Chiropractic Care & The Department of Veterans Affairs
The Foundation for Chiropractic Progress (F4CP) notes that for more than 10 years, the U.S. Department of Veterans Affairs (VA) has included chiropractic services as part of the standard medical benefits package offered to all enrolled veterans. According to a new study conducted by researchers from the VA Connecticut Healthcare System, published in the Journal of Manipulative and Physiological Therapeutics, the use of chiropractic services and the chiropractic workforce in VA has grown substantially since their introduction over a decade ago. The annual number of chiropractic visits has increased by nearly 700 percent, thus demonstrating more veterans have access to chiropractic care than ever before.
�Our work shows that VA has steadily and substantially increased its use of chiropractic services each year following their implementation in late 2004,� states lead author of the study Anthony J. Lisi, DC, Director of the VA Chiropractic Program, and Chiropractic Section Chief at the VA Connecticut Healthcare System. He adds, �VA chiropractic care includes evidence-based, patient-centered treatment options that are in demand by veterans and referring providers. VA continues its efforts to ensure appropriate access to chiropractic care across the whole system, but as this paper shows, the progress to date has been remarkable.�
Military Healthcare/Chiropractic
Among the multitude of findings during an 11 year period, the study showed that:
? The annual number of patients seen in VA chiropractic clinics increased by 821 percent.
? The annual number of chiropractic visits grew by 693 percent.
? The total number of VA chiropractic clinics climbed 9 percent annually, and the number of chiropractor employees increased by 21 percent annually.
? The average VA chiropractic patient is male, between the ages of 45 and 64, is seen for low back and/or neck conditions, and receives examination, chiropractic spinal manipulation and other health care services.
Co-Author Cynthia A. Brandt, MD, MPH, Health Services Researcher at the VA Connecticut Healthcare System and Professor at Yale University School of Medicine states, �Chiropractic care is an important component in the treatment of veterans with spinal pain conditions. The trends we identified provide a foundation for further research to examine the optimal models of care delivery for patients.�
The study notes: �Our results indicate that VA chiropractic clinics saw a greater percentage of female and younger patients compared with the national VA outpatient population. This demographic tendency is consistent with the cohort of veterans from the recent conflicts in Iraq and Afghanistan, which is known to have a high prevalence of musculoskeletal conditions.�
An Army report recommended the use of alternatives to pain drugs, including chiropractic care, massage and acupuncture. Here, Dr. Frank Lawler gives Spc. David Ash chiropractic treatment, January 7, 2011, in Tacoma, Washington. (Mark Harrison/Seattle Times/MCT)
Veterans With Back Pain
�The growing utilization of chiropractic services among veterans for pain management and other health concerns, particularly those in the Operation Enduring Freedom, Operation Iraqi Freedom, Operation New Dawn and older adult populations, showcases the clear-cut demand for chiropractic care and is a direct reflection of the improved clinical outcomes and high patient satisfaction scores that have been documented previously,� says Sherry McAllister, DC, executive vice president, F4CP. �We commend VA for its participation in ongoing chiropractic research to help further improve the health and well-being of our respected and valued veterans.�
The authors also state that the growth in VA chiropractic use has occurred without additional laws mandating expansion. This suggests an increasing recognition of the value of chiropractic care in VA. In a recent editorial, VA Under Secretary for Health, David J. Shulkin, MD, cited VA�s chiropractic program as one example of the important health care expertise provided to veterans.
Doctors of chiropractic (DCs) � who receive a minimum of seven years of higher level education � provide non-operative management of conditions such as headaches, back pain, neck pain, or pain in joints, via a comprehensive approach including manual techniques and active rehabilitation. Chiropractic services are integrated with primary care, specialty clinics and rehabilitation, and provide a non-pharmacologic option for pain management, as well as general health and wellness concerns.
About Foundation for Chiropractic Progress:
A not-for-profit organization, the Foundation for Chiropractic Progress (F4CP) informs and educates the general public about the value of chiropractic care. Visit www.f4cp.com or call 866-901-F4CP (3427). Social media: Facebook, Twitter, LinkedIn, Pinterest, YouTube.
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Substantial Growth in the Use of Chiropractic Care by the Department of Veterans Affairs. The Foundation for Chiropractic Progress (F4CP) notes that for more than 10 years, the U.S. Department of Veterans Affairs (VA) has included chiropractic services as part of the standard medical benefits package offered to all enrolled veterans.
