Listen as chiropractor and founder of the Cox Technic, Dr. James Cox explains what Cox Technic is and why it is so effective for treating back pain.
James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H)
Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world.
Resources:
About Dr. Cox
The Cox 8 Table by Haven Medical
References:
Chesterton P, Evans W, Wright M, Lolli L, Richardson M, Atkinson G. Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30201-3. doi: 10.1016/j.jmpt.2020.09.005. Epub ahead of print. PMID: 33248746.
INFLUENCE OF LUMBAR MOBILIZATIONS DURING THE NORDIC HAMSTRING EXERCISE ON HAMSTRING MEASURES OF KNEE FLEXOR STRENGTH, FAILURE POINT, AND MUSCLE ACTIVITY: A RANDOMIZED CROSSOVER TRIAL. AFTER SPINAL MOBILIZATION, IMMEDIATE CHANGES IN BILATERAL HAMSTRING FORCE PRODUCTION AND PEAK TORQUE OCCURRED DURING THE NHE. THE EFFECT ON THE NHE FAILURE POINT WAS UNCLEAR. ELECTROMYOGRAPHIC ACTIVITY INCREASED ON THE IPSILATERAL SIDE.
Meet the Nordic hamstring exercise, also known as the Nordic hamstring curl—your potential new favorite go-to that can help keep you healthy while boosting your performance. me 19
Lead researcher Nicol van Dyk, Ph.D., of Aspetar Orthopaedic and Sports Medicine Hospital in Qatar, told Runner’s World the move is simple: Begin in a kneeling position with both ankles secured—tucking your feet under a bar, for example, or having a running buddy hold them down—and then progressively lean forward as slowly as possible while keeping your back straight. When you can’t resist anymore, just fall forward, catching yourself with your hands against the floor. Check out the video below for how to do it properly.
Ekşi MŞ, Özcan-Ekşi EE, Özmen BB, Turgut VU, Huet SE, Dinç T, Kara M, Özgen S, Özek MM, Pamir MN. Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain. J Pediatr Orthop B. 2020 Nov 27. doi: 10.1097/BPB.0000000000000833. Epub ahead of print. PMID: 33252539.
FATTY INFILTRATION IN THE PARASPINAL MUSCLES AND IVDD WERE CLOSELY ASSOCIATED WITH MODIC CHANGES IN CHILDREN AND ADOLESCENTS WITH LBP. LUMBAR IVDD IN CHILDREN AND ADOLESCENTS COULD BE THE RESULT OF A MECHANICAL PATHOLOGY
Karartı C, Özüdoğru A, Basat HÇ, Özsoy İ, Özsoy G, Kodak Mİ, Sezgin H, Uçar İ. Determination of Biodex Balance System Cutoff Scores in Older People With Nonspecific Back Pain: A Cross-sectional Study. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30153-6. doi: 10.1016/j.jmpt.2020.07.006. Epub ahead of print. PMID: 33248744.
DETERMINATION OF BIODEX BALANCE SYSTEM CUTOFF SCORES IN OLDER PEOPLE WITH NONSPECIFIC BACK PAIN: A CROSS-SECTIONAL STUDY
BBS CUTOFF SCORES ARE SENSITIVE AND SPECIFIC IN DISTINGUISHING BETWEEN POOR AND GOOD POSTURAL PERFORMANCE IN OLDER PEOPLE WITH NSLBP.
TRACTION EFFECTS:
TRACTION AND DISTRACTION STUDIES ON WHICH OUR WORK IS BASED.
Luigi Albano, DC introduced the first paper on which I built the remaining studies.
This gives us foundational understanding as to the benefits of placing a spine into distraction prior to producing ranges of motion – IT FIRST REDUCES STENOTIC EFFECTS THAT COULD CAUSE GREATER NERVE AND DRG COMPRESSION AND CHEMICAL INFLAMMATORY IRRITATION. - JMC
Gaowgzeh RAM, Chevidikunnan MF, BinMulayh EA, Khan F. Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial. J Back Musculoskelet Rehabil. 2020;33(2):225-231. doi: 10.3233/BMR-171099. PMID: 31282394.
A COMBINATION OF SPINAL DECOMPRESSION THERAPY WITH CORE STABILIZATION EXERCISE HAS PROVEN TO BE MORE SIGNIFICANT WHEN COMPARED WITH CSE ALONE TO REDUCE PAIN AND DISABILITY IN SUBJECTS WITH CHRONIC LDP.
Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1015-1022. doi: 10.3233/BMR-169581. PMID: 28505956.
THIS STUDY SHOWED THAT PATIENTS WITH LHNP RECEIVED PHYSIOTHERAPY HAD IMPROVEMENT BASED ON CLINICAL AND RADIOLOGIC EVIDENCE. NON-INVASIVE SPINAL DECOMPRESSION THERAPY (NSDT) CAN BE USED AS ASSISTIVE AGENT FOR OTHER PHYSIOTHERAPY METHODS IN TREATMENT OF LUMBAR DISC HERNIATION.
Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):247-253. doi: 10.3233/BMR-160741. PMID: 27636836.
SEGMENTAL TRACTION THERAPY MIGHT PLAY AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LBP STIMULATED BY LDH.
Kamanli A1, Karaca-Acet G, Kaya A, Koc M, Yildirim H Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 247-253, 2017
CONVENTIONAL PHYSICAL THERAPIES WITH LUMBAR TRACTION WERE EFFECTIVE IN THE TREATMENT OF PATIENT WITH SUBACUTE LDH. THESE RESULTS SUGGEST THAT CLINICAL IMPROVEMENT IS NOT CORRELATED WITH THE FINDING OF MRI. PATIENTS WITH LDH SHOULD BE MONITORED CLINICALLY
Choi J, Lee S, Hwangbo G. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci. 2015 Feb;27(2):481-3. doi: 10.1589/jpts.27.481. Epub 2015 Feb 17. PMID: 25729196; PMCID: PMC4339166.
SPINAL DECOMPRESSION THERAPY AND GENERAL TRACTION THERAPY ARE EFFECTIVE AT IMPROVING THE PAIN, DISABILITY, AND SLR OF PATIENTS WITH INTERVERTEBRAL DISC HERNIATION. THUS, SELECTIVE TREATMENT MAY BE REQUIRED
JUDOVICH BD. Herniated cervical disc; a new form of traction therapy. Am J Surg. 1952 Dec;84(6):646-56. doi: 10.1016/0002-9610(52)90127-x. PMID: 12986095.
CLINICAL STUDIES INDICATE THAT IN THE AVERAGE INTRACTABLE CASE THE CERVICAL SPINE SHOULD BE STRETCHED BY FORCE RANGING FROM 25 TO 45 POUNDS. ALMOST HALF THE PATIENTS IN A SERIES OF SIXTY CASES EXPERIENCED PARTIAL OR COMPLETE MOMENTARY RELIEF WHEN THIS FORCE WAS APPLIED.
ROENTGEN STUDIES REVEAL THAT IN THE AVERAGE PATIENT THE INTERVERTEBRAL SPACES OF THE CERVICAL SPINE BEGIN TO SHOW MEASURABLE WIDENING WITH TRACTION FORCE RANGING FROM 25 TO 50 POUNDS.
