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Lower-Back Pain

Research Brief

Chiropractors in the United States Rarely Perform Spinal Manipulation for Chronic Lower Back or Neck Pain When It Is Inappropriate

Across a sample of patients seen by chiropractors, spinal manipulation was rated by experts as appropriate for most patients with chronic lower back pain and as equivocal (uncertain) for most patients with chronic neck pain.

Mar 12, 2021
Journal Article

Update of Markov Model on the Cost-effectiveness of Nonpharmacologic Interventions for Chronic Low Back Pain Compared to Usual Care

Markov modeling facilitates comparisons across interventions for lower back pain not directly compared in trials.

Dec 16, 2020
Journal Article

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part 5: Selection, Protection, and Abstraction

Of the records abstracted, many revealed incomplete provider documentation regarding the details of and rationale for care. Better documentation and more standardized record keeping would facilitate future research using patient records.

Jun 11, 2020
Journal Article

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part 4: Putting Practice Back Into Evidence-based Practice by Recruiting Clinics and Patients

This study found that clinics can be successfully recruited for practice-based studies, and patients can be recruited using iPads. Obtaining patient records presents considerable challenges, and clinics varied in whether they had electronic files, nonelectronic records, or a mixture.

Jun 10, 2020
Journal Article

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part 3: Designing Instruments With Patient Input

This article documents the challenges and the efforts involved in designing data collection tools to facilitate the inclusion of patient data into appropriateness decisions.

Jun 10, 2020
Journal Article

Coping and Management Techniques Used by Chronic Low Back Pain Patients Receiving Treatment From Chiropractors

Persons with chronic back pain were proactive in their coping strategies and frequently used self-care coping strategies like those provided by chiropractors in patient education. In alignment with patients' beliefs that their condition was chronic and lifelong, many patients attempted a wide range of coping strategies to relieve their pain.

Jun 9, 2020
Journal Article

Group and Individual-level Change on Health-related Quality of Life in Chiropractic Patients With Chronic Low Back or Neck Pain

This study suggests some benefits of chiropractic on functioning and well-being of patients with low back pain or neck pain.

Mar 31, 2020
Journal Article

The Use of Complementary and Integrative Health Approaches for Chronic Musculoskeletal Pain in Younger US Veterans: An Economic Evaluation

Chronic pain is prevalent among Veterans in general, but especially among younger Veterans, including participants in Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. Musculoskeletal pain is the most common type of chronic pain. This pain also often co-occurs with conditions such as anxiety, depression, post-traumatic stress disorder, and substance abuse.

Jun 11, 2019
Journal Article

Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain

This study describes the characteristics of a large sample of chronic low back pain and chronic neck pain patients in the United States who use chiropractic care for their chronic low back pain and chronic neck pain.

Jun 11, 2019
Journal Article

Use of Complementary and Integrated Health: A Retrospective Analysis of U.S. Veterans with Chronic Musculoskeletal Pain Nationally

This article addresses the use of a variety of nonherbal CIH therapies among any large patient population having chronic pain by exploring the frequency and predictors of CIH therapy use among a national population of VHA users with chronic musculoskeletal pain.

Jun 11, 2019
Journal Article

Yoga Versus Education for Veterans with Chronic Low Back Pain: Study Protocol For a Randomized Controlled Trial

This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities.

Jun 11, 2019
Journal Article

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part 2: What Every Researcher and Practitioner Should Know About the Health Insurance Portability and Accountability Act and Practice-based Research in the United States

In this series of articles, we describe how we gathered the varied and detailed data required to achieve the following study objectives: (1) to measure the appropriateness of M/M for CLBP and CCP and (2) to determine whether patient preferences and costs affect appropriateness, and further, whether appropriateness affects outcomes.

Jun 10, 2019
Journal Article

Are Nonpharmacologic Interventions for Chronic Low Back Pain More Cost Effective Than Usual Care? Proof of Concept Results from a Markov Model

This study presents the results of a proof-of-concept modeling effort that utilized individual patient-level data from ten randomized studies and the categorization of these study's participants by chronic pain impact level to estimate the effectiveness and cost-effectiveness of adding recommended nonpharmacologic therapies for CLBP to usual care.

Jun 10, 2019
Journal Article

Clinical Scenarios for Which Spinal Mobilization and Manipulation Are Considered by an Expert Panel to Be Inappropriate (and Appropriate) for Patients With Chronic Low Back Pain

This study used the RUAM to determine the appropriateness of spinal mobilization and manipulation for different types of patients with CLBP, and the key patient characteristics associated with appropriateness.

Jun 10, 2019
Journal Article

Patient Willingness to Pay for Reductions in Chronic Low Back Pain and Chronic Neck Pain

This study provides estimates of reported WTP for pain reduction from a large sample of patients using chiropractic care to manage their chronic spinal pain and compares these estimates to what these patients do for care over the next 3 months, to inform coverage policies for ongoing care.

Jun 10, 2019
Journal Article

Experiences With Chiropractic Care for Patients With Low Back or Neck Pain

This study provides information on the experiences of a national sample of chiropractic patients in the United States with chronic pain.

Jun 10, 2019
Journal Article

Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part I

In this series of articles, we describe how we gathered the varied and detailed data required to achieve the following study objectives: (1) to measure the appropriateness of M/M for CLBP and CCP and (2) to determine whether patient preferences and costs affect appropriateness, and further, whether appropriateness affects outcomes.

Jun 10, 2019
Report

Determining the Appropriateness of Spinal Manipulation and Mobilization for Chronic Low Back Pain

As part of a larger study, back pain experts discussed and rated the appropriateness of spinal manipulation and mobilization for chronic low back pain. Ratings were higher for mobilization than manipulation, and rates of agreement increased after panelists met to discuss the issues.

Jul 24, 2018
Journal Article

Medical Care Spending and Labor Market Outcomes: Evidence from Workers' Compensation Reforms

Following workers' compensation reforms in California, workers with low back injuries received less medical care, leading to an 8% drop in post-injury earnings relative to other injured workers. These results suggest that medical spending can impact health and that health affects labor outcomes.

May 2, 2018
Journal Article

Cognitive and Mind-Body Therapies for Chronic Low Back Pain and Neck Pain: Effectiveness and Value

A recent Institute for Clinical and Economic Review provides evidence that some cognitive and mind-body therapies are effective for chronic low back pain and also cost-effective.

Apr 18, 2018

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