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Where Does Good Balance and Coordination Come From? Introduction to Your Proprioceptive System

Where Does Good Balance and Coordination Come From? Introduction to Your Proprioceptive System

balancing-on-fence

Proprioception is a complex system of anatomical checks and balances, neural impulses, and brain functions that controls our sense of balance, coordination, and agility. Put most simply, proprioception is the “sixth sense” that enables you to scratch your head without looking in a mirror or climb a flight of stairs without having to look at each step.

Most of us are so accustomed to proprioception that we take it for granted. Its development starts soon after we are born and is observed in infants as soon as they gain control of their neck muscles. When the infant’s body tilts in any direction, its head also tilts in the opposite direction to level its eyes with the horizon. This “righting reflex” is the beginning of our sense of balance.

More technically, proprioception is your body’s ability to transmit a sense of its position in space, analyze that information, and react—either consciously or unconsciously—to stimuli with the proper movement and force. Proprioceptors are a specialized type of motor and sensory nerve that transmits impulses to the central nervous system (in particular, the area of the brain known as the cerebellum) from stimuli felt by the muscles, tendons, joints, and skin. The impulses transmitted by proprioceptors contain vital information, such as the amount of tension in a particular muscle and the relative position of a body part when it is moving.

, Proprioception is what enables you to reach for a glass and actually find it in space. It is also what allows you to pick up the glass with just the right amount of force, neither dropping it nor breaking it by squeezing too hard. Proprioception is what enables you to keep your balance when walking on uneven surfaces or when riding a bicycle. The impulses from proprioception combine with input received from the vestibular system (the fluid-filled network in the inner ear that enables us to feel the pull of gravity and know which direction is “up”) and with input from the visual system to create our sense of balance.

However, just as our eyes become weaker with age, so can the proprioceptive system, leading to a loss of proper balance. This is one of the reasons that falling is the number one cause of hospital admissions for people over 60. Something has gone wrong with the complex processing of information needed to maintain their balance, so older people are more likely to slip and fall on stairs or on slippery sidewalks and injure themselves.

Fortunately, you can strengthen your proprioceptive system by practicing simple balance exercises, thus keeping keep your sense of balance from weakening as you grow older. There are many forms of inexpensive exercise equipment (such as BOSU or Bongo Boards) that enable you to stand on a platform that is designed to be wobbly. This instability forces your muscles and your proprioceptive system to work more, and thus become stronger. So if you are over the age of 50, you should consider speaking to your chiropractor about exercises to improve your proprioception. They are very simple but can greatly improve your overall sense of balance, therefore significantly reducing your risk of injury from falls as you grow older. To schedule an appointment with Dr. Oblander, call 406-652-3553.

How Much Money You Can Save From Losing Weight at Different Ages

How Much Money You Can Save From Losing Weight at Different Ages

Today we are sharing an article from Forbes magazine on how losing weight can save you money. Just ask our doc – Dr. Greg Oblander, losing weight saves you more than just money. Think that you are doomed to all of the health woes and diseases that have plagued your parents and grandparents? Would it surprise you to know that genetics only affect about 5% of health issues? Yup, it’s true. Our health is mainly determined by our health and lifestyle choices. Love that Big Mac? Well…it doesn’t love you! Today’s article cites a report that estimates that losing weight will save the average person at least $10,000 over a lifetime. We think that estimate is way low. (Think cost of cancer treatment, heart surgery, escalating medical costs). Money issues aside, how much is it worth to you to not have chronic pain, joint issues, arthritis, heart disease, diabetes, cancer…and the list goes on? Deciding now to get rid of extra weight and adopt the habit of exercise and eating real food will save you both health woes and money! An added bonus is that you will learn a greater degree of self-discipline! If you would like to change your lifestyle habits and/or lose weight, we can help! Call our Oblander Chiropractic office at 406-652-3553 and schedule your free consultation!

Please enjoy today’s article from Forbes magazine:

Losing weight can save you money over your lifetime.

Want another reason to lose weight? How about making your wallet heavier? In our study just published in the journal Obesity, we showed how much money that losing weight can save at any age, whether you are Millennial at 20 years old or a member of the Greatest Generation at 80 years old.

