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chiropractic research update


Your ChiroUp team regularly scours emerging literature to mine out relevant clinical information that affects your practice. Some studies describe new concepts, while others simply reinforce our current understanding and provide additional support for evidence-based chiropractic practice. These findings are automatically incorporated into ChiroUp condition synopses, clinical protocols, and patient condition reports- keeping you and your patients connected to current chiropractic best practices. We thought you might enjoy reviewing ten recent clinical pearls.


1. A systematic review of 11 pertinent articles determined that cervical HVLA manipulation increased pain-free handgrip strength in patients with lateral epicondylagia.

Galindez-Ibarbengoetxea Xabier, Setuain Igor, Andersen Lars L., Ramírez-Velez Robinson, González-Izal Miriam, Jauregi Andoni, and Izquierdo Mikel. The Journal of Alternative and Complementary Medicine. September 2017, 23(9): 667-675.

Bonus: Check out this earlier video blog describing how to differentiate lateral epicondylagia from it’s look-alike: radial tunnel syndrome.

2. A cross sectional study confirmed that in patients with adolescent idiopathic scoliosis, the Cobb angle has a direct correlation to pain and disability. Bracing was associated with lower disability and pain.

Théroux J et al. Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis: A Cross-sectional Study. SPINE. 42(15):E914–E919, AUG 2017

3. The Journal of Rheumatology published an articulate narrative on the genesis of arthritis:

“Following skeletal maturation, chondrocyte numbers decline while increasing senescence occurs. Lower cartilage turnover causes diminished maintenance capacity, which produces accumulation of fibrillar crosslinks, resulting in increased stiffness and thereby destruction susceptibility.

Mechanical loading changes proteoglycan content. Moderate mechanical loading causes hypertrophy and reduced mechanical loading causes atrophy. Overloading produces collagen network damage and proteoglycan loss, leading to irreversible cartilage destruction because of lack of regenerative capacity. Thus, age seems to be a predisposing factor for OA, with mechanical overload being the likely triggering cause.”

Jorgensen AE et al. The Effect of Aging and Mechanical Loading on the Metabolism of Articular Cartilage The Journal of Rheumatology April 2017, 44 (4) 410-417

4. “The knee is the most common site of OA. Numerous studies have shown an inconsistency between patients’ reports of pain and their radiographic findings. This inconsistency may be partially explained by the fact that a portion of the pain originates from the myofascial trigger points (MTrPs) located in the surrounding muscles. Treatment focusing on MTrPs seems to be effective in reducing pain and improving function in OA patients.”

Dor, Adi et al. A myofascial component of pain in knee osteoarthritis. Journal of Bodywork and Movement Therapies , Volume 21 , Issue 3 , 642 – 647

5. In patients undergoing MRI for degenerative spinal disease, expanding the regional study to include a T2 whole spine screen identified incidental findings in 15.8% of patients, 4.3% of which required further medical or surgical intervention. The authors concluded:

“Considering the potential advantages in identifying significant incidental findings and the minimal extra time spent to perform whole spine screening, its application can be considered to be incorporated in routine imaging of spinal degenerative diseases.”

Kanna, R.M., Kamal, Y., Mahesh, A. et al. The impact of routine whole spine MRI screening in the evaluation of spinal degenerative diseases. Eur Spine J (2017) 26: 1993. 

6. A small randomized clinical trial demonstrated that periodic chiropractic maintenance care can prevent and/or minimize episodes of LBP. Patients who underwent an average of 7 visits per year suffered on average 19.3 fewer days with LBP.

Eklund A, et al. Prevention of low back pain: effect, cost-effectiveness, and cost-utility of maintenance care – study protocol for a randomized clinical trial. Trials. 2014;15:102

 Eklund A et al., Prevention of Low Back Pain: Effect of Chiropractic Maintenance Care as Compared to Symptomatic Treatment – A Pragmatic Randomized Clinical Trial. First prize 2017 European Chiropractors Convention, Cyprus.

7.In athletes who sustained an acute musculoskeletal sports injury, three minutes of acupressure was effective in decreasing VAS pain intensity.

Macznik AK. Does Acupressure Hit the Mark? A Three-Arm Randomized Placebo-Controlled Trial of Acupressure for Pain and Anxiety Relief in Athletes With Acute Musculoskeletal Sports Injuries. Clin J Sport Med. 2017 Jul;27(4):338-343.

8.A new study in Spine confirms that adults who participate in muscle strengthening exercise suffer lower incidence of LBP.

Alnojeidi AH et al. Associations Between Low Back Pain and Muscle-strengthening Activity in U.S. Adults. Spine (Phila Pa 1976). 2017 Aug 15;42(16):1220-1225.

9.For patients with Failed Back Surgery Syndrome, evidence supports exercise or spinal cord stimulation as opposed to medication and re-operation.

Amirdelfan K et al. Treatment Options for Failed Back Surgery Syndrome Patients With Refractory Chronic Pain: An Evidence Based Approach. Spine (Phila Pa 1976). 2017 Jul 15;42 Suppl 14:S41-S52.

10.A systematic review and meta-analysis found that workplace exercise programs and workstation modifications reduce the prevalence and intensity of shoulder pain.

Lowry V et al. Efficacy of workplace interventions for shoulder pain: A systematic review and meta-analysis. J Rehabil Med 2017 Jul 7;49(7):529-542.


And finding a way to automate the delivery of exercise programs and ADL advice is paramount. Consistently sharing condition-specific best practice advice with your patients leads to better care, improved clinical outcomes, and ultimately improved incomes.

ChiroUp is your system to make that happen! We are a fellowship of like-minded, patient-centric, successful, evidenced based chiropractic providers who are sharing knowledge to help each other. We invite you to submit pertinent citations and especially welcome your input on how to improve this knowledge transfer program.


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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