In this episode, Dr. Ronald Farabaugh and I discuss his recent systematic review regarding the cost of chiropractic vs. medical management of adults with spine-related musculoskeletal pain. Dr. Farabaugh has been in practice in Ohio since 1982. He was appointed by the Governor in 1994 to serve on the Healthcare Quality Advisory Council to help design managed care programs for the Bureau of Workers’ Compensation (BWC), specifically Qualified Health Plans (QHP). He became the 1996-President of the Ohio State Chiropractic Association. He is the former Chairman of the CCGPP (Council on Chiropractic Guidelines and Practice Parameters).  He was past president of the Ohio Chiropractic State Board, appointed by Governor Strickland in 2010. He is on the ODG-Board of Advisors (Official Disability Guidelines).  He currently serves as VP and National Physical Medicine Director for Advanced Medicine Integration Group, LP (AMI).

Dr. Farabaugh was appointed to serve on the Scientific Commission of The Clinical Compass and he has published 15 papers on clinical practice guidelines in peer reviewed journals including the paper that we will discuss today on cost-effectiveness that just came out in March of 2024. 

Please visit Dr. Farabaugh’s research page at researchgate.net.

Here is the reference and link to the article we discuss in this episode.

Farabaugh R, Hawk C, Taylor D, Daniels C, Noll C, Schneider M, McGowan J, Whalen W, Wilcox R, Sarnat R, Suiter L, Whedon J. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review. Chiropr Man Therap. 2024 Mar 6;32(1):8. doi: 10.1186/s12998-024-00533-4. PMID: 38448998; PMCID: PMC10918856.Copy

Dr. Daniels and I discuss some of his publications dealing with prior spine surgery, medications for low back pain, suicide prevention, and health promotion. Dr. Clint Daniels is chiropractic section chief at VA Puget Sound Health Care System in Tacoma, Washington where he supervises a team of 9 chiropractors and is a resident director. He serves on the VA chiropractic Field Advisory Committee as the Research Coordinator, is a scientific commission board member for Clinical Compass, and is appointed to the Washington State Health Technology Clinical Committee. He is a 2010 chiropractic graduate from Logan University, where he also received his Master of Science in Sports Science and Rehabilitation. He worked in private practice for 4 years, and then joined VA and was the first graduate of the St. Louis VA chiropractic integrated clinical practice residency program. He has authored and contributed to numerous scientific publications on the topics of chiropractic integration into veteran and military facilities, postsurgical spine pain, suicide prevention, chiropractic best practices, and numerous case reports on a variety clinical presentations.

Please find Dr. Daniel’s researchgate.net profile here.

Here are the articles we discuss in this episode.

1.Manipulative and manual therapies in the management of patients with prior lumbar surgery: A systematic review.Daniels CJ, Cupler ZA, Gliedt JA, Walters S, Schielke AL, Hinkeldey NA, Golley DJ, Hawk C.Complement Ther Clin Pract. 2021 Feb;42:101261. doi: 10.1016/j.ctcp.2020.101261. Epub 2020 Nov 17.PMID: 33276229
2.Systematic review of guideline-recommended medications prescribed for treatment of low back pain.Price MR, Cupler ZA, Hawk C, Bednarz EM, Walters SA, Daniels CJ.Chiropr Man Therap. 2022 May 13;30(1):26. doi: 10.1186/s12998-022-00435-3.PMID: 35562756 Free PMC article. Review.
3.The chiropractor’s role in primary, secondary, and tertiary prevention of suicide: a clinical guide.Cupler ZA, Daniels CJ, Anderson DR, Anderson MT, Napuli JG, Tritt ME.J Can Chiropr Assoc. 2021 Aug;65(2):137-155.PMID: 34658386 Free PMC article.
4.The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline.Hawk C, Amorin-Woods L, Evans MW , Jr, Whedon JM, Daniels CJ, Williams RD , Jr, Parkin-Smith G, Taylor DN, Anderson D, Farabaugh R, Walters SA, Schielke A, Minkalis AL, Crivelli LS, Alpers C, Hinkeldey N, Hoang J, Caraway D, Whalen W, Cook J, Redwood D.J Altern Complement Med. 2021 Oct;27(10):850-867. doi: 10.1089/acm.2021.0184. Epub 2021 Jul 26.PMID: 34314609

Dr. Matt Fernandez is a registered chiropractor in Australia and is currently a senior lecturer at Central Queensland University (CQU), where he teaches and supervises students in the Master of Chiropractic program. Prior to his CQU appointment, he was a lecturer at the Department of Chiropractic, Macquarie University. Matt is very passionate about research and following the completion of his PhD at the University of Sydney, he now leads various research projects and supervises research students. He also regularly presents his research at conferences in targeted areas that advances the knowledge and understanding of chiropractic through physical activity, exercise and patient education interventions. Matt is also a member of the inaugural CARL fellows.

