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Review the latest news: 

✔ Manipulation for headaches and lateral elbow pain
✔ KinesioTape for carpal tunnel syndrome
✔ Epidural steroid injections increase the risk of fracture
✔ How common are rotator cuff tears?


Successful evidence-based chiropractors continually leverage new studies to improve their clinical decision-making. ChiroUp helps by scouring fresh literature to mine out useful best practice data. This month, we’ve summarized more than two-dozen studies and have already updated ChiroUp protocols with this information. We are showcasing ten articles here. Be sure to follow our Facebook page for regular synopses of all significant new chiropractic-related research.


1. A Spine Journal study found that in patients suffering from cervicogenic headache, spinal manipulation cuts the number of symptomatic days in half:

“256 adults with chronic cervicogenic headache (CGH) were randomized to four dose levels of chiropractic SMT: 0, 6, 12, or 18 sessions. Participants were treated three times per week for 6 weeks and received a focused light-massage control at sessions when SMT was not assigned. A linear dose-response was observed for all follow-ups, a reduction of approximately 1 CGH day/month for each additional 6 SMT visits. Cervicogenic headache days/month were reduced from about 16 to 8 for the highest and most effective dose of 18 SMT visits. Cervicogenic headache intensity showed no important improvement nor differed by dose.”

Incidentally, SMT proved to be more effective than massage for CGH.

Haas M. et al. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine J. 2018 Feb 23. [Epub ahead of print]

2. Archive of Physical Medicine & Rehabilitation: “For patients with neurogenic claudication due to lumbar spine stenosis, a comprehensive conservative program demonstrated superior, large and sustained improvements in walking ability and can be a safe non-surgical treatment option.”

Ammendolia C, et al. Comprehensive non-surgical treatment versus self-directed care to improve walking ability in lumbar spinal stenosis: A randomized trial. Arch Phys Med Rehabil. 2018.

3. As many as 96% of persons over age 50 years may have shoulder abnormalities involving the rotator cuff. Many of these individuals remain asymptomatic. Now a new study has found the incidence and prevalence of subclinical supraspinatus pathology in young subjects may be significantly greater than expected:

“Forty-six subjects, having no shoulder pain or known functional impairment were assessed using physical screening and musculoskeletal sonography. Results showed that 24% of these asymptomatic shoulders demonstrated degenerative changes.”

Guffey JS, et al. Degenerative Changes in Asymptomatic Subjects: A Descriptive Study Examining the Using Musculoskeletal Sonography in a Young Population. J Allied Health. 2018.

4. A study in Spine Journal found that sheep that underwent L3/4 spinal fusion experienced significant degenerative changes:

“(In fused specimens) The MRI and histologic analysis demonstrated significant disc degeneration. The mechanical environment set up by immobilization alone is capable of inducing lumbar disc degeneration.”

Wang T et. al. A novel in vivo large animal model of lumbar spinal joint degeneration. Spine J. 2018 May 22. [Epub ahead of print]

5. A study in the Journal of Bone & Joint Surgery found that lumbar epidural steroid injections increase the risk of osteoporotic vertebral compression fracture by 21%, per injection:

“Each successive injection increased the risk of fracture by a factor of 1.21. The findings suggest that Lumbar epidural steroid injections, like other forms of exogenous steroid administration, may lead to increased bone fragility.”

Mandel S. et al. A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections. The Journal of Bone & Joint Surgery. 95(11):961–964, JUN 2013 

6. A study of over 32,000 people found that overweight people have a 21% increased risk of LBP, while obesity increases one’s risk by 55%.

Peng, Trent et al. The Association Among Overweight, Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey. Journal of Manipulative & Physiological Therapeutics , Volume 41 , Issue 4 , 294 – 303

7. Individuals who received mobilization and expressed a positive perception of effect exhibited significantly greater changes in neurodynamic mobility than those without a positive perception.

Hartstein, Aaron J. et al. Immediate Effects of Thoracic Spine Thrust Manipulation on Neurodynamic Mobility. Journal of Manipulative & Physiological Therapeutics , Volume 41 , Issue 4 , 332 – 341

8. A systematic review in the Journal of Hand Therapy has shown “compelling evidence” that joint mobilization and manipulation improve pain, grip strength, and functional outcomes in patients with tennis elbow.

Lucado AM. et. al. Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis. J. Hand Therapy 2018 Apr 25. [Epub ahead of print]

9. A randomized clinical trial compared the effectiveness of a splint vs. KinesioTape (KT) for the management of carpal tunnel syndrome:

“A significant improvement was observed in the KT group compared to the splint group in terms of electrophysiological changes, provocative test responses, symptom severity, and functional status scores. KT may help prevent the disease from progressing further in mild and moderate idiopathic CTS when applied in time using the appropriate technique and be a good alternative to neutral splinting in terms of patient compliance.”

Akturk S. et. al. Comparison of splinting and Kinesio taping in the treatment of carpal tunnel syndrome: a prospective randomized study.Clin Rheumatol. 2018 Jun 15. [Epub ahead of print]

10. NEJM: “A staggering 36,000 randomized controlled trials (RCTs) are published each year, on average, and it typically takes about 17 years for findings to reach clinical practice.”

Kanter MH et. al. A Model for Implementing Evidence-Based Practices More Quickly. NEJM Catalyst. February 5, 2017


ChiroUp.com can help you shorten that process by about 16.99 years! Our team harvests new research daily and incorporates best practice data into your protocols and patient education immediately. If you’re not yet a subscriber, start your free trial today!

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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