Management of Musculoskeletal Pain with Chiropractic, Part 1

Research shows that treating musculoskeletal pain with chiropractic is successful. Clinical guidelines translate this research into evidenced-informed practice recommendations.

The World Federation of Chiropractic provides suggested reading lists to help chiropractors stay informed about the most recent research and clinical guidelines on treating pain with chiropractic. The lists cover many topics on chiropractic and pain, including acute and chronic low-back pain, neck pain, headaches, mid-back pain, sports injuries, and nutrition.

NYCC provides you with an evidence-informed education on treating musculoskeletal pain with chiropractic.

Beyond providing you with clinical skills to treat pain, NYCC faculty call on both the research literature and their vast clinical experiences to engage students in scholarly debates on the role of chiropractic care in treating the whole person and maintaining patient wellness.

One faculty member, Dr. Mary Balliett, received her evidence-informed chiropractic and applied clinical nutrition education at NYCC.

Her clinical practice is an excellent example of your professional life as an alumnus of NYCC.

Evidence-Informed Chiropractic Clinical Practice:

Dr. Balliett practices the art and science of chiropractic by taking detailed patient histories, performing all appropriate physical assessments, making well-informed differential diagnoses, and developing evidence-informed treatment plans.

The majority of Dr. Balliett’s patients come to her office with spinal pain affecting the neck, mid-, and lower back. After patient history and physical assessments that include range of motion, neurological, orthopedic and muscle strength testing, Dr. Balliett is able to make a differential diagnosis of the cause and develop a treatment plan that may include chiropractic care and, if necessary, collaboration with other healthcare providers.

With a differential diagnosis of sprain/strain to the musculoskeletal system, Dr. Balliett’s treatment approach to relieve pain and improve physical function includes a combination of myofascial trigger point therapy to reduce muscle spasm, instrument-assisted soft-tissue therapy to improve connective tissue health, pulse ultrasound to reduce pain and swelling and increase blood supply to the affected area, and spinal manipulative therapy to improve joint motion. She combines home exercises with either heat or ice or both to promote musculoskeletal tissue healing between office visits.

For chronic back pain cases, Dr. Balliett often refers her patients to massage therapists to help relieve muscle spasms and acupuncturists to assist with pain relief. She includes nutritional counseling to guide her chronic pain patients towards an anti-inflammatory diet and recommends anti-inflammatory supplements such as boswellia or curcumin to help manage the inflammation-swelling-pain cycle.

Depending upon the chronic case presentation, she may also recommend that her chronic back pain patients increase the amount of protein in their diet and include other supplements such as glucosamine, vitamin C, micro-minerals, etc., to improve their connective tissue health.

Dr. Balliett expects 50% reduction in pain symptoms and improvement in physical function after three to five weeks, which correlates to three to five chiropractic visits in her practice schedule. Dr. Balliett will re-evaluate her differential diagnosis and/or refer her patient to the medical community if she is not getting this end result from her chiropractic treatment approach.

Self-reported pain intensity, ability to perform activities of daily living without pain, improved range of motion, and no pain on clinical tests to provoke pain symptoms are end results that Dr. Balliett uses to document clinical improvement.

She will continue chiropractic care for another three to five office visits to resolve symptoms of the acute case presentation or the flare-up of a chronic case presentation.

Her chronic back pain patients are often performing home exercises as part of their daily life and schedule office visits once per month or every other month to help prevent acute episodes or flare-ups of back pain.

Her treatment approach aligns with evidence-informed practice recommendations (e.g., dose-response) on the use of chiropractic to reduce pain symptoms and improve physical function.

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