In this episode, we discuss physical activity, exercise, practice guidelines, and the chiropractic profession.

Please find Dr. Fernandez’s researchgate.net profile here.

Here are the articles we discuss in this episode.

1.Physical activity promotion in chiropractic: a systematic review of clinician-based surveys.Fernandez M, Young A, Milton K, Pinhiero M, de Luca K, Ferreira P, Hebert J.Chiropr Man Therap. 2022 Dec 13;30(1):55. doi: 10.1186/s12998-022-00467-9.PMID: 36514061 Free PMC article. Review.
2.GLA:D® Back Australia: a mixed methods feasibility study for implementation.Fernandez M, Young A, Kongsted A, Hartvigsen J, Barton C, Wallis J, Kent P, Kawchuk G, Jenkins H, Hancock M, French SD.Chiropr Man Therap. 2022 Apr 7;30(1):17. doi: 10.1186/s12998-022-00427-3.PMID: 35392935 Free PMC article.
3.The prevalence and determinants of physical activity promotion by Australian chiropractors: A cross sectional study.Fernandez M, Moore C, Eklund A, Swain M, de Luca K, Sibbritt D, Adams J, Peng W.Complement Ther Med. 2019 Aug;45:172-178. doi: 10.1016/j.ctim.2019.06.012. Epub 2019 Jun 18.PMID: 31331556

Dr. Robert Trager is a chiropractic physician and researcher at University Hospitals, in Cleveland, Ohio, in the United States. In this episode, we discuss his research covering a variety of clinically focused topics at the intersection of medicine and chiropractic, ranging from case reports to health service utilization. Dr. Trager first became interested in research when he was an undergraduate student at Northeastern University, where took part in a co-op program that got him hands-on experience in a research laboratory. He then attended Logan University, graduating in 2013, and has since practiced in an integrative healthcare setting.

Please find Dr. Trager’s researchgate.net profile here.

Here are the articles we discuss in this episode. We also talked about the article that Dr. Brian Anderson and I discussed on episode 61 of the podcast.

1.Association between chiropractic spinal manipulation and lumbar discectomy in adults with lumbar disc herniation and radiculopathy: retrospective cohort study using United States’ data.Trager RJ, Daniels CJ, Perez JA, Casselberry RM, Dusek JA.BMJ Open. 2022 Dec 16;12(12):e068262. doi: 10.1136/bmjopen-2022-068262.PMID: 36526306 Free PMC article.
2.Chiropractic case reports: a review and bibliometric analysis.Trager RJ, Dusek JA.Chiropr Man Therap. 2021 Apr 28;29(1):17. doi: 10.1186/s12998-021-00374-5.PMID: 33910610 Free PMC article. Review.

Dr. Lindsay Gorrell and I discuss her research regarding spinal manipulation, the vertebral artery and reporting of adverse events. Lindsay Gorrell completed her clinical training in Chiropractic and a Master of Research (The effect of manual and instrument applied cervical spine manipulation on mechanical neck pain) at Macquarie University, Australia. She then completed a PhD (Musculoskeletal Biomechanical and Electromyographical Responses Associated with Spinal Manipulation) under the supervision of Drs Walter Herzog and Jay Triano at The University of Calgary, Canada. She is now working as an International Research Fellow at the Balgrist University Hospital, University of Zurich, Switzerland. Lindsay is also studying a Master of Science in Medical Education at The University of Oxford, England.

Lindsay’s research interests are centered on investigating: i) the delivery of spinal manipulation; ii) the physiological responses and clinical outcomes occurring in response to spinal manipulation; and iii) the safety of the manual therapy. This requires different experimental approaches depending on the research question of interest. Most recently, she has published on the relationship between the amount of strain experienced by the vertebral artery, the 3D movements of the head and neck and the forces applied by clinicians during cervical spine manipulation and physiological responses to cervical and upper thoracic spinal manipulation. Lindsay has maintained part-time clinical practice since graduation.  

View Dr. Gorrell’s researchgate page here.

Below are the research studies that we discuss in this episode.

