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The research is out! Our ChiroUp data collection team has reviewed more than a thousand abstracts this month to mine out the essential, best practices that will impact your practice today. 👇

Trending In

 Chiropractic manipulation
  Dry needling
  Counterforce braces
  Diagnostic ultrasound

Trending Out

Stroke myths
Cortisone injections
Being short 😀

Check out this week’s blog for 21 “quick hit” sentences that will impact your evidence-based practice.


1. Annals of Medicine: “Manual therapy does not result in an increased risk of cervical artery dissection”

Chaibi A et al. A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: A comprehensive review. Ann Med. 2019 Mar 19:1-27.

2. “Cervical rotary manipulation does not cause adverse effects on hemodynamics…and appears to be a relatively safe technique.”

Guan T et al. Effects of Cervical Rotatory Manipulation on Internal Carotid Artery in Hemodynamics Using an Animal Model of Carotid Atherosclerosis: A Safety Study. Med Sci Monit 2019; 25:2344-2351

3. “The current evidence is insufficient to support or dismiss the use of TENS for acute LBP.”

Binny J et al. Transcutaneous electric nerve stimulation (TENS) for acute low back pain: systematic review. Scand J Pain. 2019 Mar 9. pii: /j/sjpain.ahead-of-print/sjpain-2018-0124/sjpain-2018-0124.xml.

4. Acupuncture therapy is an effective and safe treatment for patients with fibromyalgia” 

Zhang XC, Chen H, Xu WT, Song YY, Gu YH, Ni GX. Acupuncture therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. J Pain Res. 2019;12:527-542. Published 2019 Jan 30. doi:10.2147/JPR.S186227

5. The use of chiropractors increased from 9.1% in 2012 to 10.3% in 2017. Women were more likely than men to see a chiropractor (11.1% versus 9.4%).”

Clarke TC et al. Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Over. NCHS Data Brief. 2018 Nov;(325):1-8.

6. For patients with lateral epicondylopathy, “The counterforce brace provides significant reduction in the frequency and severity of pain in the short term (2-12 weeks), as well as overall elbow function at 26 weeks.”

Kroslak M et al. Counterforce bracing of lateral epicondylitis: a prospective, randomized, double-blinded, placebo-controlled clinical trial. J Shoulder Elbow Surg. 2019 Feb;28(2):288-295. doi: 10.1016/j.jse.2018.10.002.

7. Diagnostic ultrasound is a sensitive and specific method in diagnosing ulnar neuropathy at the elbow (cubital tunnel syndrome).”

Rayegani SM et al. Diagnostic value of ultrasonography versus electrodiagnosis in ulnar neuropathy. Med Devices (Auckl). 2019 Feb 22;12:81-88. doi: 10.2147/MDER.S196106. eCollection 2019.

8. “Surface irregularities of the greater trochanter are not reliable radiographic indicators for the diagnosis of greater trochanteric pain syndrome.” 

Barrett MC et al. Trochanteric spurs and surface irregularities on plain radiography are not predictive of greater trochanteric pain syndrome. Hip Int. 2019 Mar 11:1120700019835641. doi: 10.1177/1120700019835641. [Epub ahead of print]

9. American Family Physician: “The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. These drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk of adverse events.”

Ebell MH.Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy. Am Fam Physician. 2019 Mar 15;99(6):Online.

10. Myofascial pain syndrome (primarily involving the gluteus medius) is present in the majority of patients with LBP (73%) , sciatica (50%), and LBP with sciatica (85%).”

Kameda M, Tanimae H. Effectiveness of active soft tissue release and trigger point block for the diagnosis and treatment of low back and leg pain of predominantly gluteus medius origin: a report of 115 cases. J Phys Ther Sci. 2019;31(2):141-148.

11. “In the treatment of lumbar disc herniation, spinal manipulation presented with a higher effective rate than acupuncture and lumbar traction.”

Mo, Zhuomao et al. Comparison Between Oblique Pulling Spinal Manipulation and Other Treatments for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis. Journal of Manipulative & Physiological Therapeutics , Volume 41 , Issue 9 , 771 – 779

12. “Substance P-positive nerve fibers were obviously increased in number and deeply ingrown into the inner anulus fibrosus and even into the nucleus pulposus in the degenerative cervical discs of patients with severe neck pain”

Wu B et al. Ingrowth of Nociceptive Receptors into Diseased Cervical Intervertebral Disc Is Associated with Discogenic Neck Pain. Pain Med. 2019 Mar 8. pii: pnz013. doi: 10.1093/pm/pnz013. [Epub ahead of print]

13. “Dry needling seems to be a reliable procedure for treating plantar fasciitis, with better outcomes than corticosteroid injection.”