THE NECESSARY FORCE TO RELIEVE PAIN CANNOT BE TOLERATED BY THE AVERAGE PATIENT WHEN IT IS ADMINISTERED AS A CONSTANT PULL. IF ADMINISTERED INTERMITTENTLY, ADEQUATE AND MUCH GREATER TRACTION LOAD CAN BE TOLERATED WITHOUT THE DISCOMFORT WHICH WOULD NORMALLY ACCOMPANY SUCH FORCE.
A NEW METHOD OF MOTORIZED INTERMITTENT TRACTION IS PRESENTED. THE CLINICAL RESULTS OF INTERMITTENT TRACTION, BECAUSE OF ADEQUATE FORCE, HAVE BEEN EXCELLENT AS COMPARED TO CONVENTIONAL TRACTION METHODS.
Burton AK, Tillotson KM, Cleary J. Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation. Eur Spine J. 2000 Jun;9(3):202-7. doi: 10.1007/s005869900113. PMID: 10905437; PMCID: PMC3611397.
BECAUSE OSTEOPATHIC MANIPULATION PRODUCED A 12-MONTH OUTCOME THAT WAS EQUIVALENT TO CHEMONUCLEOLYSIS, IT CAN BE CONSIDERED AS AN OPTION FOR THE TREATMENT OF SYMPTOMATIC LUMBAR DISC HERNIATION, AT LEAST IN THE ABSENCE OF CLEAR INDICATIONS FOR SURGERY. Further study into the value of manipulation at a more acute stage is warranted.
Kirkaldy-Willis WH, Cassidy JD. Spinal manipulation in the treatment of low-back pain. Can Fam Physician. 1985 Mar;31:535-40. PMID: 21274223; PMCID: PMC2327983.
RESULTS OF SPINAL MANIPULATION IN 283 PATIENTS WITH LOW BACK PAIN ARE PRESENTED. THE PHYSICIAN WHO MAKES USE OF THIS RESOURCE WILL PROVIDE RELIEF FOR MANY PATIENTS.
Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004 Mar-Apr;27(3):197-210. doi: 10.1016/j.jmpt.2003.12.023. PMID: 15129202.
THE APPARENT SAFETY OF SPINAL MANIPULATION, ESPECIALLY WHEN COMPARED WITH OTHER “MEDICALLY ACCEPTED” TREATMENTS FOR LDH, SHOULD STIMULATE ITS USE IN THE CONSERVATIVE TREATMENT PLAN OF LDH.
Kane MD, Karl RD, Swain JH. Effects of Gravity-Facilitated Traction on lntervertebral Dimensions of the Lumbar Spine*. J Orthop Sports Phys Ther. 1985;6(5):281-8. doi: 10.2519/jospt.1985.6.5.281. PMID: 18802302.
MEAN POSTERIOR SEPARATION WAS SIGNIFICANT AT ALL LEVELS EXCEPT L1-L2 AND L5-S1. MEAN INTERVERTEBRAL FORAMINAL SEPARATION WAS SIGNIFICANT AT ALL LEVELS BUT L5-S1. IF INCREASES IN INTERVERTEBRAL DIMENSIONS PLAY A ROLE IN THE RELIEF OF LOW BACK SYNDROME, THEN GRAVITY-FACILITATED TRACTION MAY BE AN EFFECTIVE MODALITY IN THE TREATMENT OF THIS CONDITION.
Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008 Mar;31(3):191-8. doi: 10.1016/j.jmpt.2008.02.001. PMID: 18394495.
TRACTION, ULTRASOUND, AND LOW POWER LASER THERAPIES WERE ALL EFFECTIVE IN THE TREATMENT OF THIS GROUP OF PATIENTS WITH ACUTE LDH. THESE RESULTS SUGGEST THAT CONSERVATIVE MEASURES SUCH AS TRACTION, LASER, AND ULTRASOUND TREATMENTS MIGHT HAVE AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LDH
Chung TS, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology. 2015 Jun;275(3):755-62. doi: 10.1148/radiol.14141400. Epub 2015 Jan 22. Erratum in: Radiology. 2015 Jun;275(3):934-5. PMID: 25611735.
HERNIATED LUMBAR DISKS: REAL-TIME MR IMAGING EVALUATION DURING CONTINUOUS TRACTION
CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.
Isner-Horobeti ME, Dufour SP, Schaeffer M, Sauleau E, Vautravers P, Lecocq J, Dupeyron A. High-Force Versus Low-Force Lumbar Traction in Acute Lumbar Sciatica Due to Disc Herniation: A Preliminary Randomized Trial. J Manipulative Physiol Ther. 2016 Nov-Dec;39(9):645-654. doi: 10.1016/j.jmpt.2016.09.006. Epub 2016 Nov 9. PMID: 27838140.
HIGH-FORCE VERSUS LOW-FORCE LUMBAR TRACTION IN ACUTE LUMBAR SCIATICA DUE TO DISC HERNIATION: A PRELIMINARY RANDOMIZED TRIAL
PATIENTS WITH ACUTE LUMBAR SCIATICA SECONDARY TO DISC HERNIATION WHO RECEIVED 2 WEEKS OF LUMBAR TRACTION REPORTED REDUCED RADICULAR PAIN AND FUNCTIONAL IMPAIRMENT AND IMPROVED WELL-BEING REGARDLESS OF THE TRACTION FORCE GROUP TO WHICH THEY WERE ASSIGNED. THE EFFECTS OF THE TRACTION TREATMENT WERE INDEPENDENT OF THE INITIAL LEVEL OF MEDICATION AND APPEARED TO BE MAINTAINED AT THE 2-WEEK FOLLOW-UP.
DURING THE 2-WEEK FOLLOW-UP AT DAY 28, ONLY THE LT10 GROUP IMPROVED (P < .05) IN VAS (–52%) AND EIFEL SCORES (–46%).
Onel D, Tuzlaci M, Sari H, Demir K. Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine (Phila Pa 1976). 1989 Jan;14(1):82-90. doi: 10.1097/00007632-198901000-00017. PMID: 2913674.
COMPUTED TOMOGRAPHIC INVESTIGATION OF THE EFFECT OF TRACTION ON LUMBAR DISC HERNIATIONS. CHANGES OCCURRING UNDER THE EFFECT OF A TRACTION LOAD OF 45 KG HAVE BEEN EVALUATED IN 30 PATIENTS WITH LUMBAR DISC HERNIATION WITH CT INVESTIGATION. THE HERNIATED NUCLEAR MATERIAL (HNM) HAS RETRACTED IN 11 (78.5%) OF MEDIAN, SIX (66.6%) OF POSTEROLATERAL, AND FOUR (57.1%) OF LATERAL HERNIATIONS.
Clarke J, van Tulder M, Blomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1591-9. doi: 10.1097/01.brs.0000222043.09835.72. PMID: 16778694.