1.The reporting of adverse events following spinal manipulation in randomized clinical trials-a systematic review.Gorrell LM, Engel RM, Brown B, Lystad RP.Spine J. 2016 Sep;16(9):1143-51. doi: 10.1016/j.spinee.2016.05.018. Epub 2016 May 27.PMID: 27241208 Review.
2.Differences in force-time parameters and electromyographic characteristics of two high-velocity, low-amplitude spinal manipulations following one another in quick succession.Gorrell LM, Conway PJ, Herzog W.Chiropr Man Therap. 2020 Dec 8;28(1):67. doi: 10.1186/s12998-020-00355-0.PMID: 33287851 Free PMC article.
3.Kinematics of the head and associated vertebral artery length changes during high-velocity, low-amplitude cervical spine manipulation.Gorrell LM, Kuntze G, Ronsky JL, Carter R, Symons B, Triano JJ, Herzog W.Chiropr Man Therap. 2022 Jun 1;30(1):28. doi: 10.1186/s12998-022-00438-0.PMID: 35650649 Free PMC article.
4.Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers.Gorrell LM, Sawatsky A, Edwards WB, Herzog W.J Man Manip Ther. 2022 Nov 15:1-9. doi: 10.1080/10669817.2022.2148048. Online ahead of print.PMID: 36382347

Dr. Brian Anderson and I discuss the article, Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US (2022). We question the relationship between chiropractic and emergency department – ED visits in this paper. Does it makes sense that those who first saw a chiropractor had the lowest out of pocket and overall costs of care, the least hospitalizations and serious illnesses out of any provider type and yet had the highest emergency department – ED visits? Furthermore, those who first saw a chiropractor ranked second lowest of all providers for early opioid prescription, long opioid prescription, MRI/CT imaging, and surgery.

If you have not listened to Dr. Anderson’s podcast episode on chiropractic, treatment escalation, and medical services, please visit here.

Visit Dr. Anderson’s researchgate.net profile and Dr. Smith’s researchgate.net profile.

Below are the articles that are mentioned in this episode of the chiropractic science podcast.

1.Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US.Harwood KJ, Pines JM, Andrilla CHA, Frogner BK.BMC Health Serv Res. 2022 May 23;22(1):694. doi: 10.1186/s12913-022-08092-1.PMID: 35606781 Free PMC article.
2.Influence of Initial Health Care Provider on Subsequent Health Care Utilization for Patients With a New Onset of Low Back Pain: A Scoping Review.Zouch J, Comachio J, Bussières A, Ashton-James CE, Reis AHS, Chen Y, Ferreira P.Phys Ther. 2022 Nov 1:pzac150. doi: 10.1093/ptj/pzac150. Online ahead of print.PMID: 36317766
3.Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas.Acharya M, Chopra D, Smith AM, Fritz JM, Martin BC.J Chiropr Med. 2022 Jun;21(2):67-76. doi: 10.1016/j.jcm.2022.02.007. Epub 2022 May 21.PMID: 35774633 Free PMC article.
4.Initial Choice of Spinal Manipulation Reduces Escalation of Care for Chronic Low Back Pain Among Older Medicare Beneficiaries.Whedon JM, Kizhakkeveettil A, Toler AW, Bezdjian S, Rossi D, Uptmor S, MacKenzie TA, Lurie JD, Hurwitz EL, Coulter I, Haldeman S.Spine (Phila Pa 1976). 2022 Feb 15;47(4):E142-E148. doi: 10.1097/BRS.0000000000004118.PMID: 34474443
5.Initial presentation for acute low back pain: is early physical therapy associated with healthcare utilization and spending? A retrospective review of a National Database.Marrache M, Prasad N, Margalit A, Nayar SK, Best MJ, Fritz JM, Skolasky RL.BMC Health Serv Res. 2022 Jul 2;22(1):851. doi: 10.1186/s12913-022-08255-0.PMID: 35778738 Free PMC article.
6.Risk of Treatment Escalation in Recipients vs Nonrecipients of Spinal Manipulation for Musculoskeletal Cervical Spine Disorders: An Analysis of Insurance Claims.Anderson BR, McClellan WS, Long CR.J Manipulative Physiol Ther. 2021 Jun;44(5):372-377. doi: 10.1016/j.jmpt.2021.03.001. Epub 2021 Aug 6.PMID: 34366149
7.Prescription history of emergency department patients prescribed opioids.Hoppe JA, Houghland J, Yaron M, Heard K.West J Emerg Med. 2013 May;14(3):247-52. doi: 10.5811/westjem.2012.2.6915.PMID: 23687544 Free PMC article.
8.Interpreting the National Hospital Ambulatory Medical Care Survey: United States Emergency Department Opioid Prescribing, 2006-2010.Kea B, Fu R, Lowe RA, Sun BC.Acad Emerg Med. 2016 Feb;23(2):159-65. doi: 10.1111/acem.12862. Epub 2016 Jan 23.PMID: 26802501 Free PMC article.
9.Management of patients with low back pain in the emergency department: Is it feasible to follow evidence-based recommendations?Urrutia J, Besa P, Meissner-Haecker A, Gonzalez R, Gonzalez J.Emerg Med Australas. 2020 Dec;32(6):1001-1007. doi: 10.1111/1742-6723.13544. Epub 2020 Jun 18.PMID: 32558273
10.Imaging during low back pain ED visits: a claims-based descriptive analysis.Schlemmer E, Mitchiner JC, Brown M, Wasilevich E.Am J Emerg Med. 2015 Mar;33(3):414-8. doi: 10.1016/j.ajem.2014.12.060. Epub 2014 Dec 31.PMID: 25624075
11.Diagnostic testing and treatment of low back pain in United States emergency departments: a national perspective.Friedman BW, Chilstrom M, Bijur PE, Gallagher EJ.Spine (Phila Pa 1976). 2010 Nov 15;35(24):E1406-11. doi: 10.1097/BRS.0b013e3181d952a5.PMID: 21030902 Free PMC article.
12.Review article: Best practice management of low back pain in the emergency department (part 1 of the musculoskeletal injuries rapid review series).Strudwick K, McPhee M, Bell A, Martin-Khan M, Russell T.Emerg Med Australas. 2018 Feb;30(1):18-35. doi: 10.1111/1742-6723.12907. Epub 2017 Dec 12.PMID: 29232762 Review.
Dr. Brian Anderson

