Friday, December 30, 2005

New York Chiropractor

www.drshoshany.com
New York City Chiropractor, specializing in Disc Decompression, Cold laser therapy, Gentle Chiropractic Care.
212 645 8151

Wednesday, December 28, 2005

New York Chiropractor

www.drshoshany.com
Hope everyone had a great Holiday. I want to let everyone know about the amazing success I have been having with Spinal Decompression therapy. There are only a couple of Chiropractors in New York City that practice this Non Surgical technique that can correct Disc Herniations and alleviate symptoms associated with Disc involvement like radiculopathies. If you or a loved one has a hernaited disc and do not want a surgery have them investigate this Medical breakthrough that is 86% successful! If you live in the New York City area please visit my Web Site for a first visit special at www.drshoshany.com

Monday, December 12, 2005

New York Chiropractor

www.drshoshany.com
The Cost-Effectiveness of Chiropractic for Back and Neck Pain

Two Studies in JMPT Provide Food for Thought
As health care costs continue to escalate, insurance companies, policy-makers - and many health care providers - have begun to embrace the idea of more conservative approaches to the treatment of low back pain and neck pain. Two studies published in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics compare chiropractic care to medical care in the treatment of back and neck pain, with with results demonstrating that chiropractic appears to offer benefits identical or superior to those provided by medical care, while reducing many of the costs and extraneous procedures associated with the medical approach to back and neck pain treatment.
In the first study, researchers examined the cost-effectiveness of chiropractic care compared to medical care for the treatment of low back pain, using questionnaires obtained from almost 2,700 people in Oregon and Washington. All of the patients were at least 18 years old, suffered from acute or chronic low back pain of mechanical origin, and saw either a doctor of chiropractic or a medical doctor for care.
Practitioners in both groups employed a variety of therapies in the quest for pain relief. Chiropractic care included spinal manipulation, physical modalities, exercise plans, and self-care education programs, while medical care included prescription medications, exercise plans, and self-care advice. Approximately 25 percent of the medical patients were referred out for physical therapy.
At the beginning of the study and at various times over the next two years, patients measured the severity and duration of their pain using a visual analogue scale and a revised version of the Oswestry Disability Questionnaire. At 12 months after the initial visit, patients also filled out questionnaires related to physical and mental health, and overall satisfaction with care.
On average, chiropractic office costs were higher for both chronic and acute back pain patients. Analysis revealed that the office costs for chiropractic care were 78 percent to 82 percent higher than medical care for acute patients, and 52 percent to 60 percent higher for chronic patients. However, when total costs (such as referrals to other providers and advanced imaging) were factored into the analysis, the differences were much lower (22 percent higher for chiropractic care of acute patients; 16 percent higher for chronic patients).
Despite the increased costs associated with chiropractic office visits, the treatment delivered by chiropractors appeared to be much more effective. At three months, there was an additional total cost of $5 for chiropractic patients with chronic low back pain, but these patients had an average improvement of 10.5 points in pain scores, and an improvement of 8.8 points in disability ratings, compared to patients treated by an MD.
At 12 months, the cost-effectiveness of chiropractic care for chronic low back pain patients appeared even more evident. The average additional cost for care was $1, but with 7.3- and 5.4-point improvements in pain and disability, and a 3.0-point improvement in physical health. Even more important, chiropractic patients reported far greater satisfaction with the care they received - an average of 18.1 points higher than patients receiving medical care.
"Chiropractic patients with chronic LBP showed an advantage over medical patients in pain, disability, and satisfaction outcomes without additional costs," the authors wrote in their conclusion. "Chronic pain and disability outcomes were clinically important in the short term and of lesser magnitude in the long term. ... With their mission to increase value and respond to patient preferences, health care organizations and policy makers need to re-evaluate the appropriateness of chiropractic as a treatment option for LBP."
In the second study, researchers analyzed claims data from patients who suffered from low back pain or neck pain, and who were enrolled in a managed care health plan via their employers, over a four-year period. Patient data was grouped into four categories, depending on whether the managed care plan had a chiropractic benefit, and whether patients in either plan also received treatment for low back pain or neck pain.
To determine whether chiropractic provided any meaningful benefit, patient claims were compared based on the following procedures: inpatient care for back pain and neck pain; CT/MRI scans related to back pain and neck pain; surgical procedures for back pain and neck pain; and plain-film radiographs. Usage rates for all of the procedures were calculated both on a per-episode basis and a per-patient basis.
When the claims data was analyzed, the researchers found that "the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs were all lower in the cohort with chiropractic coverage" compared to back pain patients with plans that didn't offer a chiropractic benefit. On a per-patient basis, surgery rates for patients with chiropractic coverage were 13.7 percent lower; advanced imaging rates were 20.3 percent lower; inpatient visits were 24.8 percent less frequent; and plain-film radiographs were reduced by 2.2 percent. Similar results were seen when the data was analyzed on a per-episode basis; surgery rates for patients with chiropractic coverage were reduced by 32.1 percent; advanced imaging rates were reduced by 37.2 percent; inpatient visits were reduced by 40.1 percent; and plain-film radiographs were reduced by 23.1 percent.