INTERMITTENT OR CONTINUOUS TRACTION AS A SINGLE TREATMENT FOR LBP CANNOT BE RECOMMENDED FOR MIXED GROUPS OF PATIENTS WITH LBP WITH AND WITHOUT SCIATICA. NEITHER CAN TRACTION BE RECOMMENDED FOR PATIENTS WITH SCIATICA BECAUSE OF INCONSISTENT RESULTS AND METHODOLOGICAL PROBLEMS IN MOST OF THE STUDIES INVOLVED. HOWEVER, BECAUSE HIGH-QUALITY STUDIES WITHIN THE FIELD ARE SCARCE, BECAUSE MANY ARE UNDERPOWERED, AND BECAUSE TRACTION OFTEN IS SUPPLIED IN COMBINATION WITH OTHER TREATMENT MODALITIES, THE LITERATURE ALLOWS NO FIRM NEGATIVE CONCLUSION THAT TRACTION, IN A GENERALIZED SENSE, IS NOT AN EFFECTIVE TREATMENT FOR PATIENTS WITH LBP
Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study. Arch Phys Med Rehabil. 2008 Feb;89(2):269-74. doi: 10.1016/j.apmr.2007.06.778. PMID: 18226650.
TRACTION APPLIED IN THE PRONE POSITION USING THE VAX-D FOR 8 WEEKS WAS ASSOCIATED WITH IMPROVEMENTS IN PAIN INTENSITY AND RMDQ SCORES AT DISCHARGE, AND AT 30 AND 180 DAYS AFTER DISCHARGE IN A SAMPLE OF PATIENTS WITH ACTIVITY-LIMITING LBP. CAUSAL RELATIONSHIPS BETWEEN THESE OUTCOMES AND THE INTERVENTION SHOULD NOT BE MADE UNTIL FURTHER STUDY IS PERFORMED USING RANDOMIZED COMPARISON GROUPS.
REAL-TIME MR IMAGING WHILE PERFORMING TRACTION IS POSSIBLE.
Mitchell UH, Beattie PF, Bowden J, Larson R, Wang H. Age-related differences in the response of the L5-S1 intervertebral disc to spinal traction. Musculoskelet Sci Pract. 2017 Oct;31:1-8. doi: 10.1016/j.msksp.2017.06.004. Epub 2017 Jun 9. PMID: 28624722.
TO DETERMINE DIFFERENCES IN THE APPARENT DIFFUSION COEFFICIENT (ADC) OBTAINED WITH LUMBAR DIFFUSION-WEIGHTED IMAGING (DWI) OF THE L5-S1 IVD BEFORE, AND DURING, THE APPLICATION OF LUMBAR TRACTION
STATIC TRACTION WAS ASSOCIATED WITH AN INCREASE IN DIFFUSION OF WATER WITHIN THE L5-S1 IVDS OF MIDDLE-AGE INDIVIDUALS, BUT NOT IN YOUNG ADULTS, SUGGESTING AGE-RELATED DIFFERENCES IN THE DIFFUSION RESPONSE. FURTHER STUDY IS NEEDED TO ASSESS THE RELATIONSHIP BETWEEN THESE FINDINGS AND THE SYMPTOMS OF BACK PAIN.
HIGHLIGHTS:
STATIC TRACTION IS ASSOCIATED WITH AN INCREASE IN ADC IN OLDER DISCS, NOT YOUNGER.
INVERSE RELATIONSHIP BETWEEN BASELINE ADC AND PERCENT INCREASE WITH TRACTION.
FINDINGS SUGGEST PRESENCE OF AGE-RELATED CHANGES IN THE RATE OF DIFFUSION RESPONSE.
SAAL, JEFFREY A., MD; SAAL, JOEL S., MD Nonoperative Treatment of Herniated Lumbar Intervertebral Disc with Radiculopathy: An Outcome Study, Spine: April 1989 - Volume 14 - Issue 4 - p 431-437
64 PATIENTS WITH LUMBAR HERNIATED NUCLEUS PULPOSUS WITHOUT SIGNIFICANT STENOSIS WERE TREATED NON SURGICALLY.
90% GOOD OR EXCELLENT OUTCOME WITH A 92% RETURN TO WORK RATE.
FOR THE SUBGROUPS WITH EXTRUDED DISCS AND SECOND OPINIONS, 87% AND 83% HAD GOOD OR EXCELLENT OUTCOMES, RESPECTIVELY, ALL (100%) OF WHOM RETURNED TO WORK.
SICK LEAVE TIME FOR THESE SUBGROUPS WAS 2.9 MONTHS (+/- 1.4 MONTHS) AND 3.4 MONTHS (+/- 1.7 MONTHS), RESPECTIVELY. THESE RESULTS COMPARED FAVORABLY WITH PREVIOUSLY PUBLISHED SURGICAL STUDIES. FOUR OF SIX PATIENTS WHO REQUIRED SURGERY WERE FOUND TO HAVE STENOSIS AT OPERATION.
Sari H, Akarirmak U, Karacan I, Akman H. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-Mar;21(1):3-11. PMID: 16385939.
DURING TRACTION OF INDIVIDUALS WITH ACUTE LDH THERE WAS A REDUCTION OF THE SIZE OF THE HERNIATION, INCREASED SPACE WITHIN THE SPINAL CANAL, WIDENING OF THE NEURAL FORAMINA, AND DECREASED THICKNESS OF THE PSOAS MUSCLE.
Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther. 2014 Dec;19(6):527-33. doi: 10.1016/j.math.2014.05.004. Epub 2014 May 22. PMID: 24913413. A
COMBINATION OF GLOBAL AXIAL TRACTION AND LOCAL DECOMPRESSION WOULD BE HELPFUL FOR REDUCING TENSILE STRESS ON THE FIBERS OF THE ANNULUS FIBROSUS AND LIGAMENTS, AND INTRADISCAL PRESSURE IN TRACTION THERAPY. THIS STUDY COULD BE USED TO DEVELOP A SAFER AND MORE EFFECTIVE TYPE OF TRACTION THERAPY
Chow DHK, Yuen EMK, Xiao L, Leung MCP. Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study. Musculoskelet Sci Pract. 2017 Jun;29:78-83. doi: 10.1016/j.msksp.2017.03.007. Epub 2017 Mar 20. PMID: 28347933.
HORIZONTAL TRACTION WAS EVIDENTLY EFFECTIVE IN INCREASING THE DISC HEIGHT OF LOWER LUMBAR LEVELS, PARTICULARLY IN THE POSTERIOR REGIONS OF THE DISCS. FURTHER EVIDENCE OF THE EFFECTS OF TRACTION OF DIFFERENT MODES, MAGNITUDES, AND DURATIONS ON THE CHANGE IN DISC HEIGHT IS REQUIRED FOR PROPER CONTROL OF TRACTION APPLIED TO SPECIFIC DISC LEVELS.
HIGHLIGHTS:
MECHANICAL EFFECTS OF TRACTION ON LUMBAR DISCS WAS EVALUATED USING MRI.
HORIZONTAL TRACTION USING 42% OF BODY WEIGHT WAS ASSOCIATED WITH AN INCREASED DISC HEIGHT OF LOWER LUMBAR DISCS.
HORIZONTAL TRACTION ALSO RESULTED IN REDUCED LORDOSIS AND CHANGE IN TILT ANGLE.
THE EFFECTS WERE MORE PROMINENT AT THE POSTERIOR DISCAL REGIONS.
Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14. PMID: 28192789. a systematic review of randomized, controlled trials and systematic reviews published through April 2015 on noninvasive pharmacologic and nonpharmacologic treatments for low back pain. Updated searches were performed through November 2016.
Recommendation 1: Given that most patients with acute or subacute low back pain improve over time regardless of treat-ment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence). (Grade: strong recommendation)
Recommendation 2: For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation (low-quality evidence). (Grade: strong recommendation)
Recommendation 3: In patients with chronic low back pain who have had an inadequate response to nonpharmacologic therapy, clinicians and patients should consider pharmacologic treatment with nonsteroidal anti-inflammatory drugs as first-line therapy, or tramadol or duloxetine as second-line therapy. Clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits out-weigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients. (Grade: weak recommendation, moderate-quality evidence)
Low back pain is one of the most common reasons for physician visits in the United States. Most Americans have experienced low back pain, and approximately one quarter of U.S. adults reported having low back pain lasting at least 1 day in the past 3 months (1).Low back pain is associated with high costs, including those related to health care and indirect costs from missed work or reduced productivity (2). The total costs attributable to low back pain in the United States were estimated at $100 billion in 2006, two thirds of which were indirect costs of lost wages and productivity (3).Low back pain is frequently classified and treated on the basis of symptom duration, potential cause, presence or absence of radicular symptoms, and corresponding anatomical or radiographic abnormalities. Acute back pain is defined as lasting less than 4 week
Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):493-505. doi: 10.7326/M16-2459. Epub 2017 Feb 14. PMID: 28192793.
Background: A 2007 American College of Physicians guideline addressed nonpharmacologic treatment options for low back pain. The current evidence on non-pharmacologic therapies for acute or chronic nonradicular or ra-dicular low back pain from MEDLINE (January 2008 through February 2016), Cochrane Central Register of Controlled Trials, CochraneDatabase of Systematic Reviews, and reference lists.
Evidence continues to support the effectiveness of exercise, psychological therapies, multidisciplinary rehabilitation, spinal manipulation, massage, and acupuncture for chronic low back pain.
Funding Source:Agency for Healthcare Research and Quality. (PROSPERO: CRD42014014735)Ann Intern Med.2017;166:xxx-xxx. doi:10.7326/M16-2459Annals.org
the American College of Physicians (ACP)and American Pain Society (APS) recommended spinal manipulation as a treatment option for acute low back pain and several nonpharmacologic therapies for sub-acute or chronic low back pain.
Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20. PMID: 28429142.
Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset (
If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy.
The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.
Krekoukias G1, Gelalis ID1,2, Xenakis T1, Gioftsos G3, Dimitriadis Z4, Sakellari V3. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23.
MANUAL THERAPY SPINAL MOBILIZATION IS PREFERABLE TO CONVENTIONAL PHYSIOTHERAPY IN ORDER TO REDUCE THE PAIN INTENSITY AND DISABILITY IN SUBJECTS WITH CHRONIC LBP AND ASSOCIATED DISK DEGENERATION. THE FINDINGS OF THIS STUDY MAY LEAD TO THE ESTABLISHMENT OF SPINAL MOBILIZATION AS ONE OF THE MOST PREFERABLE APPROACHES FOR THE MANAGEMENT OF LBP DUE TO DISK DEGENERATION.
REFERENCES FOR 25% RELIEF PAPER BY WIRTH ET AL
Wirth B1, Riner F1, Peterson C1, Humphreys BK1, Farshad M2, Becker S3, Schweinhardt P1. An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment. Chiropr Man Therap. 2019 Feb 5;27:6. doi: 10.1186/s12998-018-0225-8. eCollection 2019.
Refs on minimal clinical improvement determination:
Chung TS1, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology 2015 Jan 22:141400.
CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.
Wong A, Parent E, Dhillon S, Prasad N, Kawchuk G: Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls? Spine: 01 September 2015 - Volume 40 - Issue 17 - p 1329–1337 doi: 10.1097/BRS.0000000000000981
PARTICIPANTS WITH LBP AND ASYMPTOMATIC CONTROLS ATTENDED 3 SESSIONS FOR 7 DAYS. ON SESSIONS 1 AND 2, PARTICIPANTS WITH LBP RECEIVED SMT (+LBP/+SMT, N = 32) WHEREAS ASYMPTOMATIC CONTROLS DID NOT (−LBP/−SMT, N = 57). IN THESE SESSIONS, SPINAL STIFFNESS AND MULTIFIDUS THICKNESS RATIOS WERE OBTAINED BEFORE AND AFTER SMT AND ON DAY 7. RESULTS.
AFTER THE FIRST SMT, SMT RESPONDERS DISPLAYED STATISTICALLY SIGNIFICANT DECREASES IN SPINAL STIFFNESS AND INCREASES IN MULTIFIDUS THICKNESS RATIO SUSTAINED FOR MORE THAN 7 DAYS;
THESE FINDINGS WERE NOT OBSERVED IN OTHER GROUPS. SIMILARLY, ONLY SMT RESPONDERS DISPLAYED SIGNIFICANT POST-SMT IMPROVEMENT IN APPARENT DIFFUSION COEFFICIENTS.
Wong AYL1,2, Parent EC3, Dhillon SS4, Prasad N5, Samartzis D6, Kawchuk GN3. Differential patient responses to spinal manipulative therapy and their relation to spinal degeneration and post-treatment changes in disc diffusion. Eur Spine J. 2019 Jan 2. doi: 10.1007/s00586-018-5851-2.
NON-SPECIFIC LOW BACK PAIN PATIENTS WHO RESPOND WITH >30% RELIEF SHOW HIGHER APPARENT DIFFUSION COEFFICIENT DISC DIFFUSION OF WATER THAN NON POSITIVE RESPONDERS. MRI WAS PERFORMED BEFORE AND AFTER SMT ON DAY 1 OF CARE. OSWESTRY DISABILITY TEST WAS ALSO USED.
Beattie PF, Butts R, Donley JW, Liuzzo DM. The Within-Session Change in Low Back Pain Intensity Following Spinal Manipulative Therapy is Related to Differences in Diffusion of Water in the Intervertebral Discs of the Upper Lumbar Spine and L5-S1. Orthop Sports Phys Ther. 2013 Nov 21.
Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC.
STUDY TO DETERMINE DIFFERENCES IN THE CHANGES IN DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS BETWEEN THOSE SUBJECTS WITH LOW BACK PAIN (LBP) WHO DID, AND DID NOT, REPORT A WITHIN-SESSION REDUCTION IN PAIN INTENSITY FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY (SMT) WAS DONE.
CHANGES IN THE DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS AT THE L1-2, L2-3, AND L5-1 LEVELS APPEAR TO BE RELATED TO DIFFERENCES IN WITHIN-SESSION PAIN REPORTS FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY. PARTICIPANTS UNDERWENT T2- AND DIFFUSION-WEIGHTED LUMBAR MAGNETIC RESONANCE IMAGING SCANS IMMEDIATELY BEFORE, AND AFTER, RECEIVING A SINGLE TREATMENT OF SMTJ
Kuo, Ya-Wen PhD; Hsu, Yu-Chun MS; Chuang, I-Ting MS; Chao, Pen-Hsiu Grace PhD; Wang, Jaw-Lin PhD Spinal Traction Promotes Molecular Transportation in a Simulated Degenerative Intervertebral Disc Model. Spine: April 20th, 2014 - Volume 39 - Issue 9 - p E550
Traction biomechanics studied in the porcine model biomechanical benefits include disc height recovery, foramen enlargement, and intradiscal pressure reduction.