Dr. Brian Anderson DC, MPH, MS, PhD is an Assistant Professor within the Palmer Center for Chiropractic Research (PCCR) at the Palmer College of Chiropractic, where his research is focused on evaluation of nonpharmacological spine care delivery in the US. His background includes 15 years of clinical experience as a licensed chiropractic physician in a variety of settings, including private practice, a hospital-based integrative medicine center, and a chiropractic academic teaching clinic. He has also been an educator for the past 15 years, teaching courses at the undergraduate, graduate, and post-graduate level. With a passion to better understand and contribute to conservative spine care research, he enrolled in a PhD program in Health Sciences in 2015 with a focus on Health Services Research. His dissertation was titled “A Secondary Analysis Of Insurance Claims Data To Determine The Association Between Provider Type And Treatment Escalation In Musculoskeletal Disorders”, which is a topic he continues to investigate currently. In this interview, we discuss his journey from chiropractor to researcher, and several of his publications.

After graduating with his PhD in 2019, he joined the faculty at the Palmer Center for Chiropractic Research, where he participated in a pilot clinical study as a treating clinician, developed relationships with several research collaborators, and made progress towards developing his own research program.

Dr. Anderson’s research has been presented at many academic conferences, for which he has received several best paper awards. He is currently a co-investigator and primary analyst on a R15 grant titled “Spinal Manipulative Therapy vs Prescription Drug Therapy for Care of Aged Medicare Beneficiaries with Neck Pain”. He was recently awarded a 2-year Loan Repayment Award through the National Center for Complementary & Integrative Health (NCCIH), and also participated in the Fall 2022 cohort of the US Bone & Joint Young Investigators Initiative.

View Dr. Anderson’s publications at researchgate.net.

Here are the articles we discuss in this episode:

1.Risk of Treatment Escalation in Recipients vs Nonrecipients of Spinal Manipulation for Musculoskeletal Cervical Spine Disorders: An Analysis of Insurance Claims.Anderson BR, McClellan WS, Long CR.J Manipulative Physiol Ther. 2021 Jun;44(5):372-377. doi: 10.1016/j.jmpt.2021.03.001. Epub 2021 Aug 6.PMID: 34366149
2.The Effect of Reduced Access to Chiropractic Care on Medical Service Use for Spine Conditions Among Older Adults.Davis M, Yakusheva O, Liu H, Anderson B, Bynum J.J Manipulative Physiol Ther. 2021 Jun;44(5):353-362. doi: 10.1016/j.jmpt.2021.05.002. Epub 2021 Aug 8.PMID: 34376317 Free PMC article.
3.The Relationship Between Healthcare Provider Availability and Conservative Versus Non-conservative Treatment for Back Pain Among Older Americans.Anderson BR, Yakusheva O, Liu H, Bynum JPW, Davis MA.J Gen Intern Med. 2022 Mar;37(4):992-994. doi: 10.1007/s11606-021-06889-0. Epub 2021 May 24.PMID: 34031853 No abstract available.
4.Three Patterns of Spinal Manipulative Therapy for Back Pain and Their Association With Imaging Studies, Injection Procedures, and Surgery: A Cohort Study of Insurance Claims.Anderson BR, McClellan SW.J Manipulative Physiol Ther. 2021 Nov-Dec;44(9):683-689. doi: 10.1016/j.jmpt.2022.03.010. Epub 2022 Jun 24.PMID: 35753873
Dr Frank Scali

