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:
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.
]]>Because back pain is such a common problem, a group of Canadian researchers recently investigated the role that the type of primary caregiver has on financial compensation.
This was a large study of 5,511 patients who experienced a work-related back injury in Ontario, Canada. The patients saw the following providers for their first visit:
The authors set out to “compare the duration of financial compensation for back pain” among patients from each care group.
The study found that chiropractic patients had the shortest amount of time receiving compensation for their pain and also were less likely to have a recurrence.
In addition, chiropractic patients didn’t need to see other healthcare providers for their pain. 75% of chiropractic patients saw no other provider, while 58.6% of physical therapy patients also saw a medical doctor.
The authors conclude:
“The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest.”
Blanchette M, Rivard M, Dionne CE, et al. Association between the type of first healthcare provider and the duration of financial compensation for occupational back pain. Journal of Occupational Rehabilitation 2016 Sep 17.
But researchers at Michigan State University recently found that only about 1 person in 20 actually washes his or her hands properly in even the most obvious hand washing scenario—after using a public restroom. According to a summary by writer Lindsay Abrams of the Atlantic:
“Of 3,749 people observed leaving the bathrooms, 66.9 percent used soap, while 10.3 percent didn’t wash their hands at all. The other 23 percent of people stopped at wetting their hands, in what the researchers, for some reason, call “attempted washing” (as if maybe those people just weren’t sure how to follow through). Although the researchers generously counted the combined time spent washing, rubbing, and rinsing, only 5.3 percent of people spent 15 seconds or longer doing so, thus fulfilling the requirements of proper handwashing. They average time spent was 6 seconds.
Why Hand Washing?
Bacterial and viral infections can be spread when the hands come into contact with infectious respiratory secretions and carry them elsewhere. This happens most often as a result of someone coughing, sneezing, shaking hands, or touching an object that has been in the proximity of a sick person and then touching the face—particularly the nose, mouth or eyes. This is one of the primary ways of transmitting the virus that causes the common cold.
Washing your hands after using the toilet or changing a diaper is of utmost importance, as the ingestion of even the smallest amount of fecal matter can cause serious illness from deadly pathogens such as E. coli, salmonella, giardiasis and hepatitis A, among others. You should also be particularly careful about washing your hands after touching garbage, handling animals or animal waste, visiting or caring for an ill person, or if your hands show visible dirt.
Those who handle food should routinely wash their hands, not only after using the toilet, but also after touching raw meat, fish or poultry, since the microbes present on uncooked food can cause gastrointestinal infections ranging from mild to severe or even life-threatening.
Perhaps those with the greatest need to wash their hands on a regular basis are healthcare workers. Because they’re constantly exposed to sick patients and patients with weakened immune systems, and since they frequently come into contact with contaminated surfaces, these professionals have a special responsibility. Before the importance of hand washing was widely understood within the healthcare community, millions of people became sick or died from infections passed along on the hands of their caregivers. During the 19th century, up to 25% of women died in childbirth from childbed fever (puerperal sepsis), a disease subsequently found to be caused by the bacteria Streptococcus pyogenes. After hand washing was introduced as a standard practice in the delivery room, the rate of death dropped to less than 1%.
It All Begins With Hand Awareness
Here are the “4 Principles of Hand Awareness”:
How to Wash Your Hands the Right Way
To wash your hands properly, you need only two things: soap and clean, running water. If these two things are not available, you can use an alcohol-based hand sanitizer that has a minimum 60% alcohol content.
Before washing your hands, remove all rings and other jewelry. Using running water, wet your hands thoroughly, then apply enough soap to work up a nice lather. Keeping your hands out of the water, rub them together, being sure to scrub both the front and backs of your hands, including your wrists, and also washing between the fingers and under the nails. Do this for 20 seconds, then rinse completely under the running water. Be sure to turn off the taps with a paper towel rather than your bare hand. According to the CDC, the whole process should take about as much time as singing “Happy Birthday” twice.
But What About Drying?