Five members of our Global Obesity Prevention Center (GOPC) at Johns Hopkins University (Saeideh Fallah-Fini, Atif Adam, Lawrence J. Cheskin, Sarah M. Bartsch and I) developed a computational model that simulated an adult at different starting ages and weights and calculated what could happen to the person’s weight, health and associated costs over time for the rest of his or her life. (Dr. Fallah-Fini is also an Assistant Professor of Engineering at the California State Polytechnic University.) Think of this model as a virtual person whom we can follow like a friend while the person ages.

For example, a simulated person could start as overweight at age 20 and then with each passing simulated year of the person’s life gain or lose weight and develop different types of chronic weight-related conditions such as diabetes, heart disease and cancer, just like a real person. The simulation would continue until the person died from either age-related causes or a weight-related condition such as having a fatal heart attack.

At the end of the simulation, we could then tabulate the amount of medical costs that occurred (e.g., hospitalizations and medications for stroke) and the amount of productivity losses that resulted (e.g., lost salary from being disabled or missing days of work for hospitalizations, clinic visits, falling ill or passing away early). By running the model with different starting weights (e.g., within the ideal body weight range) and then comparing the results, we could then see how medical costs and productivity losses may change with losing or gaining weight.

The model utilized data from a variety of sources such as the Coronary Artery Disease Risk Development in Young Adults (CARDIA) and Atherosclerosis Risk in Communities (ARIC) studies, the Framingham Heart Study (FRS), the Northern Manhattan Stroke cohort study, the National Cancer Institute database, the National Health Interview Survey, the Medical Expenditure Panel Survey (MEPS) and the Bureau of Labor Statistics. Dr. Adam played a major role in assembling and analyzing all of this data to help construct the model.

On average, going from obesity to normal weight, a 20-year-old could save a net present value of more than $28,000 throughout their lifetime, a 40-year-old more than $30,000, a 50-year-old more than $36,000, a 60-year-old more than $34,000, a 70-year-old more than $29,000 and an 80-year-old more than $16,000.

Going from overweight to an ideal weight range could save more than $10,000 at any age from 20 to 80, peaking at age 60 ($18,604). It may be that “love don’t cost a thing,” but obesity or being overweight certainly do.

In nearly all situations, at least half of these costs are from productivity losses (lost salary). In many cases, productivity losses constituted as high as nearly two-thirds of the costs. Since we used median wages, if you make much more, then losing weight could save you substantially more than the numbers we reported.

These numbers actually may be underestimates because the model focused on just a handful of major weight-related health conditions. We didn’t account for costs associated with a number of other weight-related issues such as joint problems and mental health issues such as anxiety and depression.

Extra weight not only hits you in the gut, but potentially in the heart, the brain, the liver, the kidneys and other parts of the body, and also the wallet.

And since we are all connected with each other via taxes (assuming that you pay taxes), insurance premiums (assuming that you pay for insurance) and the economy (assuming that you are a person and not a wombat), extra weight for someone else also may end up hitting your wallet, too.

Today’s article is shared from the following website: https://www.forbes.com/sites/brucelee/2017/09/27/how-much-money-you-can-save-from-losing-weight-at-different-ages/#7a2e40295c2a

 

Nine Reasons to Lose Weight That Have Nothing to Do with Fitting into Your Skinny Jeans

Nine Reasons to Lose Weight That Have Nothing to Do with Fitting into Your Skinny Jeans

We talk a lot about the importance of reaching a goal weight and how to stay motivated. Sometimes, though, it still seems like a laborious task. If you’re carrying extra weight, you probably already know there are a myriad of health-related reasons to slim down. While it may seem impossible, little steps will carry you bit by bit down your weight loss path to your ultimate goal.While keeping your eyes on the big prize, it may help you to realize that even small changes in your weight may improve blood sugar, blood pressure, heart health, reduce cholesterol, and decrease your chances of developing diabetes. We’ve shared many motivational tips, but did you know that when you lose 10% of your bodyweight, you are instantly healthier? There’s no doubt that dropping weight will make you look and feel better, but there are numerous other benefts that you can realize while on your weight loss journey, which have nothing to do with how you look in your skinny jeans. Read more: Strategies for successful maintenance after weight loss.

Fewer Asthma and Allergy Symptoms

The link may not be immediately obvious, but new research has found that for some people, being overweight can make their asthma and allergy symptoms worse. Carrying excess weight on your body puts a burden on the adrenal glands, and your adrenal glands help manage asthma and allergies. In addition, being overweight strains your respiratory system and can make allergy symptoms worse.