In this interview, Dr. Scali discusses with me the upper cervical spine and myodural bridge (connective tissue between suboccipital muscles and the cervical spinal dura mater). Dr. Frank Scali grew up in Valley Stream, Long Island, New York, and studied Neuroscience at Stony Brook University. In 2009, he received his Doctorate in Chiropractic at Logan University in Chesterfield, Missouri. During his time in medical school, Dr. Frank Scali professionally prosected cadaveric specimens for Gray’s Anatomy and illustrated for multiple journals and textbooks, including the Oxford Handbook of Bariatric Surgery. While attending medical school, he published multiple non-variant anatomical findings in the medical literature and served as an Ad Hoc Reviewer in Journals such as The Spine Journal, The Anatomical Record, Surgical and Radiological Anatomy, and others. In 2018, he graduated with his MD from AUC School of Medicine with fifty-four publications, including textbook contributions and a patent for a medical device.

Dr. Scali is board certified in Chiropractic and Medicine. His current title is Assistant Professor of Medical Education and Anatomy at the California University of Science and Medicine. At CUSM, Dr. Scali serves as the Director of the ATLAS Lab Center, is the Director of the USMLE Board Preparation, and is the Course Director for MSK/Derm, Surgical Anatomy, and the Step 1/2CK Board Prep course. He was inducted into the Sigma Xi Scientific Research & Honor Society in 2020 and serves on the Editorial Board for the Journal of Medicine since 2019. As Assistant Professor of Medical Education, Dr. Scali has achieved dozens of teaching awards in Medical Foundations, MSK/Derm, Neuroscience, Reproductive Medicine, and Medical Board Preparation courses. Because of his innovative teaching style, in 2021, Dr. Scali became the inaugural recipient of the Robert Suskind & Leslie Lewinter-Suskind Pre-Clinical Faculty of the Year award.

Visit Dr. Scali’s research at researchgate.net and view his faculty page.

Here are the articles we discuss during this episode:

1.Anatomical connection between the rectus capitis posterior major and the dura mater.Scali F, Marsili ES, Pontell ME.Spine (Phila Pa 1976). 2011 Dec 1;36(25):E1612-4. doi: 10.1097/BRS.0b013e31821129df.PMID: 21278628
2.Investigation of meningomyovertebral structures within the upper cervical epidural space: a sheet plastination study with clinical implications.Scali F, Pontell ME, Nash LG, Enix DE.Spine J. 2015 Nov 1;15(11):2417-24. doi: 10.1016/j.spinee.2015.07.438. Epub 2015 Jul 22.PMID: 26210227
3.Histological analysis of the rectus capitis posterior major’s myodural bridge.Scali F, Pontell ME, Enix DE, Marshall E.Spine J. 2013 May;13(5):558-63. doi: 10.1016/j.spinee.2013.01.015. Epub 2013 Feb 11.PMID: 23406969
4.The Posterior Atlantooccipital Membrane: The Anchor for the Myodural Bridge and Meningovertebral Structures.Scali F, Ohno A, Enix D, Hassan S.Cureus. 2022 May 30;14(5):e25484. doi: 10.7759/cureus.25484. eCollection 2022 May.PMID: 35686279 Free PMC article.
Dr. Carlos Gevers

Dr. Carlos Gevers joins me to discuss mechanisms of spinal manipulation, particularly as they relate to central sensitization and neuroinflammation. He also shares a study on Tumor Necrosis Factor-Alpha in Urine Samples of Patients With Chronic Low Back Pain Undergoing Chiropractic Care.

