Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast.
In this week’s news: We’ll Be Looking At –
- Back Pain and Work Factors
- And Finally, a Story about Testing for Rotator Cuff Shoulder Injuries
For HealthBeat, This is Dr. Todd Eglow!
Welcome to HealthBeat Podcast #474 recorded August 29, 2014.
HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.
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Back Pain and Work Factors
Gwenllian Wynne-Jones, MD, and colleagues analyzed 11 general practitioners from an existing general practice survey and six physiotherapists selected randomly using “snowball” sampling techniques. Each participant was given a 30-minute interview, and the researchers identified themes contrasted between and within both groups of respondents.
Several themes were identified from the interviews, including approaches to evaluating patients’ work problems, perceived ability to manage work and pain, and policies and penalties in the workplace.
The researchers noted that whereas physiotherapists were more likely to take a structured approach and ask patients about their job and work difficulties, general practitioners were less likely to ask about their patients’ work situations. Additionally, assessing patients’ ability to return to work appeared to cause tension between general practitioners’ roles as “gatekeeper” and patient advocate.
Wynne-Jones and colleagues concluded these health care professionals need to take patients’ work difficulties and their own perceived ability to offer effective guidance in account when working with them. Additionally, to ensure a smooth return to work, practitioners should take into account their patients’ workplace receptivity to their work problems.
As always, also consider discussing all Back and related Spinal Issues with your Doctor of Chiropractic.
Surf to our Show Notes for Links – http://www.healio.com/spine-surgery/pain-management/news/online/%7B521da182-468c-4f88-8f4f-a39b04141d84%7D/management-of-patients-back-pain-in-relation-to-work-presents-difficulties
Testing for Rotator Cuff Shoulder Injuries
Study data have shown no one test can accurately diagnose rotator cuff tears or tendinosis.
Researchers reviewed 139 consecutive patients being examined at two orthopedic clinics for possible rotator cuff lesions. If a diagnosis was uncertain after taking patients’ medical history, a clinician performed physical examinations to diagnose possible lesions.
Arthroscopy and MRI with arthrogram were the reference standards for patients with and without surgery, respectively. Sensitivity, specificity and likelihood ratios were determined to ascertain whether multiple combinations of frequently used tests offered stronger predictions of accurate diagnosis.
Separately, none of the tests were highly sensitive in the diagnosis of rotator cuff tears or tendinosis, according to the researchers.
Additionally, although no combination of tests improved diagnosis sensitivity and specificity, if there was at least one positive test for tendinosis, sensitivity for detecting full-thickness tears was 88.5%.
Internal rotation and lateral rotation lag sign did not improve the likelihood of an accurate diagnosis of subscapularis or supraspinatus tears; however, lateral rotation lag sign was found to demonstrate a discriminatory ability for tear size.
The ideal cutoff for accurately diagnosing a supraspinatus tear was found to be 2.9 cm with a sensitivity of 80% and a specificity of 81.4%, according to the researchers. Subscapularis tests were unable to differentiate tear sizes.
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Finally, I leave you with the following quote:
“It’s not the years in your life that count. It’s the life in your years.”
– Abraham Lincoln
For Chiropractic OnLine Today’s HealthBeat, This has been Dr. Todd Eglow.