48 thoracic discs were dissected from 8 porcine spines and then divided into 3 groups: intact, degraded without traction, and degraded with traction.
From Day 4 to Day 6, half of the degraded discs received a 30 min traction treatment per day (traction force: 20 kg, loading: unloading = 30 sec: 10 sec).
Traction treatment is effective in enhancing nutrition supply and promoting disc cell proliferation of the degraded discs.
Dr. Lee Hazen, a Cox Certified practitioner and his wife Cheri, a Functional Nutritional Lifestyle practitioner share how they use a wholistic approach to healing by sharing a recent patient story.
Dr. Hazen graduated Cum Laude from Cleveland Chiropractic College of Los Angeles in 1989. After a short post-ceptorship in Burbank, Ca, he was invited to become a resident in Dr. James Cox's clinic. From 1989 until 1998 he was co-director and resident in Ft. Wayne Indiana with Dr. Cox. While there, he attended and completed a 400 hour post-graduate Chiropractic Orthopedics training sponsored by National University of Health Sciences. Dr. Hazen has been serving the Murrieta-Temecula area for 15 years.
As a Cox Technique instructor for the past 25 years, he has taught many chiropractors across the country the use of the specialized decompression table, diagnosis and care of spinal disease. Currently, he is on the post-graduate faculty of National University of Health Sciences.
Lee Hazen D.C. and TCIM is committed to helping you regain and then maintain your quality of life, devoid of spine and extremity pain. Dr. Hazen offers specific protocols for spinal pain relief that are well-researched, well-documented, repeatedly-published and clinically-effective: Cox Technic Flexion-Distraction and Decompression Adjusting Manipulation. The protocols were started 48 years ago by Dr. James M. Cox in Fort Wayne, Indiana. The Cox Technic protocols have evolved as clinical application demands and research studies dictate. We are proud to offer the most cutting-edge, 21st century, non-surgical decompressive spinal pain relief.
RN (Registered Nurse)
ICHC (International Cert. Health Coach)
FNLP (Functional Nutrition Lifestyle Practitioner)
LE (Lifestyle Educator)
Cheri has dedicated her life to serving others and working with people on making true transformational changes in their lives. As a dedicated founder of TCIM, her unique approach to healing and her calming influence are appreciated by everyone that gets the privilege to work with her.
Cheri’s formal training is in Nursing. She graduated from BYU in 1984 and started her career by working on a very busy surgical floor preparing patients for surgery. Throughout her career, she has spent time working at a number of different hospitals in California and Indiana. She has helped countless patients ranging from those faced with cancer to helping mothers deliver babies. Cheri has also graduated from massage therapy school and most recently, she has worked with the love of her life, her husband Dr. Lee Hazen at Chiropractic Works, in Murrieta CA as his medical assistant.
She received her degree as a certified Health Coach from the Institute for Integrative Nutrition. She is excited that her degree and unique life experiences will give her the ability to empower others and help to restore their health and vitality.
Cheri’s unique approach to healing comes from her own first-hand experience with suffering from a life-altering chronic condition. Cheri’s journey through intense pain and chronic fatigue forced her to make permanent lifestyle changes, practice coping skills like deep breathing and meditation, and discover the power that proper nutrition has in reversing the disease process. Now that she is healthy, she has rededicated her life to sharing her story and helping others faced with similar challenges.
Healing is possible…and Cheri is the living proof that her methods work. Cheri makes healing fun, exciting, and breaks everything down into small, obtainable steps. She will never overwhelm a patient with too much information or too much radical change all at once. She understands that this is all a process and she hopes to be viewed as a health partner helping her patients through it all!
Cheri works with patients on the following:
Health Coaching
Stress Management
Diet and Exercise Plans
Lifestyle Changes
Breathing Exercises and Techniques
Encouragement and Reinforcement
Nutritional Consulting
Resources:
Spine specialist, Dr. Elra Morgan shares a story of a young man that collapses while playing basketball.
Dr. Elra Morgan is a chiropractor serving Marine City and the surrounding area. Our chiropractor and the rest of the welcoming team at American Chiropractic Medical Services are committed to providing chiropractic solutions to address your unique needs, whether you are experiencing back pain, neck pain, headaches, or even muscular tightness and tension. You may be searching for pain relief after an accident, experiencing an injury, or if you suffer from a specific condition like chronic back pain or a spinal condition. Even if you are looking to improve your overall health, our chiropractor can help you attain your everyday wellness goals! Visit our testimonials page to find out what our patients are saying about our Marine City chiropractor and our chiropractic care plans.
“I regularly attend and teach continuing education classes to ensure that I stay current and provide you with the highest level of care available.”
“Professional organizations and Memberships are other ways I work to stay current. Membership means that I meet the high standards expected by these groups.”
“I understand the needs of the community and work to ensure that this area and our youth will have a bright future.”
Resources:
Dr. Robert Patterson and his patient share her 30-year history of back pain. Together they tell her story that resulted in back surgery and her treatment that followed to manage her pain.
DR. ROBERT PATTERSON
Dr. Patterson is a native to Overland Park. He graduated Cum Laude from Cleveland Chiropractic College in 1988. He founded Overland Chiropractic Health Services PA in February of 1988 and has been practicing in Overland Park since. He believes in taking a “whole person” approach to patient care. This means looking for the underlying causes of disease, dysfunction, and pain, as opposed to treating the symptoms.
Posture Training
Internal Health Specialist – Loomis System of Enzyme Therapy
Chicago spine specialist, Dr. Peter Meyer shares three very patient similar stories with neck and arm pain who opted not to undergo neck surgery.
In addition to earning his Doctor of Chiropractic from the National College of Chiropractic, Dr. Meyer earned his BA in biology from Illinois Wesleyan University. He is also a Certified Chiropractic Sports Physician® (CCSP®). He also has a degree in sports injuries, and took an additional 200 hours of sports education. Additionally, Dr. Pete has postgraduate training in the following:
Dr. Pete is also a Cox Certified physician for both the cervical and lumbar spines.
“I like the fact that we have required continuing education hours as I love learning.” Dr. Pete loves updating his skills and learning what’s new in the field of chiropractic.
He also stays active professionally as a member of the American Chiropractic Association and the Illinois Chiropractic Society.
Resources:
Call Dr. Meyer's office 773-725-4979
http://thebackdoctorspodcast.com/
The Cox 8 Table by Haven Medical
New York Spine specialist, Dr. Gary Stefanick shares a story of a 68 year old woman who had back surgery, but had continued back pain after the surgery.
A word from Dr. Stefanick:
As a chiropractor in practice for over 34 years in the west village of New York City. I specialize the treatment of acute and chronic spinal conditions through the use of spinal decompression, manipulation, physio and exercise therapy. I am also board certified in musculoskeletal rehabilitation and therefore excel at treating non-spinal conditions such as shoulder, wrist, hip, knee, and ankle pain. I also do excellent work with headache, migraine, and TMJ.
