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How is the intervertebral disc affected by some treatments?

March 16, 2018
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Several treatments used by doctors of chiropractic and other health professionals are thought to generate beneficial physiological effects on intervertebral discs. Traction (or decompression) high-velocity low-amplitude (or thrust) spinal manipulation, and various forms of mobilization (or non-thrust manipulation) have been described as treatments that reduce nerve root compression and/or intervertebral disc protrusion as a...
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What does management theory have to do with being a good doctor?

February 7, 2018
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A recent article authored by Sadati and colleagues entitled “From good to great physician: a critical ethnography based on patients’ views” describes patient perceptions of what great physicians are.1 This article is one of many reporting that the doctor-patient interaction is crucial in determining the quality of a doctor from a patient’s perspective. Not...
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Nutcracker syndrome

January 17, 2018
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Nutcracker syndrome is a condition characterized by compression of the left renal vein where it courses between the aorta and superior mesenteric artery. Anatomical variations in vascular structures and other conditions such as pancreatic or retroperitoneal tumors can also cause left renal vein compression. The term “nutcracker” suggests compression from two opposing structures, but...
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Red Flag Challenges

November 10, 2017
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Clinical guidelines for spine care routinely recommend screening for red flags because they potentially indicate serious conditions often requiring prompt and specific management. Verhagen and colleagues reviewed 16 clinical guidelines for low back pain including those from North America, Australia, Europe, and Pacific region countries revealing 46 recommended red flag signs or symptoms indicating...
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Connecting with patients, detaching from outcome

October 10, 2017
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In a recent study authored by Janisse and colleagues, physicians rated highest in patient satisfaction described how they think about role and relationship with patients . Each example offered in the article describes events that prompted and enabled transformed thinking, which resulted in improved communication and patient satisfaction. One physician experienced significant mental/emotional energy...
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Your job is NOT to do your thing

September 8, 2017
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The title of this post may seem counterintuitive or even provocative, but it makes sense when viewed from a certain perspective. In a study of highly rated physicians, one physician serves as an example of someone who fundamentally reversed how they thought about their role, leading to improved communication and patient satisfaction. Despite concerted...
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Rethinking purpose

August 11, 2017
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In a recent article, authors Tom Janisse and Karen Tallman described a study reporting key traits of physicians rated highest by patients . These characteristics are expressed typically through interpersonal communication methods, but they are rooted in fundamental ideas about how providers think. This study uncovered personal experiences that helped transform physician’s ways of...
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Low back pain and respiratory disorders

July 10, 2017
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Researchers in Belgium reported an association between respiratory disorders and low back pain in a recent article published in the journal Manual Therapy. Analyzing data collected from 16 clinical trials, investigators concluded a significant relationship existed between dyspnea, asthma, some allergies, respiratory infections and low back pain. No relationship was found between chronic obstructive...
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Patients sometimes avoid care because of their doctor

June 12, 2017
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Why patients don’t seek care may be revealed in results from a study that interviewed 93 participants over age 65 who were asked about their experience with restricting back pain. Questions probed for beliefs, behaviors, coping mechanisms, emotional effects, and experiences with doctors. The full study results are reported in the journal BMC Geriatrics.1...
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Spinal manipulation and cervical disc herniation

May 12, 2017
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A recent article published in the Journal of Manipulative and Physiological Therapeutics reports findings of a study evaluating treatment costs, pain reduction, and overall improvement for patients with symptomatic cervical disc herniation (1). In this study, patient databases within a European orthopedic/rheumatology university hospital were searched. Clinical outcomes and cost of care for 52...
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