Gonstead Clinic

"...Until further breakthroughs emerge, we should remember that modifiable lifestyle factors like diet and physical activity should not be marginalized. Decades of empirical evidence supports both as key factors promoting health and wellness.." Considerations for obesity, vitamin D, and physical activity amidst the COVID-19 pandemic As the biomedical community races to disentangle the unknowns associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - the ...virus responsible for causing coronavirus disease (COVID-19) - the link between diminished immune function and individuals with obesity raises important questions about the possibility for greater viral pathogenicity in this population. Increased adiposity may undermine the pulmonary microenvironment wherein viral pathogenesis and immune cell trafficking could contribute to a maladaptive cycle of local inflammation and secondary injury. A further challenge to those with obesity during the current pandemic may involve vitamin D deficiency/insufficiency. In the interest of personal and public health, we caution decision/policy makers alike not to pin all hope on a proverbial 'silver bullet.' Until further breakthroughs emerge, we should remember that modifiable lifestyle factors like diet and physical activity should not be marginalized. Decades of empirical evidence supports both as key factors promoting health and wellness. Obesity (Silver Spring). 2020 Apr 16. doi: 10.1002/oby.22838. [Epub ahead of print] Considerations for obesity, vitamin D, and physical activity amidst the COVID-19 pandemic. Carter SJ1, Baranauskas MN1, Fly AD2.

Tylenol, acetaminophen and back pain and arthritis the British Medical Journal 2015 https://www.bmj.com//wp-co/uploads/2015/04/paracetamol.pdf

https://academic.oup.com///doi/10.1093/pm/pnaa014/5788462

Compared with initial primary care provider consultation, patients consulting with a DC or PT had decreased odds of being prescribed opioids within 1 year from the index visit (DC: adjusted odds ratio [aOR], 0.54; 95% CI, 0.39-0.76; PT: aOR, 0.59; 95% CI, 0.44-0.78). Patients consulting with a DC additionally demonstrated decreased odds of advanced imaging (aOR, 0.43; 95% CI, 0.15-0.76) and injections (aOR, 0.34; 95% CI, 0.19-0.56). Initiating care with a specialist or PT inc...reased the odds of advanced imaging (specialist: aOR, 2.96; 95% CI, 2.01-4.38; PT: aOR, 1.57; 95% CI, 1.01-2.46), but only initiating care with a specialist increased the odds of injections (aOR, 3.21; 95% CI, 2.31-4.47). Mayo Clin Proc Innov Qual Outcomes. 2017 Oct 19;1(3):226-233. doi: 10.1016/j.mayocpiqo.2017.09.001. eCollection 2017 Dec. Influence of Initial Provider on Health Care Utilization in Patients Seeking Care for Neck Pain. Horn ME1, George SZ2,3, Fritz JM4. OBJECTIVE: To examine patients seeking care for neck pain to determine associations between the type of provider initially consulted and 1-year health care utilization. PATIENTS AND METHODS: A retrospective cohort of 1702 patients (69.25% women, average age, 45.3214.75 years) with a new episode of neck pain who consulted a primary care provider, physical therapist (PT), chiropractor (DC), or specialist from January 1, 2012, to June 30, 2013, was analyzed. Descriptive statistics were calculated for each group, and subsequent 1-year health care utilization of imaging, opioids, surgery, and injections was compared between groups. RESULTS: Compared with initial primary care provider consultation, patients consulting with a DC or PT had decreased odds of being prescribed opioids within 1 year from the index visit (DC: adjusted odds ratio [aOR], 0.54; 95% CI, 0.39-0.76; PT: aOR, 0.59; 95% CI, 0.44-0.78). Patients consulting with a DC additionally demonstrated decreased odds of advanced imaging (aOR, 0.43; 95% CI, 0.15-0.76) and injections (aOR, 0.34; 95% CI, 0.19-0.56). Initiating care with a specialist or PT increased the odds of advanced imaging (specialist: aOR, 2.96; 95% CI, 2.01-4.38; PT: aOR, 1.57; 95% CI, 1.01-2.46), but only initiating care with a specialist increased the odds of injections (aOR, 3.21; 95% CI, 2.31-4.47). CONCLUSION: Initially consulting with a nonpharmacological provider may decrease opioid exposure (PT and DC) over the next year and also decrease advanced imaging and injections (DC only). These data provide an initial indication of how following recent practice guidelines may influence health care utilization in patients with a new episode of neck pain.

https://chiropracticscience.com/podcast/drandreaseklund/

https://m.youtube.com/watch?v=-Sin-OpiiP4

http://ebm.bmj.com/content/early/2016//23/ebmed-2016-110401

Small scoliosis over time leads to... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959823/

Reducing the global burden of musculoskeletal conditions Andrew M Briggs,aAnthony D Woolf,bKarsten Dreinhöfer,cNicole Homb,dDamian G Hoy,eDeborah KopanskyGiles,fKristina Åkessong & Lyn Marchh http://www.who.int/bulletin/volumes/96/5/17-204891.pdf?ua=1

JAMA Otolaryngol Head Neck Surg. 2018 Jun 7. doi: 10.1001/jamaoto.2018.0614. [Epub ahead of print] Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. Byars SG1,2, Stearns SC3, Boomsma JJ2. Author information Abstract...Continue reading

http://bmjopen.bmj.com/content/8/1/e019040.long

Explore (NY). 2018 Mar 1. pii: S1550-8307(18)30022-3. doi: 10.1016/j.explore.2018.02.001. [Epub ahead of print] Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: the Consortium Pain Task Force White Paper. Tick H1, Nielsen A2, Pelletier KR3, Bonakdar R4, Simmons S5, Glick R6, Ratner E7, Lemmon RL8, Wayne P9, Zador V10; Pain Task Force of the Academic Consortium for Integrative Medicine and Health. Author information Abstract... Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices. See more

https://www.ncbi.nlm.nih.gov/pubmed/29760552