Resources:
49 West 12th, Suite #1E, New York, NY
(212)-243-3080
Dr. Kelly Brinkman chronicles the 10 year back pain history of a 55 year old man and then shares his road to recovery.
Dr. Kelly Brinkman earned her BS degree from Iowa State University in 1983 and graduated from Logan College of Chiropractic in 1990. She has been in private practice in both Illinois and Missouri and has worked on a volunteer medical team on the Pine Ridge Indian Reservation. She finished the Insurance Consultant post graduate program and earned her MCS-P (Medical Compliance Specialist – Physician) in 2009. She has held the position of clinician and Educational Coordinator at Logan and is currently full time faculty. She has taught the Cox Flexion Distraction course since 1991 and has lectured for James Cox DC, DACBR through National College of Chiropractic post graduate department in years past. She also currently teaches the Billing and Documentation and Clinical Reasoning 1 courses and has assisted in numerous other classes.
Resources:
Spine specialist, Dr. Silke Laub shares a case of abdominal pain due to a bulging thoracic disc.
Dr. Silke Laub
Dr. Laub is a Webster & Cox Technic certified Chiropractic Sports Physician. She provides flexion distraction therapy, prenatal and postpartum care, pediatric chiropractic, instrument assisted myofascial release techniques, athletic and functional taping, craniosacral therapy and nutritional counseling. She is currently working towards her goal of becoming a certified pediatric chiropractor.
Resources:
As a board-certified chiropractic orthopedist and certified laser pain management physician, Dr. Ed Barry has spent the past 38 years helping patients get back to all the things they used to do. Over that time, Dr. Barry utilized traditional chiropractic techniques as well as laser therapy to treat a variety of conditions including arthritis, sciatica, spinal stenosis, hip pain, back and neck pain, and carpal tunnel syndrome.
Many years ago, while Dr. Barry was exercising in the gym, he was drawn to a curious apparatus that was specifically designed for toning the abdominal muscles. What made this piece of equipment so interesting was in the design and movement – a bench was fitted with a pivot bearing in the mid-point of the table so the user could alter the plane of movement in the abdomen as you contracted upward, creating resistance to both the anterior and oblique muscles in the abdomen.
That got him thinking about the possibility of creating a device that could combine the two movements of flexion and traction for the lower back. And that’s when the seed for Lift was planted, and with those years of development, refinement, and engineering, Dr. Barry is now proud to introduce Lift to patients all over the world.
Resources:
http://thebackdoctorspodcast.com/
The Cox 8 Table by Haven Medical
Board Certified Physical Medicine & Rehabilitation and Board Certified Pain Management
Helping reduce his patients’ often debilitating pain is why Dr. Scott Taylor is practicing medicine. His main focus is interventional pain management which provides his patients less invasive procedures that fill the gap between major traditional back surgery and conservative care. In practice for 26 years, he finds these procedures offer exciting and new opportunities to help his patients maximize quality of life, maximize function and reduce their pain. Dr. Taylor is a graduate of the Indiana University School of Medicine and completed his internship and residency at the Eastern Virginia Graduate School of Medicine in Norfolk, Virginia.
Resources:
The Cox 8 Table by Haven Medical
The Cox 8 Table made by Haven Medical is essential to the certified Cox Technic doctor. It is a combination of Dr. James Cox's vision and the engineering genius of Mr. Don Wisner and his team at Haven Medical. Mr. Wisner discusses the continuing evolution of the Cox Table and it's application in treatment spine pain and documentation of improving spine function.
About Don Wisner, the President of Haven Medical:
Growing up in Flint, Michigan in the 50’s and 60’s meant there was one thing ingrained in our culture: Cars!
This was the Golden Era of the U.S. Auto Industry and Flint was was a shining gem the crown jewel of Detroit’s auto manufacturing dominance. For the families who lived and worked here, cars were part of our DNA.
Haven’s founder, Don Wisner, grew up in Auto Mecca surrounded by people who loved to get their hands dirty building things, working on things and fixing things; mostly (you guessed it) cars… parts for cars… or tools, equipment and gadgets to work on cars.
Since an early age, Don was afflicted with "Creative A.D.H.D.," the product of a curious mind, an active imagination and a short attention span. His dad trained him not to read instruction or assembly manuals, but to figure out how things went together and worked for himself. (To this day, if Don gets lost he won’t stop to ask directions let alone use his GPS, and he thinks “moderation” – especially when it comes to building stuff to last -- is for wimps).
While most of the boys would run to the ball field or soda shop after school, Don would race home to his Pop’s workshop where he learned first hand how to repair anything that broke, or build anything the family needed but couldn’t afford to go out and buy. That’s how it was done back then.
By the time Don graduated high school he could rebuild an engine in his sleep, but the passion to invent and build things from scratch had him in its grip, so he went on to earn a degree in Engineering from the prestigious Michigan Tech, aka the “MIT of The Midwest.”
After graduating from Michigan Tech, Don quickly became a rising star in General Motors’ Buick and Cadillac Luxury Divisions where he invented ABTS (All Belt To Seat) Technology, a revolutionary new safety system which forever changed the way seat belts function, move and are installed in certain luxury vehicles. ABTS was first used in the Buick Park Avenue and continues to be a standard safety feature to this day.
Resources:
The Cox 8 Table by Haven Medical
http://thebackdoctorspodcast.com/
Spine specialist, Dr. Shawn Nelson shares a story of a woman who had traumatic spine injuries that left her leg and the last four toes of her foot numb for 10 years. He describes how he was able to help this patient return to a higher quality of life.
Dr. Shawn Nelson
My journey to becoming a Chiropractor began as a patient in my early teens. I was being treated for some debilitating migraine headaches that would take my vision from me. I began to get adjustments and these went away. Continued treatment then kept them away. When the time came to make some career choices in high school; I chose Chiropractor, FBI agent, and stuntman (The Fall Guy was my favorite TV show and the impetus for this choice). Due to my natural aptitude in science, my experiences with my own issues, and my overwhelming desire to be able to help in any situation I could; I made my choice.
I was educated my entire life inside the State of Iowa. First attending and graduating from Waldorf College with an AA in pre-med. I continued on at the University of Northern Iowa and then the Palmer College of Undergraduate Studies earning my BS in General Science. I finished my education graduating from Palmer College of Chiropractic in Iowa March of 2002. I have practiced in Michigan continuously since moving here in April of 2002.
My wife and I have 2 boys and a girl which keeps us very active. We have been living in nearby Grosse Pointe Woods for 8 years and stay very active with the local schools and churches. My work ethic was shaped by growing up on our family farm outside my hometown of 500 people. My parents worked full time jobs and I played 5 sports in high school, so we farmed at night when everyone else had gone in for the night. If something broke we were up as long as we needed to be to get ready for the next night.