For patients with neck pain, analysis of the claims data revealed strikingly similar results. According to the authors, "Comparing the cohort with chiropractic coverage to (the) cohort without chiropractic coverage, the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs were all reduced in the cohort with chiropractic coverage." On a per-patient basis, surgery, advanced imaging, inpatient visit, and radiograph rates were reduced by 31.1 percent, 25.7 percent, 31.1 percent, and 12.5 percent, respectively. On a per-episode basis, surgery rates were reduced by 49.4 percent; advanced imaging, 45.6 percent; inpatient visits, 49.5 percent; and plain-film radiographs, 36 percent.
Procedure Rates Among Low Back Pain Patients
Procedure (per patient/episode)
Patients With Chiropractic Coverage
Patients Without Chiropractic Coverage
% Reduction
Surgical rate Per 1,000 patients Per 1,000 episodes
5.883.26
6.814.80
13.7%32.1%
CT/MRI Per 1,000 patients Per 1,000 episodes
77.9543.19
97.7968.88
20.3%37.2%
Inpatient visits Per 1,000 patients Per 1,000 episodes
16.719.26
22.2215.65
24.8%40.1%
Plain-film radiographs Per 1,000 patients Per 1,000 episodes
315.80174.96
322.86174.96
2.2%23.1%
Procedure Rates Among Neck Pain Patients
Procedure (per patient/episode)
Patients With Chiropractic Coverage
Patients Without Chiropractic Coverage
% Reduction
Surgical rate Per 1,000 patients Per 1,000 episodes
7.013.87
10.177.65
31.1%49.4%
CT/MRI Per 1,000 patients Per 1,000 episodes
47.1626.09
63.4847.98
25.7%45.6%
Inpatient visits Per 1,000 patients Per 1,000 episodes
7.213.98
10.477.88
31.1%49.5%
Plain-film radiographs Per 1,000 patients Per 1,000 episodes
282.16156.12
322.49243.74
12.5%36.0%
The authors stopped just short of saying their analysis confirms that chiropractic care results in fewer surgeries and other costly procedures associated with the standard medical treatment of back pain and neck pain: "The conclusion that the presence of a chiropractic benefit results in more appropriate use diagnostic and therapeutic procedures is suggested but not proven by this study." In addition, the authors were unable to prove that chiropractic provided better levels of patient care for back and neck pain, because outcomes such as pain and disability were not included in the study design.
These shortcomings aside, the crux of the study - measuring the effects of a chiropractic benefit on commonly used diagnostic and therapeutic procedures in the treatment of neck pain and back pain-demonstrated clear benefits in favor of chiropractic. As the researchers noted in their conclusion:
"Among employer groups with chiropractic coverage compared with those without such coverage, there is a significant reduction in the use of high-cost and invasive procedures for the treatment of low back pain and neck pain. The presumed mechanism of this effect is the substitution of chiropractic care for medical care for the treatment of back and neck pain. The resultant chiropractic care is far less likely to lead to the use of these invasive procedures."
Implications for Chiropractic
The conclusions reached by the authors of these studies reinforce chiropractic's viability as a cost-effective treatment for both back pain (whether acute or chronic) and neck pain. Additionally, they provide significant points to consider for future studies comparing the effectiveness of chiropractic versus medical care.
Office costs alone should not be considered an appropriate measurement when comparing medical care and chiropractic care. As the first study shows, the costs associated with medical care in a medical doctor's office typically do not include physical therapy, a modality which is often performed in a chiropractic office. In the opinion of the study's authors, these and other referral costs are "the great equalizers for medical and chiropractic care," and the overuse or underuse of these therapies "could have a dramatic effect on relative cost-effectiveness."
Because the chiropractic scope of practice varies from state to state, the type of modalities chiropractors can use to treat back and neck pain may be limited in some instances. The authors of the first study noted that Oregon's scope of practice "included physical modalities, whereas neighboring Washington's did not." As a result, study findings conducted in one region of the country may not necessarily apply to the practice of chiropractic nationwide.
Clinical outcomes are a vital component to any comparison of treatment options for a given condition. In the second study, for example, the researchers observed that because of the significant differences in procedure rates, "it is important to consider which rates represent a more optimal level of care for back pain and neck pain." However, they were unable to determine whether chiropractic care was more effective in relieving back and neck pain because, as they freely admitted, "there are simply no clinical outcomes measured in this study."
These two studies add to the growing body of scientific evidence suggesting chiropractic is a safe, noninvasive, and cost-effective treatment for low back pain and neck pain, especially when compared to traditional medical care. These studies also serve as a guide for future trials and policies related to the delivery of chiropractic care.
Editor's note: The abstracts to both JMPT studies have been reprinted in this issue of Dynamic Chiropractic. Complete copies of both studies are available online at www.mosby.com/jmpt.
Resources
Luo X, Pietrobon R, Sun SX, et al. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine 2004;29:79-86.
Medical Data International, Market and Technology Reports. U.S. Markets for Pain Management Products, Report RP-821922, June 1999.
Nelson CF, Metz RD, LaBrot T. Effects of a managed chiropractic benefit on the use of specific diagnostic and therapeutic procedures in the treatment of low back and neck pain. Journal of Manipulative & Physiological Therapeutics October 2005;28:564-569.
Haas M, Sharma R, Stano M. Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain. Journal of Manipulative & Physiological Therapeutics October 2005;28:555-563.
New York City Chiropractor
www.drshoshany.com

