a.m. CDT

The American Chiropractic Association reports on May 25, 2010, and FOUND HERE at Chiroeco.com that “the U.S. House of Representatives passed H.R. 1017, the “Chiropractic Care Available to All Veterans Act,” putting America’s veterans one step closer to gaining access to chiropractic care at all major Department of Veterans Affairs (VA) medical centers. The bill was approved 365:6.”

“H.R. 1017 requires the VA to have doctors of chiropractic on staff at no fewer than 75 major VA medical centers before the end of 2011 and for all major VA medical centers to have a doctor of chiropractic on staff before the end of 2013. There are nearly 160 VA treatment facilities nationwide. Currently, the VA provides chiropractic care at 32 treatment facilities across the country.”

“The bill comes after a recent VA report, “Analysis of VA Health Care Utilization Among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans,” from February 2010, which cites “diseases of Musculoskeletal System/Connective System,” such as back pain, as the number one ailment of Iraq and Afghanistan veterans accessing VA treatment.”

“The American Chiropractic Association (ACA) believes inclusion of chiropractic care in the VA healthcare system would speed the recovery of many of the veterans returning from current operations in Iraq and Afghanistan. Chiropractic care has been proven to be a cost-effective and beneficial treatment option. In fact, a 2010 study published in Clinical Rehabilitation found that spinal manipulation provided better short and long-term functional improvement and more pain relief in follow-up assessments than other physiotherapy interventions. Furthermore, a 2003 study published in the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications.”

“House VA Committee Chairman Bob Filner (D-CA), a strong supporter of extending chiropractic care benefits to military retirees and active-duty personnel, introduced the legislation. Over the years, Rep. Filner has worked closely with ACA in securing support for a number of pro-chiropractic measures. Rep. Michael Michaud (D-ME), Ranking Member Steve Buyer (R-IN) and Rep. Jerry Moran (R-KS) also deserve recognition for their support of this legislation.”

“Prior to congressional intervention over the past decade, no doctors of chiropractic served on the staff of any VA treatment facility. The availability of chiropractic care for eligible veterans was limited to VA “referrals” to doctors of chiropractic serving in private practice outside of the VA system. Such referrals were so rare that chiropractic care was essentially non-existent within the VA system.”

“I am especially proud that the member institutions that comprise the Association of Chiropractic Colleges will play a pivotal role in preparing the next generation of doctors of chiropractic to serve our military veterans throughout the United States and overseas,” said Frank J. Nicchi, DC, MS, President of the Association of Chiropractic Colleges. “This legislation will assist in making that possible.”

“In the U.S. Senate, a companion bill (S1204) has been introduced by Sen. Patty Murray (D-WA), who is a member of the Senate VA Committee. This legislation would also expand access to chiropractic care within the VA system.”

AirForceTimes.com REPORTS HERE that “the Senate passed a bill earlier this year to require chiropractic treatment at a minimum of 42 locations, an increase from the current 36, but legislation passed by the House on Monday by voice vote requires every Veterans Affairs Department medical center to provide the care. This big difference between the two bills will have to be worked out later this year, probably as part of a package of veterans health care legislation.”

“Rep. Bob Filner, D-Calif., the House Veterans’ Affairs Committee chairman and chief sponsor of the House bill, said chiropractic care could be important to today’s service members, who may carry up to 55 pounds of combat equipment and armor. ‘Consistently supporting such a heavy load places a serious strain on the backs and joints of our service members, causing musculoskeletal injuries,’ Filner said.”

“‘Musculoskeletal disorders “are the single most common ailment facing returning veterans,’ he said. ‘Among veterans of Operation Enduring Freedom and Operation Iraqi Freedom who have received treatment from VA, over 52 percent have been diagnosed with such a disorder; however, VA is not presently equipped to serve this clear need.’”

“Rep. Steve Buyer of Indiana, ranking Republican on the veterans committee, said he is a big supporter of the proposal and wants to ensure that care is available through contracts for veterans who do not live near VA medical centers.”

“The Congressional Budget Office estimates each additional chiropractor would cost an average of $115,000 a year.”

Visit us at All Injury Rehab for more information and to set up an appointment.