Super Bowl LI kicks-off with a team of doctors of chiropractic (DC)�to help these professional athletes prevent, manage and care for injuries, as well as, achieve peak performance. The Foundation for Chiropractic Progress� (F4CP), the leading voice of the chiropractic profession, points to the role of DCs with all four play-off teams,and cites data from the Professional Football Chiropractic Society (PFCS) showing on average, a professional football DC performs between 30 to 50 weekly treatments during the regular season � not including training camp or the playoffs.
F4CP� celebrates Super Bowl LI with NFL doctors of chiropractic
New England Patriots Team Chiropractor of 35+ years and proud to attend his ninth Super Bowl, Dr. Michael Miller, states, �During the NFL season, I regularly visit the stadium on my afternoon off from my office, as well as on game days both at home and away. Chiropractic care is emphasized by the head coach, trainers and medical staff as a proactive regimen to prevent injuries, with most of the players receiving adjustments roughly 1-2 times per week.�
He adds that chiropractic care has proven itself over the years in the sports injury arena to be well-accepted as the choice of champions and an integral part of any injury prevention program. �We�ve also earned the respect of other team physicians as a necessary protocol, and are all committed to one goal: keeping the athletes performing at their maximum potential and preventing and managing injuries as they occur.�
He says that chiropractic care provides the athletes with the confidence they need to play without the distraction of pain. �The players are educated about the principles of chiropractic and that it is designed to eliminate the cause of their problem rather than just masking their symptoms.�
Joseph Krzemien, DC, team chiropractor, Atlanta Falcons, says that there is growing evidence and a correlation between football players who receive consistent chiropractic care and a decline in injuries during practice or play:
�During the six seasons I�ve spent with the Atlanta Falcons, my goal has always been to prepare each player�s body to better resist trauma and to speed its natural recovery time,� he says. �This season, the Falcons have been successful for a lot of reasons, but I firmly believe that regular chiropractic care has played an important role in helping us stay healthy and get to Super Bowl LI � I am proud of the role I�ve played in their success.�
For Michael Zoelle, DC, team chiropractor, Green Bay Packers, the trauma experienced by the athletes� bodies during a game is very similar to that of a car accident.
�Ensuring that the joints are functioning properly is critical in the healing process, as well as for injury prevention and optimal performance,� says Dr. Zoelle. �The players recognize that chiropractic care helps them to perform better and heal faster, ultimately leading to better team success.�
DCs receive a minimum of seven years of higher level education, and are qualified to diagnose, treat and manage a broad spectrum of health conditions. They are the primary care professionals for spinal health and well-being. For athletes, chiropractic care helps to reduce the risk of injuries and improve health and performance through enhancements in range of motion, flexibility, balance, muscle strength and other key factors.
On every sideline all over the NFL and NCAA game you will now see chiropractors fixing and maintaining their local teams. In our very own back yard, you will see chiropractors treating El Paso’s finest at most high school games. �UTEP now has Dr. Paul Munoz standing tall ready to help our kids perform better. �The story is getting better each and every year how the public understands joint health as to how it applies to peak performance. �This last Olympics we saw Usain Bolt getting tuned just before his record breaking run. �The day of ushering in alternative care for high performance has for sure landed. �The spine was created to propel the creature faster and to transmit power. �No surprise that most sports have embraced the science and art. �Proud to be a part of the movement…..
One of the most troubling concerns facing our community is domestic violence. In Texas, 1 in 3 adult women has been a victim of domestic violence. Over the past year and a half, the Corpus Christi Caller-Times has done an excellent job of putting domestic violence at the forefront by covering its effects and exploring solutions to reduce the deadly trend. These stories and statistics should motivate all of us to work to better protect victims.
Since the 1980s, the prevention of domestic violence in Texas has been a top priority and much of my legislation supports programs that aim to overcome domestic violence. When I was chairman of the House Criminal Jurisprudence Committee, we held public hearings that discussed the serious problem of women serving prison time for defending themselves against a violent partner. As a result, several members carried legislation to change the laws to help protect victims of family violence.
In 2009, committee Chairman Abel Herrero and I authored Mary’s Law, which allows for GPS monitoring of domestic violence offenders. And most recently, in 2015, I sponsored House Bill 2645, which allows juries to hear more information about family violence and increases accountability for offenders monitored by GPS as part of a protective order. This bill now allows law enforcement to arrest the violator in real time for a violation of a protective order, thereby increasing victim safety and offender accountability.