Friday, December 09, 2005

New York Chiropractor

www.drshoshany.com
Are You Suffering From Back Pain?
Back pain is the number one complaint in North America, affecting 80% of us at one time or another. Back problems often mean a permanent loss of some function, forcing you to give up things in your life you may not want to give up. That's the bad news.
The good news is Spinal Disc Decompression. No surgery. No drugs. No incisions or injections. And for most people... no more back pain!
Studies have demonstrated that 86% of patients report good to excellent relief of their symptoms.

Facts About Spinal Disc Decompression
It is a Non-Surgical treatment which is Safe and Painless.
Studies have demonstrated that 86% of patients report good to excellent relief of their symptoms.
Designed to correct the underlying problem, not just relieve the symptoms.
Pre-determined treatment period.
Treatment is covered by most health insurance plans.

Spinal Disc Decompression Is An Effective Treatment For:
Herniated Disc
Degenerative Disc
Sciatica
Facet Syndrome
Spinal Stenosis
Pre / Post Surgical Patients
www.drshoshany.com

Thursday, December 08, 2005

New York Chiropractor

www.drshoshany.com
Disc herniations, Sciatica, Radicular symptoms, try decompression therapy.
Visit www.drshoshany.com

Tuesday, December 06, 2005

New York Chiropractor

www.drshoshany.com
New York chiropractic (chiropractor) in our office specializes in the treatment of musculoskeletal problems.
The chiropractic care in our New York City offices at Downing Chiropractic care is based upon the integrity and alignment of the spine and proper functioning of the nervous system. The care that our chiropractors deliver helps many types of back disorders, neck and back pain, and pain from various joints throughout the body.
These conditions can be caused by herniated disc, sprains and strains, or injuries and accidents , sports injuruies and/or stress. Chiropractic care also often eliminates stress one gets from living a NYC type lifestyle, and generates an overall feeling of well-being.
Using a gentle form of spinal alignment and joint mobilization throughout the body. By manipulating areas like the shoulders, elbows, knees, and feet, greater mobility can be gained in the neck, back, and joints. Chiropractic care also often eliminates stress, generating an overall feeling of well being. There are a few basic types of chiropractic treatments that are commonly called adjustments. The traditional adjustment is rendered by a manual technique. Other types of adjustments use instruments or activators. Some soft tissue manipulation uses acupressure and craniosacral techniques.
New York Chiropractic doctors at Downing Chiropractic have extensive training and experience and are able to select the optimal treatment for your specific condition. There are a few basic types of chiropractic treatments that are commonly called adjustments. The traditional adjustment is rendered by a manual technique in our New York offices. Other types of adjustments use instruments or activators. Some soft tissue manipulation uses acupressure and craniosacral techniques.
The Chiropractic doctors at Downing Chiropractic , located in Downtown, NY have extensive training and experience and are able to select the optimal treatment for your specific condition.
Visit www.drshoshany.com