Arthritis Relief

Not only does losing weight help relieve arthritis pain, it can also help keep you from developing arthritis—the less you weigh, the less stress on the joints. In addition, recent studies have shown that when you have arthritis and you lose weight, your pain is reduced and your joint functionality significantly improves.

Less Foot Pain

You may not really think about it, but excess weight can put a lot of pressure on your feet, even if you don’t have arthritis. In a recent study, people who had lost an average of 90 pounds found that their incidence of foot pain lowered by 83%. This is understandable because your feet support your entire body, and therefore your entire body’s weight. Relief from foot pain is motivation enough for losing weight.

Glowing Skin

There are numerous ways being overweight may affect your skin, which is the body’s largest organ. Both skin elasticity and color can be altered by lack of proper nutrition, and a diet high in carbohydrates and sugar can cause pale skin and skin tags. Darkness around the eyes can also signal poor nutrition, such as iron defciency, diabetes, protein anemia, or stress.

Better Mood

When you are overweight, your entire system will be out of balance, including the hormones that affect your mood. Losing weight may increase your overall sense of well-being and decrease feelings of depression. Many overweight people suffer from extreme depression, and depression may increase a person’s chances of being overweight, setting up a cycle that is hard to break.

Improved Cognition and Memory

A recent study found that older adults who were overweight scored worse on cognitions tests than adults who were at a healthy weight. Past studies have linked excess weight in animals to cognitive decline, but little has been previously understood about the interaction between obesity and the brain. However, new research suggests that being overweight weakens the blood-brain barrier, and this allows substances manufactured by fat to flow to the brain. Researchers also discovered that 12 weeks after weight loss, memory significantly improves.

Sounder Sleep

If you’ve ever suffered from insomnia, you understand the benefits of a good night’s sleep. During sleep, your cells are repaired and your brain processes and remembers the day’s events. In fact, the most common prescription for sleep apnea is weight loss. In studies involving people with diabetes and sleep apnea, those who lost a greater amount of weight had the most significant drop in sleep apnea symptoms. It only takes a weight loss of 5% in obese people to start seeing results.

Reverse Type 2 Diabetes

Almost everyone has either heard or read about the global epidemic of type 2 diabetes and its link to obesity. It may be a surprise for many to learn how effective losing weight can be at reversing the impact of type 2 diabetes. In fact, many people can avoid the disease altogether by achieving and maintaining a healthy weight. Studies have shown that type 2 diabetes patients on a restricted eating plan, such as the doctor-supervised ChiroThin Weight Loss Program, were able to lower their blood sugar and insulin levels to normal within seven days. If you have type 2 diabetes, reversing the condition and avoiding future complications could just be the best benefit of your weight-loss journey.

Economic Savings

Many complain that eating a healthy diet is costly, and sometimes it does seem like fast food, junk food, and convenience food is cheaper. However, in the long run, slimming your waist can plump up your wallet. When you calculate the cost of medical bills, missed days at work, short-term disability, low-productivity, workers’ compensation, and more, there is a real difference between the financial health of obese people and their peers who have healthier weights. There’s nothing wrong with wanting to look good in your clothes, but the harsh reality is that being overweight can take up to 20 years off your life. Reducing your weight by even 5% can have a positive effect on your health, and it is a great beginning for your transformation. If you are ready to start your weight loss journey, call our office at Oblander Chiropractic to find out more about the doctor-supervised ChiroThin Weight Loss Program.

 

The office phone number is 406-652-3553

 

 

 

Inspiring Weight Loss Story!

Inspiring Weight Loss Story!

Extreme Makeover features a celebrity trainer helping very overweight individuals reach their weight loss goals. Sometimes, their attitudes aren’t great, but other times, the people on the show are truly amazing, like Sara. Sara is a little person, standing at only 4’5″. She was a nutrition speaker on local television shows at the start of her journey, but ashamed of herself. Not only had she spent her life dealing with her short stature, but she had suffered greatly at the hands of her sister. She turned to eating and by the time she was 37 years old, weighed over 200 pounds.

When she began her time on Extreme Makeover, her first challenge was to climb the stairs of an amphitheater holding an 80 pound weight. The stairs came up past her knees. But she didn’t complain once. She kept going. Slowly, all the people in the theater started to watch her. By the time she reached the last step, the crowd cheered for her.

