Guidelines and recommendations for everything from how to correctly change a light bulb
to appropriately decide on whether to do back surgery pervade
our world. Guidelines are valued by people facing
a new challenge or a new health condition for the first
time. Guidelines for the care of back pain have been available
for years, many recommending non-surgical
care including spinal manipulation as first line treatment. Just how well are
those guidelines followed by involved healthcare practitioners,
by back pain patients? Paulette Hugulet, DC, LLC found these recent reports interesting and thought
our La Grande chiropractic patients would, also. We can all
use them to design and follow a guideline-based
treatment plan.
BACK PAIN TREATMENT GUIDELINES
Your La Grande chiropractor is aware of the current guidelines to best assist you, our La Grande
back pain patient. Back in 2009, the American College of Physicians listed spinal
manipulation in its guidelines’
recommendations of appropriate spinal pain care options.
(1) Paulette Hugulet, DC, LLC uses the well-documented Cox® Technic
System of Spinal Pain Management which has a published algorithm of
decision-making for patients with pain below the knee
and patients who have pain that does not
extend below the knee with a goal of 50% improvement in a month of care. These guidelines came out in 1996
and have been tested in clinic-based data collections through
the years. (2) Such guidelines with research support and
proper clinical application help
our La Grande chiropractic patients!
ARE GUIDELINES BEING FOLLOWED?
We hope so! Nearly 64% of chiropractors say they use (Cox®)
flexion distraction with their spine pain patients and have the algorithm/guideline
accessible to them. Paulette Hugulet, DC, LLC is one of those
chiropractors. Beyond chiropractic, general guidelines for back
pain care are available. Are they followed? A newly
completed review of chiropractic and OT/PT use among 146,087 adults
with low back pain in the past 3 months documented that
chiropractic care or OT/PT care for low back pain increased after
clinical guidelines recommending their care were introduced in
2016. Between 2002 and 2018, a little less than a third of said
adults with low back pain said that they were going
through chiropractic and/or PT/OT with an increase
to a third after the 2016 clinical guidelines were published.
(3) This does demonstrate that guidelines help
with treatment planning but are not always followed. In Denmark
where guidelines for low back pain care are outlined
for primary care before referral found that 33% of
patients had not undergone an adequate course of treatment
in primary care before referral. The patients were on
average 53 years old with almost 50% of them saying
that they’d had pain for over a
year, and 75% saying that they experienced
pain below the knee. (4) Struggles in the healthcare system to follow guidelines are seemingly global.
CHIROPRACTIC’S ROLE
A group of chiropractic leaders compiled
their thoughts on the role of the chiropractor in his/her own
practice, with his/her own patients, within the healthcare community, and
within society for healthcare. Very interesting! Individually,
chiropractors reported themselves as competent
and well-educated spine and musculoskeletal care experts who delivered
evidence-based care based on the latest research,
clinical expertise, and patient values. They delivered
patient-centered care that extends to cooperating with other
healthcare providers with the best interest of the patient in mind. (5) Using guidelines, chiropractors are
confident that they can assist their back pain patients with
their best interests in mind.
CONTACT Paulette Hugulet, DC, LLC
Listen to this PODCAST
with Dr. Ted Siciliano on The Back Doctors Podcast with
Dr. Michael Johnson as he describes how he used The Cox® Technic System of Spinal Pain Management to help
a patient dealing with back pain and foot drop.
Schedule your La Grande chiropractic
appointment soon. Facing a serious episode of back
pain is certainly not equivalent to changing a light bulb for
the first time, but it’s comforting to know that there are published
guidelines to best manage
each task!