Monday, December 05, 2005

New York Chiropractor

www.drshoshany.com
New York City Chiropractors

Friday, December 02, 2005

New York Chiropractor

www.drshoshany.com
Manahattan, New York City,
New York chiropractic (chiropractor) in our office specializes in the treatment of musculoskeletal problems.
The chiropractic care in our New York City offices atDowning Chiropractic Center is based upon the integrity and alignment of the spine and proper functioning of the nervous system. The care that our chiropractors deliver helps many types of back disorders, neck and back pain, and pain from various joints throughout the body.
These conditions can be caused by herniated discs, sprains and strains, or injuries and accidents, sports injuries, and/or stress. In our centrally located and convenient Manhattan offices, our chiropractor works under the direction of our physiatrist who makes the initial diagnosis. No other outside prescription is necessary at Downing Chiropractic Center. Chiropractic care also often eliminates stress one gets from living a NYC type lifestyle, and generates an overall feeling of well-being.
Using a gentle form of spinal alignment and joint mobilization throughout the body. By manipulating areas like the shoulders, elbows, knees, and feet, greater mobility can be gained in the neck, back, and joints. Chiropractic care also often eliminates stress, generating an overall feeling of well being. There are a few basic types of chiropractic treatments that are commonly called adjustments. The traditional adjustment is rendered by a manual technique. Other types of adjustments use instruments or activators. Some soft tissue manipulation uses acupressure and craniosacral techniques.
New York Chiropractic doctors at Downing Chiropractic Center have extensive training and experience and are able to select the optimal treatment for your specific condition. There are a few basic types of chiropractic treatments that are commonly called adjustments. The traditional adjustment is rendered by a manual technique in our New York offices. Other types of adjustments use instruments or activators. Some soft tissue manipulation uses acupressure and craniosacral techniques.
www.drshoshany.com

Thursday, December 01, 2005

New York Chiropractor

www.drshoshany.com

America's #1 Choice For Healthcare is Chiropractic - From Yahoo News comes an article titled, "Patient Empowerment Drives Healthcare Changes."

According to the article, "the patient empowerment movement" is changing healthcare and its effects are being felt nationwide.
The article points out that when there is a "4% unemployment economy" and employees are not happy with the healthcare options given by their employers, the employer had better pay attention.
The article suggests that employers give money directly to the employee to allow them the freedom to choose their own healthcare providers and insurance.
According to the article, Dr. David M. Eisenberg, director for alternative medicine research and education at Harvard Medical Center stated that,"In 1997, Americans spent more than $30 billion on alternative therapies like chiropractic, herb supplements, massage and acupuncture--most of it out of pocket."
Dr. Eisenberg further stated that, "Each year, patients make nearly 200 million more visits to complementary providers than primary care physicians in the US" according to the article.
It is important to note that of those 200 million more visits, the majority were made to chiropractic offices making chiropractic the #1 choice for healthcare in the US.
Chiropractors have been educating the public for years and have created more "patient empowerment" than any other healthcare profession in the world.
Through chiropractic, the world has learned that the kingdom of health lies within. Just yesterday, a person (non DC) at a business gathering told me they had just been to their chiropractor that day. The person then said to me, "isn't innate intelligence great?" Yes it is I commented, yes it is.
Yahoo News: Patient Empowerment Drives Healthcare Changes
Are you considering seeing a Chiropractor in the New York City Area? Visit www.drshoshany.com for information about becoming a patient of New York City Chiropractor Dr. Steven Shoshany.