The Mayo Clinic recently published its own comprehensive review and analysis of every known hand washing-related study produced since 1970. Interestingly, their researchers found that drying hands was a key part of preventing the spread of bacteria. They also concluded that paper towels are better than blowers for this purpose. Here’s some of their reasoning:
As chiropractic physicians, we have a special interest in helping our patients (and non-patients, for that matter) avoid illness and injury. This means helping them develop healthy lifestyle habits—like regular hand washing—that prevent disease. We also work closely with them in areas like diet, exercise, sleep and stress management. If you’d like to learn more about what we can do to help you stay healthy and live your life to its fullest, please call or visit our office today!
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Because chiropractic physicians are experts in treating conditions that involve the musculoskeletal and nervous systems (including many common workplace injuries), we have a unique perspective on why they happen, how they can be prevented and the best ways to treat them.
Musculoskeletal Disorders by the Numbers
Let’s start with a long-term trend that’s good news for the nation’s workers but that doesn’t get much media attention. The number of reportable occupational injuries and illnesses has declined steadily across the past decade from 50 cases per 1,000 full-time workers in 2003 to 33 cases in 2013. So progress is clearly being made, even if it doesn’t grab the headlines.
That said, musculoskeletal injuries continue to be among the most common on-the-job injuries, and they can require significant recuperation time. The Bureau of Labor Statistics (BLS) says that musculoskeletal disorders (MSD) “are injuries or illnesses affecting the connective tissues of the body such as muscles, nerves, tendons, joints, cartilage, or spinal disks.”
A very high percentage—about one-third—of 2013 workplace injury and illness cases that required days off from work involved the musculoskeletal system. Plus, workers who sustained musculoskeletal injuries required more time to recover before returning to work—a median of 11 days to recuperate compared with 8 days for all types of workplace injury and illness cases. In 2011:
As we mentioned earlier, though, MSDs are not distributed evenly across all industries and occupations.
So it’s clear from the numbers that the dangerous jobs featured on reality TV shows (think about Deadliest Catch and Ice Road Truckers) aren’t necessarily the ones that result in the most MSD-related visits to the chiropractor or general practitioner.
The Role of Chiropractic Care in Prevention and Treatment
Over the past several years, companies of all sizes have become increasingly interested in occupational health and wellness programs. Chiropractic physicians have a special interest in working with employees and business managers alike to help prevent job-related injuries and to encourage a healthy, productive work environment. If you’d like to learn more, we encourage you to call or visit our office today.
Chiropractic care can be one of the most effective ways to treat musculoskeletal pain and accelerate recovery. Dr. Oblander has the training and experience necessary to successfully diagnose and treat a wide range of workplace injuries, and he’ll be happy to answer any questions you may have! So if you or someone you care about has recently been hurt on the job, please give us a call at 406-652-3553 or stop by either of our Billings chiropractic offices. We have an office located at 3307 Grand Avenue and an office at 410 Wicks Lane in the Heights and we’re here to help!
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A recent evidence-based report on the effectiveness of chiropractic treatment for people dealing with low back and neck pain contains some very good news. And it’s good news for three important groups of people—patients who benefit from chiropractic, employers who sponsor health care plans, and insurance companies who manage the costs.
The report is called “Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans?”. It was prepared for the Foundation for Chiropractic Progress by a panel of esteemed medical authors who were tasked with investigating the clinical effectiveness and economic efficiency of today’s chiropractic care.
In their summary, the authors concluded that chiropractic care is “more effective than other modalities in treating low back pain and neck pain.” In terms of cost, they determined that chiropractic care for low back pain, compared with medical physician care, increased annual spending per patient by only $75 per year. For neck pain, there was actually a cost savings – the cost of chiropractic care compared with medical physician care was reduced by $302 per year.
In terms of overall cost-effectiveness, the authors of the report concluded: “When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.” They also concluded that their cost-savings estimates were likely to be “understated” since their analysis didn’t capture reduced spending on over-the-counter and prescription medications that would have been associated with conventional treatment.
This should indeed be seen as good news by the many Americans who already use chiropractic care to treat their back and neck pain. It should also be considered good news for American employers and health care providers concerned about providing the best value for every dollar in their health benefit plans. But the good news isn’t limited to the US—the researchers found the effectiveness and cost figures also applied in the European Union.
The report authors concluded with an even stronger statement in favor of chiropractic care: “Our findings in combination with existing US studies published in peer-reviewed scientific journals suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorably to most therapies that are routinely covered in US health benefit plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.”
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