I have always been around athletics. After high school I was a 2 sport athlete in college on scholarship for both football and wrestling. I continued to receive Chiropractic care through these years specifically after severely spraining my left knee at the end of my freshman years. Once those ended I changed my focus to rugby. I was on scholarship for it through my chiropractic college. My playing career ended in 2012. I played in 2 countries, countless states, and for 6 teams (including a cameo for the Navy). I have coached both the men and women of Detroit. For the last 7 years I have stayed active with refereeing. I have been taking care of athletes nearly 20 years starting in our rehab department in college, treating the whole rugby team in college for a year, and then being the on field trainer and chiropractor for all of the teams I played on and coached for 17 years here in Detroit.
Resources
https://provider.kareo.
http://thebackdoctorspodcast.com/
The Cox 8 Table by Haven Medical
Spine specialist, Dr. Robert Borzone and his patient tell their story of continuation of care from one Certified Cox Technic doctor to another.
Dr. Robert Borzone, DC, LAc, DACBN is a Chiropractor, Licensed Acupuncturist, Diplomate of the American Clinical Board of Nutrition and Certified AMMA Therapist. He received his Bachelor’s degree in Biology and Chemistry from Rider College and his Doctorate degree from New York Chiropractic College. Dr. Borzone is the former Dean of the School of Massage Therapy and Chair of the Science Department of the New York College for Health Professions where he also received his training in acupuncture. He is an adjunct faculty member at Stony Brook University teaching courses on Complementary Medicine and Ancestral Medicine for the School of Social Welfare. Dr. Borzone is an adjunct faculty member at Nassau Community College teaching courses on Nutrition and Biology and has lectured at Hofstra University on Nutrition and Wellness. He is a Diplomate in Acupuncture and Oriental Bodywork through the NCCAOM, a Certified Asian Bodywork Therapy Instructor with the AOBTA and a Certified COX practitioner. Dr. Borzone is a Category A Provider of NCBTMB.Dr. Borzone has dedicated over 30 years to the health professions through education, consulting and professional development. He has lectured extensively in the fields of Oriental Medicine, Nutrition, Back Care and Wellness and has published works in professional journals as well as contributed to books on wellness.
Resources:
Spine specialist, Dr. Jasmine Hornberger and her patient share her story of recovery following a second back surgery.
I have been in private practice at Inspired Health in Grand Haven, MI for just over eight years. I was inspired to move here in 2012 to be close to Lake Michigan and infuse the grounded recommendations of being outside as part of my holistic approach to health and healing. I love nature and enjoy hiking, sailing, paddle boarding and the beach.
I have over 300 post-doctoral hours in functional nutrition and focus on balancing body chemistry using Standard Process whole food supplements. I believe in supporting the internal cellular environment to aid in the recovery of injuries and imbalances. I became Cox Flexion/Distraction certified in the fall of 2015 and have been implementing the gentle traction-force technique in my treatment plans ranging from minor over-use injuries to post-surgical pain syndromes and am trained to handle complex, multi-faceted clinical presentations.
As a lover of movement medicine, I completed my 200 hour yoga teacher training in the summer of 2017 and began teaching twice a week. Yoga and cathartic movement have so many benefits for mind/body health and through rhythmic flow I believe heavy emotions that continue to block growth can finally be released and self-love is then the ultimate gift we can give ourselves. Currently I offer an online subscription of classes I developed called Primal Pulse. Each class varies slightly but includes a warm-up, yoga flow, breath work with aromatherapy and ends with a short meditation to crystal singing bowls.
I love being of service to my community and am passionate about helping people move away from pain-based, reactionary care and focus on long-term prevention and holistic natural living. I believe everyone has the capability to remove interference in their life, restoring mind/body harmony and reclaiming a full and vibrant life.
I look forward to helping you discover your Everyday Alignment,
Dr. Jasmine
Graduated Cum Laude from
Palmer College of Chiropractic, 2011
Resources:
https://www.everyday-alignment.com/
https://www.inspiredchiro.com/
Dr. Steven Baroody shares an interesting story about a woman who receives lots of treatment on her shoulder for shoulder pain, but her shoulder is not the problem.
Dr. Steven Baroody is a 2004 graduate of New York Chiropractic College in Seneca Falls, NY. A martial artist for more than thirty years, he was introduced to chiropractic when he injured his lower back being thrown. The quick recovery that followed, and the opportunity to help others convinced him that chiropractic was the career for him.
Halfway through his education, however, Dr. Baroody sustained a shoulder injury serious enough to require surgery. After the surgery, however, active release therapy (ART) accelerated his rehabilitation and enabled him to return to both chiropractic and the high level of martial arts he had enjoyed before the injury.
Having been through the pain of a chronic injury, and the long search for someone who could help him, Dr. Baroody became very well-versed in the diagnosis and treatment of shoulder injuries, and pursued full certification in ART to allow him to provide the same quality of care that he had received.
Resources:
Australian spine specialist, Dr. Amelia Pappas shares a story about an active 43 year old mother of four who experiences severe back pain that impacts her ability to care for her children.
Your spine is your most important structural asset-, It's the key to movement and function. Dr. Amelia Pappas has been practicing in the Malvern area for over 10 years. Her certification in Cox Therapy has steered her focus towards the management and rehabilitation of disc injuries, pregnancy-related back pain, postural strain and joint dysfunction. Amelia has recently been invited to join the Board of Chiropractic Australia Research Foundation (CARF) who are dedicated to supporting research in the chiropractic profession.
Resources:
Spine specialist, Dr. Tyler Lomnicki shares a story of a gentleman who has many health challenges in addition to his severe back and leg pain.
Dr. Tyler Lomnicki has been in practice since 2014 after graduating from the National University of Health Sciences near his hometown of Chicago, IL. Dr. Tyler is a board certified Chiropractic Orthopedist, achieving Diplomate status from the Academy of Chiropractic Orthopedists in 2016. He is also a board member of the Academy of Chiropractic Orthopedists, serving since late 2018. Dr. Tyler is full-spine certified in Cox® Technic, has completed multiple continuing education courses in Motion Palpation, and is certified in Parts A and B of McKenzie Diagnosis and Treatment®, Lower Extremity Active Release Technique®, is certified as a mobility specialist (FRCms) and Functional Range Release (F.R.) practitioner through Functional Anatomy Seminars.
He lives in Minster, Ohio with his wife Sunni and daughters Drea and Luca.
Resources:
http://thebackdoctorspodcast.com/
The Cox 8 Table by Haven Innovation
Julie Cox-Cid, the daughter of Dr. James Cox, the developer of Cox Technic shares her very personal experience as a patient suffering with a large disc herniation.
Resources:
The Cox 8 Table by Haven Medical
http://thebackdoctorspodcast.com/
Neurosurgeons recommended immediate spine surgery for a former professional football player with neck pain. Dr. Matthew Scott explains how he treated this large man with non-surgical Cox Technic and prevented him from having neck surgery.
About Dr. Scott
Listen as spine specialist and founder of the Cox Technic, Dr. James Cox discuss the non-surgical treatment of scoliosis.
James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H)
Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world.
