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Your ChiroUp team regularly scours emerging clinical literature to mine out relevant information.  These findings are automatically incorporated into ChiroUp condition synopses, clinical protocols and patient condition reports- keeping you and your patients connected to current “best practices”. We thought you might enjoy reviewing ten recent clinical pearls.


1. In young asymptomatic adults, a loss of the normal lumbar lordosis is associated with a significantly increased incidence of degenerative disc disease, specifically at L4/5.

Menezes-Reis R, Bonugli GP, Dalto VF, da Silva Herrero CF, Defino HL, Nogueira-Barbosa MH. Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults. Spine (Phila Pa 1976). 2016 Sep 15;41(18):E1081-7.

2. In patients with chronic nonspecific LBP, Kinesio taping the lumbar erectors has been shown to reduce pain and disability, while improving flexibility.

Al-Shareef AT, Omar MT, Ibrahim AH. Effect of Kinesio Taping on Pain and Functional Disability in Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial. Spine (Phila Pa 1976). 2016 Jul 15;41(14):E821-8.

3. Acupuncture has been shown to provide short-term pain relief and long-term functional improvements in patients with knee osteoarthritis.

Lin X, Huang K, Zhu G, Huang Z, Qin A, Fan S. The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. J Bone Joint Surg Am. 2016 Sep 21;98(18):1578-85.

4. In overweight adults, the addition of a wearable technology device (i.e. FitBit) to a standard diet and exercise plan results in less overall long-term weight loss.

Jakicic JM, Davis KK, Rogers RJ, King WC, Marcus MD, Helsel D, Rickman AD, Wahed AS, Belle SH. Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial. JAMA.  2016 Sep 20;316(11):1161-1171.

5. A systematic review of more than 5600 studies of chronic pain following motor vehicle collision concluded: “Engagement with compensation systems was related to more prevalent self-reported chronic pain and reduced return to work. Recovery was poorer when fault was attributed to another, or when a lawyer was involved.”

Giummarra MJ, Ioannou L, Ponsford J, Cameron PA, Jennings PA, Gibson SJ, Georgiou-Karistianis N. Chronic Pain Following Motor Vehicle Collision: A Systematic Review of Outcomes Associated With Seeking or Receiving Compensation. Clin J Pain. 2016 Sep;32(9):817-27.

6. A systematic review concluded: “no relevant association could be shown between the MRI finding of “stenosis” and the severity of the patient’s pain.

Burgstaller JM, Schüffler PJ, Buhmann JM, Andreisek G, Winklhofer S, Del Grande F, Mattle M, Brunner F, Karakoumis G, Steurer J, Held U; LSOS Study Group.. Is There an Association Between Pain and Magnetic Resonance Imaging Parameters in Patients With Lumbar Spinal Stenosis? Spine (Phila Pa 1976). 2016 Sep;41(17):E1053-62.

7. “Surgical and nonsurgical treatments of acute Achilles tendon ruptures have similar results in terms of the Achilles tendon performance score, but surgery restores calf muscle strength earlier.”

Lantto I, Heikkinen J, Flinkkila T, Ohtonen P, Siira P, Laine V, Leppilahti J. A Prospective Randomized Trial Comparing Surgical and Nonsurgical Treatments of Acute Achilles Tendon Ruptures. Am J Sports Med. 2016 Sep;44(9):2406-14.

8. Manipulation and mobilization of the cervical and thoracic spine are beneficial for managing tension-type and cervicogenic headaches.

Varatharajan S, Ferguson B, Chrobak K, Shergill Y, Côté P, Wong JJ, Yu H, Shearer HM, Southerst D, Sutton D, Randhawa K, Jacobs C, Abdulla S, Woitzik E, Marchand AA, van der Velde G, Carroll LJ, Nordin M, Ammendolia C, Mior S, Ameis A, Stupar M, Taylor-Vaisey A. Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario  Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur Spine J. 2016  Jul;25(7):1971-99.

9. An article in American Family Physician found “significant evidence to support the effectiveness and safety of several complementary or integrative treatment approaches”, including:

Acupuncture is effective in the management of chronic low back pain.
Yoga and tai chi may be helpful for treating insomnia.
Exercise can reduce anxiety symptoms.
Probiotic supplementation can significantly reduce the likelihood of antibiotic-associated diarrhea.
Fish oil may lower hypertriglyceridemia
St. John’s wort helps depression
Ginkgo biloba extract helps dementia
Coenzyme Q10 is a useful adjunct for heart failure.

Kligler B, Teets R, Quick M. Complementary/Integrative Therapies That Work: A  Review of the Evidence. Am Fam Physician. 2016 Sep 1;94(5):369-74.

10. A systematic review found the implementation of new “best practice” evidence into clinical practice does not happen after a single exposure, but is most effective when using a system of consistently sustained strategies.

Mesner SA, Foster NE, French SD. Implementation interventions to improve the management of non-specific low back pain: a systematic review. BMC Musculoskelet  Disord. 2016 Jun 10;17:258.


Wow! ChiroUp is just that type of system… keeping you and your patients up-to-date. This leads to better care, improved clinical outcomes, and starting in January- improved incomes.

ChiroUp is a fellowship of like-minded, patient-centric, successful, evidenced based 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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