Episode

066- Dr. Ronald Farabaugh – The Cost of Chiropractic vs Medical Management of Adults With Spine-Related Musculoskeletal Pain

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

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065- Dr. Clinton Daniels Discusses Manipulation and Prior Spine Surgery, Medications for Back Pain and More

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
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062- Dr. Lindsay Gorrell Discusses Spinal Manipulation, the Vertebral Artery, Reporting of Adverse Events

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
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052- Dr. Ken Weber Discusses Advanced MRI Techniques, Pain & Manual Therapy

Dr. Ken Weber

Dr. Ken Weber and I discuss his research pursuits which involve: 1) developing imaging modalities that are more sensitive and specific to the pathology, providing more diagnostic, prognostic, and predictive information; 2) providing more quantitative information to the clinician; and 3) using these measures to better understand the nervous system and how it functions, the neurophysiology of pain, how treatments work, and why certain treatments work for some patients but not for others. Dr. Ken Weber is an Instructor in the Department of Anesthesia, Perioperative and Pain Medicine at Stanford University. He obtained his Doctor of Chiropractic from Palmer College of Chiropractic Florida in 2009 and then completed a PhD in neuroscience at Northwestern University in 2016, specializing in movement and rehabilitation science. Ken’s research intersects clinical pain research and advanced MRI techniques with an emphasis on brain, spinal cord, and musculoskeletal imaging. His research aims to better understand the neural and musculoskeletal changes underlying clinical pain conditions, the mechanisms of treatments, and predictors for recovery. Ken is currently supported by a K23 Mentored Patient-Oriented Research Career Development Award from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health. His previous funding has included the National Center for Complementary and Integrative Health, the National Institute on Drug Abuse, and the NCMIC Foundation, Inc.

I’d also like to point out that Ken was recently selected to be part of the CARL (Chiropractic Academy for Research Leadership) program. 

View Dr. Weber‘s research at researchgate.net.

Here are some of the papers we discuss in this episode.

1. Machine Learning for the Prediction of Cervical Spondylotic Myelopathy: A Post Hoc Pilot Study of 28 Participants.
  Hopkins BS, Weber KA 2nd, Kesavabhotla K, Paliwal M, Cantrell DR, Smith ZA.
  World Neurosurg. 2019 Jul;127:e436-e442. doi: 10.1016/j.wneu.2019.03.165. Epub 2019 Mar 25.
  PMID: 30922901 [PubMed – indexed for MEDLINE]
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2. Are Magnetic Resonance Imaging Technologies Crucial to Our Understanding of Spinal Conditions?
  Crawford RJ, Fortin M, Weber KA 2nd, Smith A, Elliott JM.
  J Orthop Sports Phys Ther. 2019 May;49(5):320-329. doi: 10.2519/jospt.2019.8793. Epub 2019 Mar 26.
  PMID: 30913967 [PubMed – in process]
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3. Lateral Corticospinal Tract Damage Correlates With Motor Output in Incomplete Spinal Cord Injury.
  Smith AC, Weber KA 2nd, O’Dell DR, Parrish TB, Wasielewski M, Elliott JM.
  Arch Phys Med Rehabil. 2018 Apr;99(4):660-666. doi: 10.1016/j.apmr.2017.10.002. Epub 2017 Oct 26.
  PMID: 29107041 [PubMed – indexed for MEDLINE] Free PMC Article
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4. Evidence for decreased Neurologic Pain Signature activation following thoracic spinal manipulation in healthy volunteers and participants with neck pain.
  Weber Ii KA, Wager TD, Mackey S, Elliott JM, Liu WC, Sparks CL.
  Neuroimage Clin. 2019;24:102042. doi: 10.1016/j.nicl.2019.102042. Epub 2019 Oct 18.
  PMID: 31670070 [PubMed – in process] Free PMC Article
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5. Deep Learning Convolutional Neural Networks for the Automatic Quantification of Muscle Fat Infiltration Following Whiplash Injury.
  Weber KA, Smith AC, Wasielewski M, Eghtesad K, Upadhyayula PA, Wintermark M, Hastie TJ, Parrish TB, Mackey S, Elliott JM.
  Sci Rep. 2019 May 28;9(1):7973. doi: 10.1038/s41598-019-44416-8.
  PMID: 31138878 [PubMed – in process] Free PMC Article
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