Her trainer gave her the goal to run a half marathon 6 months after starting her diet and exercise program. Sara said no. She wouldn’t run the half. Instead she would run a full marathon. Her trainer advised against it because it would be extra hard on her body. She’d have to take many extra strides due to her short stature. Sara didn’t care. She ran the whole marathon.

She succeeded in loosing more than half her body weight and becoming a runner, like she had always dreamed.

If you would like to follow Sara’s example and lose weight and begin your inspirational journey of change, be sure to contact our office to get the details on our ChiroThin diet. It is doctor supervised and is amazing in its ability to not only help you lose weight but also learn new and healthier eating habits! What a win/win! Office phone number: 406-652-3553.

Story is shared from the following website: https://www.livin3.com/5-motivational-and-inspiring-short-stories

Chiropractic & Exercise: Perfect Fibromyalgia Treatment

Chiropractic & Exercise: Perfect Fibromyalgia Treatment

Anyone with a chronic pain condition like fibromyalgia knows it can be difficult to adhere to a complex set of treatment instructions: physical therapy, medications, creams, journals, the list goes on. We get busy or forget and sometimes don’t comply completely with the treatment, but sooner or later the pain creeps back in.  It turns out that regular chiropractic visits can actually help fibromyalgia patients adhere to long-term physical-therapy programs, thereby ensuring that patients receive the full benefits of exercise.

In a 2009 study, 55 women with fibromyalgia ages 21-59 years old were divided into two groups: some completed resistance training and the others received chiropractic adjustments in addition to doing resistance training.  Both groups improved significantly with increased upper and lower body strength, decreased pain and tender points, and an improved ability to perform everyday tasks. But the patients who received chiropractic care were more likely to follow the exercise program consistently. They also had more significant improvements in functionality, balance, flexibility, and endurance.

This study confirmed the power of exercise and resistance training to ease the pain of fibromyalgia. At the same time, it demonstrates that combining chiropractic adjustments and physical therapy may enhance the benefits of both treatments.

Panton LB, Figueroa A, Kingsley JD, et al. “Effects of resistance training and chiropractic treatment in women with fibromyalgia.” Journal of Alternative and Complementary Medicine 15.3 (2009): 321-328.

Preventing Sciatica

Preventing Sciatica

Learning the risk factors of sciatica can help you minimize your risk of developing it. A recent study sheds light onto what makes you more likely to develop sciatica.

The study evaluated 5261 participants aged 40-60. Researchers collected data on participants’ occupational class, physical and psychosocial working conditions, body mass index, smoking, leisure-time physical activity, and history of neck and back pain.

Risk factors for sciatica varied based on gender. Women were more likely to have sciatica if they worked in manual occupational class, were overweight, smoked, lived a sedentary lifestyle, and had previous neck and back pain. Among men participants, those employed in semi-professional and manual occupational classes had higher risk levels. Researchers concluded that occupational class, unhealthy lifestyle and a personal history of back and neck pain made patients more likely to develop sciatica.

Chiropractors have been successfully treating sciatica patients for years. If you are having sciatic pain, be sure to call our office to schedule an appointment with Dr. Oblander to assess your risk factors for sciatica and/or receiving effective treatment.

Kaaria S, Leino-Arjas P, Rahkonen O, Lahti J, Lahelma E, Laaksonen M. Risk factors of sciatic pain: A prospective study among middle-aged employees. European Journal of Pain. 2010 Dec 14.

Shared from www.chironexus.net
Risk Factors for Spinal Degeneration

Risk Factors for Spinal Degeneration

As we age, the discs in our spine start to naturally break down due to normal, everyday living . This is commonly referred to as disc degeneration and can result in pain in the neck and/or back area–pain that is felt by almost half of the population 40 years of age or older . For those over 80, this rate doubles to a whopping 80 percent, which makes understanding what factors promote this particular condition critical to raising the quality of life as we enter our later years. Fortunately, recent research provides some very important information in this area.

Disc Degeneration Risk Factors Revealed In Recent Study

On November 9, 2015, a study conducted by health experts from Mie University Graduate School of Medicine in Japan, Osaka University (also in Japan), and Rush University Medical Center in Chicago, Illinois was published in BMC Musculoskeletal Disorders. In this research, these experts followed 197 individuals living in Miyagawa, Japan who were over the age of 65 for a 10-year period, measuring their disc height at two year intervals to determine what factors, if any, contributed to their spinal discs degenerating at a faster rate.