Carlos Gevers Montoro is a second-generation chiropractor. He graduated from Life Chiropractic College West in 2003 as Valedictorian and the recipient of the Clinical Excellence Citation award. After practicing for a few years in Spain and France, he was instrumental in the opening of the Madrid College of Chiropractic (MCC), where he still lectures. His contributions at the MCC were mostly related to the clinical sciences. In parallel, he served for seven years as the President of the Spanish Chiropractic Association, being involved in chiropractic politics and policy at the national and international level.

In 2018 he decided to switch gears and take a completely new path in the research arena. He started his PhD in Pain Neurosciences at UQTR – University of Montreal joint program under the supervision of Prof. Mathieu Piché. His PhD studies are partially funded, by a prestigious grant from the Government of Quebec. His line of research and his first publications are mostly focused on mechanisms of spinal manipulation, particularly as they relate to central sensitization and neuroinflammation. These two phenomena seem to be strongly implicated in the development of chronic pain syndrome and other conditions.

Check out Dr. Carlos Gevers researchgate profile page.

Here are the articles we discuss in this episode:

1.Presence of Tumor Necrosis Factor-Alpha in Urine Samples of Patients With Chronic Low Back Pain Undergoing Chiropractic Care: Preliminary Findings From a Prospective Cohort Study.Gevers-Montoro C, Romero-Santiago M, Losapio L, Conesa-Buendía FM, Newell D, Álvarez-Galovich L, Piché M, Ortega-De Mues A.Front Integr Neurosci. 2022 Apr 12;16:879083. doi: 10.3389/fnint.2022.879083. eCollection 2022.PMID: 35492573 Free PMC article.
2.Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals.Gevers-Montoro C, Provencher B, Northon S, Stedile-Lovatel JP, Ortega de Mues A, Piché M.Front Pain Res (Lausanne). 2021 Jul 20;2:702429. doi: 10.3389/fpain.2021.702429. eCollection 2021.PMID: 35295504 Free PMC article.
3.Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain.Gevers-Montoro C, Provencher B, Descarreaux M, Ortega de Mues A, Piché M.Eur J Pain. 2021 Aug;25(7):1429-1448. doi: 10.1002/ejp.1773. Epub 2021 Apr 15.PMID: 33786932 Review.

In this episode, Dr. Meier discusses how people move differently in the presence of (or in anticipation of) pain. Changes in motor control may play an important role in musculoskeletal pain. His lab uses a cross-disciplinary approach that combines neuroscience and movement biomechanics to provide new insights into the role of potential interactions between movement behavior, psychological factors and supraspinal mechanisms in the development and maintenance of persistent low back pain. We’ll touch also on fear avoidance and pain related movement avoidance.  Dr. Michael L. Meier is a senior pain researcher and group leader at the Department of Chiropractic Medicine at the University of Zurich. He received his master’s degree in neuropsychology and his doctorate in cognitive neuroscience from the University of Zurich, focusing on the processing of pain and nociception in the brain. In 2019, he received a grant from the Swiss National Science Foundation (SNF) to study the role of movement behavior and cortical processes in the development and persistence of low back pain. A hallmark of his work is linking research from different disciplines such as biomechanics, neuroscience, and psychology, shedding light on novel interacting pathomechanisms underlying persistent low back pain whose pathoanatomical cause is often unclear.

Please see Dr. Michael Meier’s research profile at researchgate.net.  Further information and links to his research can be found at the Balgrist University Hospital website.

Below are the articles Dr. Michael Meier and I discuss in this episode:

1.
Fear-avoidance beliefs are associated with reduced lumbar spine flexion during object lifting in pain-free adults.
Knechtle D, Schmid S, Suter M, Riner F, Moschini G, Senteler M, Schweinhardt P, Meier ML.
Pain. 2021 Jun 1;162(6):1621-1631. doi: 10.1097/j.pain.0000000000002170.
PMID: 33323888 Free PMC article.
2.
Neural responses of posterior to anterior movement on lumbar vertebrae: a functional magnetic resonance imaging study.
Meier ML, Hotz-Boendermaker S, Boendermaker B, Luechinger R, Humphreys BK.
J Manipulative Physiol Ther. 2014 Jan;37(1):32-41. doi: 10.1016/j.jmpt.2013.09.004. Epub 2013 Nov 12.
PMID: 24229849
3. Identifying Motor Control Strategies and Their Role in Low Back Pain: A Cross-Disciplinary Approach Bridging Neurosciences With Movement Biomechanics.
Schmid Stefan, Bangerter Christian, Schweinhardt Petra, Meier Michael L.
Frontiers in Pain Research. 2021 Aug;(2):42. doi: 10.3389/fpain.2021.715219