Uygur E et al. Preliminary Report on the Role of Dry Needling Versus Corticosteroid Injection, an Effective Treatment Method for Plantar Fasciitis: A Randomized Controlled Trial. J Foot Ankle Surg. 2019 Mar;58(2):301-305. doi: 10.1053/j.jfas.2018.08.058.

14. “Extracorporeal shockwave therapy (ESW)  was found to be more effective than cortisone injections for plantar fasciitis.”

Mishra BN et al. Effectiveness of extra-corporeal shock wave therapy (ESWT) vs methylprednisolone injections in plantar fasciitis. J Clin Orthop Trauma. 2019 Mar-Apr;10(2):401-405. doi: 10.1016/j.jcot.2018.02.011. Epub 2018 Feb 23.

15. “Smokers with fibromyalgia were more likely to report increased severity of fibromyalgia symptoms, worse quality of life, more sleep problems, and increased anxiety compared with nonsmokers with fibromyalgia.”

Ge L et al.  Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction: A Prospective Questionnaire Study. Mayo Clin Proc Innov Qual Outcomes. 2019 Feb 26;3(1):78-85. doi: 10.1016/j.mayocpiqo.2018.12.002. eCollection 2019 Mar.

16. In 80 NFL players with Achilles tendon rupture, “The overall return to play rate was 61.3%.” 

Yang J, Hodax JD, Machan JT, et al. Factors Affecting Return to Play After Primary Achilles Tendon Tear: A Cohort of NFL Players. Orthop J Sports Med. 2019;7(3):2325967119830139. Published 2019 Mar 12. doi:10.1177/2325967119830139

17. “Achilles tendinopathy is associated with large deficits in plantar flexor torque and endurance. The deficits are bilateral in nature and appear to be explained by a greater loss of soleus force rather than the gastrocnemius.”

O’Neill S et al. Plantarflexor strength and endurance deficits associated with mid-portion Achilles tendinopathy: The role of soleus. Phys Ther Sport. 2019 Mar 9;37:69-76. doi: 10.1016/j.ptsp.2019.03.002. [Epub ahead of print]

18. Regarding carpal tunnel syndrome, “The Nerve Conduction Study (NCS) demonstrated the highest estimated sensitivity of 97%, and the Wainner Clinical Prediction Rule had the highest estimated specificity of 97%.”

Wang WL et al. A Comparison of 6 Diagnostic Tests for Carpal Tunnel Syndrome Using Latent Class Analysis. Hand (N Y). 2019 Mar 10:1558944719833709. doi: 10.1177/1558944719833709. [Epub ahead of print]

19. “Care must be taken when performing yoga positions with extreme spinal flexion and extension. Patients with osteopenia or osteoporosis may have higher risk of compression fractures or deformities and would benefit from avoiding extreme spinal flexion.”

Lee M et al. Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management. Mayo Clin Proc. 2019 Mar;94(3):424-431. doi: 10.1016/j.mayocp.2018.09.024. Epub 2019 Feb 18.

20. “Soft tissue calcification is likely iatrogenic complication of steroid injection for lateral epicondylitis patients.”

 Park HB et al. Association of steroid injection with soft-tissue calcification in lateral epicondylitis. J Shoulder Elbow Surg. 2019 Feb;28(2):304-309. doi: 10.1016/j.jse.2018.10.009.

21. A study of nearly 400,000 patients demonstrated “a causal relationship between short stature and higher risk of carpal tunnel syndrome”

Wiberg A, Ng M, Schmid AB, et al. A genome-wide association analysis identifies 16 novel susceptibility loci for carpal tunnel syndrome. Nat Commun. 2019;10(1):1030. Published 2019 Mar 4. doi:10.1038/s41467-019-08993-6

BONUS: “Facet joint tropism correlates with intervertebral disc degeneration but not with facet joint degeneration.”

Cui JH et al. Relationship between facet joint tropism and degeneration of facet joints and intervertebral discs based on a histological study. J Orthop. 2018 Dec 20;16(2):123-127. doi: 10.1016/j.jor.2018.12.008. eCollection 2019 Mar-Apr.

Wow! Talk about an easy button for staying up-to-date this month. But that’s only a small piece of the battle… staying at the top of your Clinical “A” Game means applying the new data into your assessments, treatments, exercises, and patient education… 🤔

If only that had an easy button… 🛎

Well guess what: there IS. You know & love ChiroUp for the research updates, but we also offer a platform that allows you to easily incorporate everything mentioned above.

Your “easy button” is just a click away

About the Author

Dr. Tim Bertelsman

Dr. Tim Bertelsman


Dr. Tim Bertelsman graduated with honors from Logan College of Chiropractic and has been practicing in Belleville, IL since 1992. He has lectured nationally on various clinical and business topics and has been published extensively. He has served in several leadership positions within the Illinois Chiropractic Society and currently serves as President of the executive board.

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