What they discovered was that, over the time span of the study, the participants’ disc height gradually reduced an average of 5.8 percent, with roughly 55 percent experiencing degeneration in one or two of their discs. Furthermore, there were three factors that they identified that increased the likelihood of disc degeneration. They were: 1) being female, 2) having radiographic knee osteoarthritis, and 3) the presence of low back pain when the study began.

Based on these results, women should take extra care to protect the discs in their spinal column, potentially saving themselves from experiencing neck or back pain later in life. Some options for doing this include maintaining a healthy weight, avoiding repeated lifting of heavy objects, and not smoking as studies have found that smokers tend to experience disc degeneration at greater rates than non-smokers . Chiropractic can help with the other two factors.

For instance, in one study published in The Journal of the Canadian Chiropractic Association, researchers looked at 43 different individuals between the ages of 47 and 70 who were experiencing osteoarthritic knee pain. Some participants received treatment three times a week for two weeks and others served as a control. The subjects who engaged in treatment reported more positive results than those who did not, citing that, after the treatments they experienced fewer osteoarthritic symptoms, had greater knee mobility, and felt that it was easier to “perform general activities.” And this was after just two weeks of care.

Chiropractic can also help lower back pain, further reducing the likelihood that your discs will degenerate at a faster rate when you age. That makes this specific remedy beneficial both now and well into the future–ultimately raising your quality of life. If you need to see Dr. Oblander for an adjustment, please be sure to give our office a call at 406-652-3553!

 

 

  • Akeda K, Yamada T, Inoue N, et al. Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly. BMC Musculoskeletal Disorders 2015;16(1):344.
  • Fogelholm RR, Alho AV. Smoking and intervertebral disc degeneration. Medical Hypotheses; 56(4):537-9.
  • Pollard H, Ward G, Hoskins W, Hardy K. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. Journal of the Canadian Chiropractic Associations 2008;52(4):229-42.

 

Article shared from Chironexus.net
“Exercise” Versus “Lifestyle Activity”: How Active Are You—Really?

“Exercise” Versus “Lifestyle Activity”: How Active Are You—Really?

If you are like most people, working out just for the sake of working out does not really appeal (although there are many dedicated gym buffs who couldn’t live without their daily workouts!). We all know that it’s important to exercise regularly if we want to live a long and healthy life. However, if you find the idea of trotting along on a treadmill for 15 minutes and then spending half an hour of working out on Nautilus machines to be about as exciting as a trip to the dentist, then this article is for you!

Experts recommend that we get at least 150 minutes of exercise each week to stay in shape. But many people find taking this much exercise at once (or in three 50-minute stretches) too daunting. The good news is that a recent study conducted by researchers at Boston University that was published in the journal Medicine & Science in Sports & Exercise found that bouts of exercise lasting less than 10 minutes a couple of times daily, such as the kind you get when cleaning the house, were sufficient to meet your weekly exercise needs.

Over 2,000 participants were included in the study, more than half of whom were overweight. Motion detectors were attached to each of the subjects for eight days, and an average of half the participants met their weekly exercise quota of 150 minutes. The average participant met his or her quota with exercise that lasted less than 10 minutes at a time. The types of exercise ranged from moderate (heavy cleaning, walking briskly and sports such as golf and badminton) to vigorous (running, hiking, shoveling and farm work).

As long as the participants met their 150-minute per week quota, no matter the length of their exercise, they had lower body mass index, smaller waists, lower triglycerides and better cholesterol levels than those who did not meet the quota. Assistant professor at Boston University’s School of Medicine, Nicole Glazer, says “But this study really speaks to the idea that some activity is better than nothing. Parking a little bit farther away, getting off the bus one stop early—all of these little things can add up and are related to a healthier profile.”

For years, researchers have studied the effects of exercise from practicing sports or visiting the gym. However, according to Glazer, “This idea of lifestyle activity is one that is under-measured in research studies.” Activities such as taking the stairs instead of the elevator, using a push mower instead of a riding mower, etc. can add up to a significant amount of energy expenditure. Experts still stress that it’s important to also get in some traditional forms of exercise and not merely replace it with lifestyle activity. Still, any exercise is useful.