Funding to help prevent family violence is critical. As vice chairman of the Senate Committee on Finance, I secured a $1 million increase in funding for the Battery Intervention Prevention Program, in which offenders are held accountable for past abusive behavior and taught the fundamentals of leading healthy, nonviolent relationships. The increase in funds allows services to expand and adds innovative approaches to current practice. Additionally, the 2016-2017 budget included $53.9 million for core services provided by family violence programs and $3 million to address unmet needs such as housing and childcare. We will continue to work with advocates to address funding shortfalls for organizations that provide assistance to victims and offenders.
While the Texas Legislature has strengthened laws against abusers to give district attorneys and our communities more tools to protect family violence victims and provide funds for family violence programs, much work remains to be done. In order to end the cycle of violence, our community needs to focus on prevention by raising public awareness while also effectively implementing and enforcing laws.
Implementation is key to protecting victims. It was alarming to learn that the family violence center in our community was closed on weekends. However, through the Coastal Bend Community Coordinated Response Coalition forums, victims and advocates called for change. As a result, Corpus Christi Police Chief Mike Markle implemented changes so that family violence detectives are rotated for weekends and after-hours duty. This is a step in the right direction so that victims of abuse do not live in fear simply because it is a weekend.
One solution to addressing domestic violence is to adopt components from the city of El Paso’s 24-Hour Contact Domestic Violence Initiative. The program takes a proactive and aggressive approach by moving domestic violence cases through the criminal justice system more effectively and focuses on victim outreach. Victim advocates seek face-to-face contact with victims of a domestic violence crimes for which an offender has been arrested within the past 24 hours. We need to collaborate among relevant agencies and discuss how we can improve and adopt El Paso’s model.
It will take more than one person, one agency, or one government entity to curb domestic violence. It will take work from legislators, law enforcement, the probation department, our local family violence shelter, public officials, parents, students and residents throughout our community to ensure we protect victims and hold their abusers accountable. Together, and only together, can we make our community a safer place.
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
The crime victims program continues to help so many in need here in our very own El Paso. As a practicing Chiropractor, I have seen more than my share of domestic dispute violence drama and the physical toll on individuals and families. We touch these individuals and work on their bodies after the ordeals they undergo at the physical and emotional levels. It is this proximity to our patients that allows us to see firsthand the true effects. Logically, the impact of the unseen consequences may not always be physical in nature; the program’s outreach covers the unseen concomitant emotional damage caused by the crimes. The attorney general and district attorney have pledged continued support of this outstanding program. This continues to be great news in our growing city.
�Healthcare in the U.S. and the VA has operated on a �find it, fix it� reactive disease model,� Gaudet said in a recent interview. �What we�re undertaking is truly a paradigm shift that promotes health and wellness.�
As compared to initiating with a patient�s suggested complication or attempting to identify a condition early in its development, Tracy Gaudet believes healthcare providers should begin by understanding the veteran and their ambitions. She explains that medical staff at the VA shouldn�t be asking, �what�s the matter?�, rather, they should be asking, �what matters to you?�. The goal of complete health at the VA is to assist all veterans in order to determine their basic health achievement goals and desires and to also help them focus on all the areas of their lives that affect their health and don�t allow them to reach those goals.
�It�s not just a �feel good� program,� Gaudet noted, �but an approach informed by evidence that makes use of all appropriate therapeutic approaches as well as emphasizing self-care at all points along the spectrum of health and disease.�
This approach often takes veterans out of the clinic. The nine-week, peer-to-peer program emphasizes on guiding veterans through various questions to encourage them to discuss why they want to be healthy, what they want to accomplish and the kinds of relationships they want to have. According to Tracy Gaudet, the results have been astounding. Many veterans have found meaning and purpose in their lives again and connected to healthier lifestyles through these new programs being available at Veterans Affairs clinics. Veterans can then follow through with other available programs to help them reduce stress like meditation or they can increase their overall fitness levels. Additionally, as their health improves, the cost of caring for them drops. The complete health approach encourages veterans to make continuous changes in their health and life which may involve working on their closest relationships.
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
Many medical staff members at the Veterans Affairs Medical Clinics, such as Tracy Gaudet, MD, have been inspired to change their approach to medicine as well as transform the way they handle care to best provide veterans and active duty service members with the best possible benefits and opportunities to improve their health. The VA now focuses on granting veterans the ability to enhance their overall wellness and achieve their goals for well being. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.
Many clinicians at the VA frequently argue whether chiropractic treatment methods, such as spinal adjustments and manual manipulations, are actually effective towards improving injuries and conditions causing chronic back pain. A new research was conducted to determine the effects chiropractic care had with chronic pain symptoms. While the study concluded that spinal adjustments and manual manipulations were similarly as effective as placebo for pain relief, the study did find that individuals demonstrated an increased improvement in disability at 12 weeks after receiving consistent chiropractic treatment, according to a report published in the journal, �Geriatric Orthopedic Surgery & Rehabilitation�.