Resources:
About Dr. Cox
The Cox 8 Table by Haven Medical
References:
McAviney J1, Roberts C2, Sullivan B2, Alevras AJ2, Graham PL3, Brown BT4,5. The prevalence of adult de novo scoliosis: A systematic review and meta-analysis. Eur Spine J. 2020 May 22. doi: 10.1007/s00586-020-06453-0. [Epub ahead of print]
Dai F1, Yu PF1, Liu JT1, Jiang H1. [A 5 year follow-up study on non-surgical treatment of ruptured lumbar disc herniation]. Zhongguo Gu Shang. 2020 May 25;33(5):414-9. doi: 10.12200/j.issn.1003-0034.2020.05.005. [Article in Chinese]
Minetama, Masakazu PT, PhD; Kawakami, Mamoru MD, PhD; Teraguchi, Masatoshi MD, PhD; Kagotani, Ryohei MD, PhD; Mera, Yoshimasa MD; Therapeutic Advantages of Frequent Physical Therapy Sessions for Patients With Lumbar Spinal Stenosis. SPINE: June 1, 2020 - Volume 45 - Issue 11 - p E639-E646
Spears CA1, Hodges SE1, Kiyani M1, Yang Z2, Edwards RM1, Musick A1, Park C1, Parente B1, Lee HJ2, Lad SP1. Healthcare Resource Utilization and Management of Chronic, Refractory Low Back Pain in the United States. Spine (Phila Pa 1976). 2020 May 21. doi: 10.1097/BRS.0000000000003572. [Epub ahead of print]
Tian G, Shen MR, Jiang WG, Xie FR, Wei WW. Case-control study on spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis]. Zhongguo Gu Shang. 2015 Jun;28(6):508-11
Faraj SSA1, Haanstra TM1, Martijn H1, de Kleuver M2, van Royen BJ1. Functional outcome of non-surgical and surgical management for de novo degenerative lumbar scoliosis: a mean follow-up of 10 years. Scoliosis Spinal Disord. 2017 Dec 5;12:35. doi: 10.1186/s13013-017-0143-x. eCollection 2017.
Bao H, Zhu F, Liu Z, et al. Coronal curvature and spinal imbalance in degenerative lumbar scoliosis: disc degeneration is associated. Spine (Phila Pa 1976). 2014;39(24):E1441–E1447. doi:10.1097/BRS.0000000000000603
Kobayashi K1, Ando K1, Nakashima H1, Machino M1, Morozumi M1, Kanbara S1, Ito S1, Inoue T1, Yamaguchi H1, Mishima K1, Ishiguro N1, Imagama S1. Scoliosis Caused by Limb-Length Discrepancy in Children. Asian Spine J. 2020 May 21. doi: 10.31616/asj.2019.0374. [Epub ahead of print]
Aspegren DD1, Cox JM. Correction of progressive idiopathic scoliosis utilizing neuromuscular stimulation and manipulation: a case report. J Manipulative Physiol Ther. 1987 Aug;10(4):147-56.
Tomoki Oshikawa, Gen Adachi, Hiroshi Akuzawa, Yu Okubo, Koji Kaneoka. Change in Regional Activity of the Quadratus Lumborum During Bridge Exercises. J Sport Rehabil. 2020 Apr 22;1-9. doi: 10.1123/jsr.2019-0225. Online ahead of print.
Abdulmonem Alsiddiky 1, Rheema Alfadhil 1, Maram Al-Aqel 1, Noura Ababtain 1, Norah Almajed 1, Khalid Bakarman 1, Waleed Awwad 1, Raheef Alatassi . Assessment of Serum Vitamin D Levels in Surgical Adolescent Idiopathic Scoliosis Patients. BMC Pediatr. 2020 May 11;20(1):202. doi: 10.1186/s12887-020-02114-9.
Erwin J1, Carlson BB1, Bunch J1, Jackson RS1, Burton D2. Impact of unoperated adolescent idiopathic scoliosis in adulthood: a 10-year analysis. Spine Deform. 2020 May 28. doi: 10.1007/s43390-020-00142-0. [Epub ahead of print]
Mariscal G1, Nuñez JH2,3, Figueira P4, Malo A5, Montiel V2, López MA6, Castro M7, Barrios C1, Fern PD8. Validation of the concavity-convexity quotient as a new method to measure the magnitude of scoliosis. J Craniovertebr Junction Spine. 2020 Jan-Mar;11(1):31-35. doi: 10.4103/jcvjs.JCVJS_22_20. Epub 2020 Apr 4.
On this episode, I along with two patients share their stories of back and leg pain after having previous back surgeries.
Hi…I’m Dr. Michael Johnson. I’m a practicing physician specializing in treating spinal related problems. My professional quest for over 25 years has been to find the most effective treatments for the most painful and debilitating spine conditions.
We live, exist, and function in a gravitational environment. This takes a toll on our spine, our posture, and thus our overall health. Conditions such as degenerative disc disease, arthritis, disc herniation, spinal stenosis, previous spine surgery, and pregnancy can cause back pain, leg pain, neck pain, arm pain, and a host of other spinal related symptoms.
My goal is to connect you with a doctor who can help you.
The mission of The Back Doctors is to engage in meaningful exchanges with doctors from around the world who have a similar passion in treating the multitudes of individuals suffering with spine pain. I want to find hope for you. There is help out there, let’s go find it together.
Resources:
The Cox 8 Table by Haven Medical
http://thebackdoctorspodcast.com/
Spine specialist, Dr. Ted Magnuson shares a remarkable story of a wheelchair bond patient who walks again.
Dr. Magnuson practices in Lancaster, CA. He is Cox Technic Certified doctor. Dr. Magnuson treats difficult spine cases, mostly patients with disc issues.
Resources:
Dr. Nima Rahmany talks about the connection of stress and anxiety to chronic pain.
Dr. Nima helps people who are stuck in toxic relationships who, career limbo, and emotional trauma overcome their anxiety and create powerfully aligned relationships by deepening their intimate relationship with the most important person of all: themselves.
Resources:
The "Becoming Trigger Proof" Virtual Workshop
Promo Code: triggerproof
Facebook "Trigger Proof: How to Regulate Stress + Strengthen Immunity
Psychotherapist, Daniel G. Lyman, LCSW, relates the mind-body connection and chronic pain with this patient story.
Daniel G Lyman, LCSW is a licensed psychotherapist and mental health coach, specializing in anxiety, depression, chronic pain (TMS, MBS, Central Sensitization, PPD, Amplified Pain), sexuality and LGBTQ related issues. Based in Los Angeles, California, Daniel also offers Skype Coaching throughout the world. With thousands of hours experience and clients on 5 different continents, Daniel's training and experience can help you reach your goals, including reducing anxiety, overcoming depression, eliminating chronic pain, and much more.
Resources:
Dr. Bret White from Keiser University shares a story about a retired mail worker with back and leg pain as a result of a synovial cyst.
Dr. Bret White is an Assistant Professor for the Keiser University, College of Chiropractic Medicine in West Palm Beach, FL. He is also an Attending Physician in the KUCCM Student Clinic. He was the first chiropractor to hold a faculty position at the prestigious Tufts University School of Medicine in Boston, where he was a Clinical Instructor in the Department of Public Health and Family Medicine for 5 years. Dr. White graduated in 1995 from the New York Chiropractic College. He practiced for 10 years in Boston and has been practicing in south Florida for the last 15 years, with a special emphasis on sports injuries and orthopedics. Dr. White is diplomate of the American Board of Chiropractic Orthopedists.
Resources:
Keiser University Spine Care Clinic