“The levels of sedentary behavior in this country are alarming. So the concern that someone’s going to stop exercising and instead just get off the bus a stop earlier, that’s not my concern,” Glazer says. “The real concern is, is this a stepping-stone? Is this the way we can get inactive people to do any sort of activity? People will come up with any excuse to not exercise. I don’t need to worry about my giving them one. They’ll be able to think of something.”

Remember Dr. Oblander’s adage: If you don’t use it, you will lose it! Make sure that you figure out a way to move and remain active…no matter what your age is or your athletic ability!

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Chiropractic Safer than Medical Care for Elderly

Chiropractic Safer than Medical Care for Elderly

Many studies have found that chiropractic care is a safe and effective treatment method when dealing with a number of spine-related issues. The American Chiropractic Association even lists a number of research studies on their website that show that it is a valuable treatment method for easing (and sometimes completely resolving) back pain, neck pain, headaches, and more.

While all of this is good news for professionals that practice in the chiropractic field, some researchers wondered if chiropractic was just as safe for elderly patients as it is for younger patients experiencing these types of problems. So, they set out to find the answer, which they did via a retrospective cohort study funded by NIH and the National Center for Complementary and Alternative Medicine, and also which was subsequently printed in Spine upon its completion.

What researchers wanted to discover was whether the relationship between the risk of injury to people 66 years old and older when engaging in chiropractic care was higher than, lower than, or equal to the risk of injury to this same age group after undergoing medical care by their primary care physician. To find their answer, they studied data on Medicare B patients who went to the doctor in 2007 for a neuromusculoskeletal issue, evaluating their risk of injury seven days post-treatment.

They discovered that seniors that received chiropractic care had a 76% lower rate of injury within seven days of treatment when compared to the subjects that met with their primary physician as a result of a neuromusculoskeletal complaint. Researchers also pointed out that they found that males contained within the research group, older study participants, and those with a higher Charlson co-morbidity score were most at risk of injury within the week after acquiring a neuromusculoskeletal issue.

Additionally, certain medical conditions raised the risk of injury, even after chiropractic care. Therefore, chiropractic professionals should consider whether treatment via spinal manipulation is best for “patients with coagulation defects, inflammatory spondylopathy, osteoporosis, aortic aneurysm & dissection, or [those who have engaged in] long term use of anticoagulant therapy” as the increased risk may not be worth the benefits.

Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation. Spine 2014;Dec 9.

Why Chiropractic is Superior for Musculoskeletal Pain

Why Chiropractic is Superior for Musculoskeletal Pain

Countless studies have demonstrated that chiropractic care is a safe and effective way to treat musculoskeletal complaints like back pain, neck pain, or sciatica. Now a new study from Switzerland has looked at the relative benefits of chiropractic compared to medical care for the most common types of pain issues.

In this study, the authors examined data from people who reported spinal, hip, or shoulder pain. 403 patients saw a medical doctor for relief; 316 people saw a chiropractor. Four months after treatment, the patients were asked to fill out a survey reporting on their recovery.

The authors found that:

  • “Patients initially consulting MDs had significantly less reduction in their numerical pain rating score…”
  • Patients who saw MDs  were significantly less satisfied with the care they received and the outcome of that care.
  • Patients who saw a chiropractor had significantly lower healthcare costs for their treatment.

The authors conclude that patients should first be sent to a chiropractor for musculoskeletal problems, rather than a medical doctor:

“The findings of this study support first-contact care provided by DCs as an alternative to first-contact care provided by MDs for a select number of musculoskeletal conditions. Restrictive models of care in which patients are required to contact a medical provider before consulting a chiropractic provider may be counterproductive for patients experiencing the musculoskeletal conditions investigated and possibly others. In addition to potentially reducing health care costs, direct access to chiropractic care may ease the workload on MDs, particularly in areas with poor medical coverage and hence enabling them to focus on complex cases. The minority of patients with complex health problems initially consulting a chiropractic provider would be referred to, or comanaged with, a medical provider to provide optimal care.”

Houweling TAW, Braga AV, Hausheer T, et al. First-Contact Care With a Medical vs Chiropractic Provider After Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes, Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder Pain Patients. Journal of Manipulative and Physiological Therapeutics 2015;38(7):477-83.

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