With the contribution of Paul Dougherty, DC, a staff chiropractor at the Canandaigua VA Medical Center in upstate New York, the authors of the study described that the almost identical improvements between the individuals of the different study groups suggested the presence of a non-specific therapeutic effect from the treatments.
For the study, researchers classified 136 veterans, 65 years old or older, with lower back pain whom had never received chiropractic treatment. The individuals were then divided into two separate groups, with 69 of the veterans receiving spinal adjustments and manual manipulations.
Dougherty explained, �spinal manipulative therapy, or SMT, is where you take a joint to its end range. When you crack your knuckles and squeeze them together, you hear the pop. That pop is the joint changing pressure. SMT is basically doing that, taking a joint that isn�t moving enough and trying to maneuver it to where it moves normally again and changes pressure.�
The other 67 veterans participating in the study were enrolled in a procedure known as sham intervention, where a water-based ultrasound gel is spread across the lower back while the individuals lay face down, followed by the chiropractor rubbing a detuned ultrasound machine across the affected area for approximately 10 minutes. The ultrasound machine made noise but did not transmit any sound waves.
Additionally, the participating veterans from both groups were given an educational pamphlet from the Arthritis Foundation on different varieties of back pain and other symptoms.
After four weeks of twice-a-week treatment, the individuals were evaluated on the fifth week to rate their pain on a standardized scale. Both groups showed comparable pain improvement. Paul Dougherty explained that pain is perception-based, originating equally from the mind as it does from the body, but that disability is a better measure of effectiveness. Dougherty quoted, �Twice a week for four weeks, we met with these patients. We talked to them about their pain. They were touched in a caring and meaningful way. It comes down to this: If people believe they�re going to get better, it changes the way they thing about pain.�
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
For many veterans, since the introduction of chiropractic care as a part of their Medical Benefits Package, their disabilities caused by injuries or conditions as a result of their military service have been effectively improved through the use of spinal adjustments and manual manipulations. In a recent study, chiropractic treatment demonstrated an improvement in veterans disabilities after consistent treatment. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.�
Cheri Bustos, U.S. Representative, D-Moline, toured Healing Heroes in the Heartland, a nonprofit organization which implements alternative medical treatment and care to active duty military members and veterans.
�During the visit, Rep. Bustos joined several HHH volunteers and Ernest Ledtje, a veteran who was being treated by the organization at the time. Healing Heroes in the Heartland provides free chiropractic, acupuncture, reflexology, herbal medicine, nutritional supplements, massage therapy, life coaching and group and art therapy to treat post-traumatic stress disorder (PTSD) through holistic care.
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
A majority of veterans and active duty military members experience a variety of musculoskeletal injuries or conditions as a result of their services. Similarly, many of these individuals are affected by emotional disorders, such as post-traumatic stress. Many are in great need of medical services but currently, a diverse amount of organizations and institutions located around the nation have started providing medical benefits for these valuable individuals. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.
In 2002, President George Bush signed Public Law 107-135, which assures chiropractic treatment for all eligible Veterans Affairs patients. Although, many veterans are not aware this service is available to them, despite its inclusion in their Medical Benefits Package since 2004.
�Additionally, the VA is still seeking to make this service accessible to all veterans requiring care. According to the American Chiropractic Association, or ACA, only 48 of 152 Veterans Affairs Medical Centers currently offer chiropractic care for their patients.
Veterans in general have a higher chance of developing any of these conditions due to the strict nature of their military duties. The Seattle Times stated that merely walking and wearing heavy gear has caused many veterans a variety of musculoskeletal injuries. According to the article by Hal Bernton, �The number of soldiers medically retired from the Army with at least one musculoskeletal condition increased nearly 10-fold from 2003 to 2009.� These numbers were determined according to Army statistics.
Dr. Alex Jimenez D.C.,C.C.S.T’s insight:
Generally, active duty service members and veterans may be at a higher risk of developing musculoskeletal injuries or conditions as a result of the strict nature of their military duties. Even simply wearing heavy gear and walking can cause complications for these valuable individuals. Treating their injuries is important and according to a law signed in 2002, veterans may be eligible for free chiropractic care at participating medical clinics. For more information, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.
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Joseph Krzemien, DC, team chiropractor, Atlanta Falcons, says that there is growing evidence and a correlation between football players who receive consistent chiropractic care and a decline in injuries during practice or play:
