# The Clinical Compass

> Evidence. Education. Empowerment.


## Posts

- [Best Practices for Chiropractic Management of Adult Patients With Mechanical Low Back Pain: A Clinical Practice Guideline for Chiropractors in the United States](https://clinicalcompass.org/clinical-guidelines/best-practices-for-chiropractic-management-of-adult-patients-with-mechanical-low-back-pain-a-clinical-practice-guideline-for-chiropractors-in-the-united-states/)
- [The Clinical Compass 2021 Fall-Winter Progress Report](https://clinicalcompass.org/news/the-clinical-compass-2021-fall-winter-progress-report/)
- [Best practices recommendations for chiropractic care for pregnant and postpartum patients: results of a consensus process. J Manipulative Physiol Ther 2021](https://clinicalcompass.org/clinical-guidelines/best-practices-recommendations-for-chiropractic-care-for-pregnant-and-postpartum-patients-results-of-a-consensus-process-j-manipulative-physiol-ther-2021/)
- [The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline](https://clinicalcompass.org/clinical-guidelines/the-role-of-chiropractic-care-in-providing-health-promotion-and-clinical-preventive-services-for-adult-patients-with-musculoskeletal-pain-a-clinical-practice-guideline/)
- [Resources for Providers and Patients](https://clinicalcompass.org/news/resources-for-providers-and-patients/)
- [COVID-19 Prevention and Treatment](https://clinicalcompass.org/clinical-guidelines/covid-19-prevention-and-treatment/): Covid-19 Prevention and Treatment Prepared by: Tom Augat, DC, MS, CCSP, FASA Ronald Farabaugh, DC, CCSP Wayne Whalen, DC, FIACN, FICC Alec Schielke, DC Jay Greenstein, DC, CCSP, CCFI-L1, CKTP, FMS Cheryl Hawk, DC, PhD, CHES, LMT Purpose: The purpose of this paper is to provide relevant, timely, and accurate information regarding conventional medical and non-pharmacologic treatment and prevention options regarding COVID-19. The Clinical Compass (Council on Chiropractic Guidelines and Practice Parameters) recognizes the worldwide impact of COVID-19 and is concerned over the distribution of inadequate, misleading, and often inaccurate information spread primarily over social media. Background: The Clinical Compass| Continue reading
- [Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline](https://clinicalcompass.org/clinical-guidelines/best-practices-for-chiropractic-management-of-patients-with-chronic-musculoskeletal-pain-a-clinical-practice-guideline/)
- [The Clinical Compass Fall Progress Report](https://clinicalcompass.org/news/the-clinical-compass-fall-progress-report/): Published The mission of the Clinical Compass is to improve patient outcomes by advancing evidence – based care in an effort to transform healthcare through knowledge translation. The Clinical Compass collaborates with every major chiropractic organization, many states and their respective associations, individual chiropractors, as well as other healthcare providers interested in providing the best, most evidence based care to their patients. Participation and process are as transparent as possible and a diverse cross-section of the chiropractic profession is represented. Since November 2019, the Clinical Compass has written, funded, or contributed to numerous publications: Journal of Manipulative and Physiological Therapeutics| Continue reading
- [Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review](https://clinicalcompass.org/clinical-guidelines/chiropractic-care-for-adults-with-pregnancy-related-low-back-pelvic-girdle-pain-or-combination-pain-a-systematic-review/)
- [Clinical Compass Anti-Racism and Solidarity Statement](https://clinicalcompass.org/news/clinical-compass-anti-racism-and-solidarity-statement/): The Clinical Compass is standing in solidarity with the American Black Chiropractic Association (ABCA), peaceful protesters, and our global community, as we work to end racism and health disparity. Diversity is critical to the chiropractic profession’s ability to maximize positive impact, specifically, for Black communities. Diversity propels innovation and collective success. Making diversity a priority, we commit to making necessary changes within our organization to facilitate equality, opportunity, and justice for all persons. The magnitude of the moment additionally calls us to collaborate to address the unique disparities faced by Black Americans. None of us alone can save the nation| Continue reading
- [Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain](https://clinicalcompass.org/clinical-guidelines/best-practice-recommendations-for-chiropractic-management-of-patients-with-neck-pain/)
- [Council on Chiropractic Guidelines and Practice Parameters Best Practice: Common Questions & Answers](https://clinicalcompass.org/other-good-stuff/council-on-chiropractic-guidelines-and-practice-parameters-best-practice-common-questions-answers/): Council on Chiropractic Guidelines and Practice Parameters Best Practice: Common Questions & Answers Eugene A. Lewis, DC, MPH CCGPP Chairman The best practice initiative undertaken by the Chiropractic Guidelines and Practice Parameters is progressing at a steady pace, with the Introduction and first completed chapter of the document (lumbar spine disorders) scheduled for release in early 2005. The dedicated volunteers of the Commission who are compiling the literature strive to be as thorough as possible. The sheer volume of research gathered to date is very impressive and will no doubt result in reliable evidence-based treatment options for all types of| Continue reading
- [The Chiropractic Report: March 2009](https://clinicalcompass.org/other-good-stuff/the-chiropractic-report-march-2009/): The Chiropractic Report: March 2009 The Chiropractic Report is an international review of professional and research issues published six times annually. You are welcome to use extracts from this Report. Kindly acknowledge the source. Subscribers may photocopy the Report or order additional copies (.80 cents each, plus shipping – minimum of 20 copies) for personal, noncommercial use in association with their practices. However, neither the complete Report nor the majority or whole of the leading article may be reproduced in any other form without written permission. The opinions and statements in this publication are those of the individual authors alone,| Continue reading
- [Council on Chiropractic Guidelines and Practice Parameters Best Practice: How Valid is This Document or Process?](https://clinicalcompass.org/other-good-stuff/council-on-chiropractic-guidelines-and-practice-parameters-best-practice-how-valid-is-this-document-or-process/): Council on Chiropractic Guidelines and Practice Parameters Best Practice: How Valid is This Document or Process? Jeffrey R. Cates, DC, MS, DABCO, DABCC As you may or may not know, a new initiative is currently underway that has the potential to impact your practice in a positive and significant manner. But how do we know the resultant guideline will be any more or less credible than any other guideline? This article will help illuminate the difference between a “best practice (BP) initiative” and a “guideline”, as well as explain how the process insures that the current initiative is above reproach.| Continue reading
- [Council on Chiropractic Guidelines and Practice Parameters Best Practice: The Chiropractic Clinical Compass](https://clinicalcompass.org/other-good-stuff/council-on-chiropractic-guidelines-and-practice-parameters-best-practice-the-chiropractic-clinical-compass/): Council on Chiropractic Guidelines and Practice Parameters Best Practice: The Chiropractic Clinical Compass Mark Dehen, D.C. The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is currently in the process of developing the new Chiropractic Clinical Compass. This is a best practices document designed to direct the doctor of chiropractic toward a comprehensive health solution for the patient, rather than providing only a cookbook recipe for a particular condition. The Chiropractic Clinical Compass will accomplish this by providing the field practitioner with the latest, most comprehensive compilation of relevant research available, while also incorporating the doctor’s experience, the patient’s preferences,| Continue reading
- [Council on Chiropractic Guidelines and Practice Parameters Best Practice: The Process to Select Revelant Research](https://clinicalcompass.org/other-good-stuff/council-on-chiropractic-guidelines-and-practice-parameters-best-practice-the-process-to-select-revelant-research/): Council on Chiropractic Guidelines and Practice Parameters Best Practice: The Process to Select Revelant Research By John J. Triano, D.C., PhD The pace at which information is being published is almost too intense to conceive. Critical appraisal of the literature is a skill unto itself. It has been estimated that if an individual attempted to keep up with all the literature related to their own discipline by reading one article per day, by the end of one year he / she would be 99 years behind. The AHCPR guidelines; which were the first governmentally sanctioned review leading to the recognition| Continue reading
- [The "Best Practice" Initiative: What is it?](https://clinicalcompass.org/other-good-stuff/the-best-practice-initiative-what-is-it/): The “Best Practice” Initiative: What is it? By Ronald J. Farabaugh, D.C.  |  Board member, Council on Chiropractic Guidelines and Practice Parameters A rumor has it that the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is developing a new guideline. I say rumor, because like all rumors the information released so far has been filled with a combination of fact, fiction, and at times outright misinformation. I intend on producing a series of short articles over the next six months explaining the facts in an effort to help the Chiropractic profession understand the process, and the difference between a| Continue reading
- [Literature Syntheses for the Council on Chiropractic Guidelines and Practice Parameters: Methodology](https://clinicalcompass.org/other-good-stuff/literature-syntheses-for-the-council-on-chiropractic-guidelines-and-practice-parameters-methodology/): Literature Syntheses for the Council on Chiropractic Guidelines and Practice Parameters: Methodology Journal of Manipulative and Physiological Therapeutics | Council on Chiropractic Guidelines and Practice Parameters | VOLUME 31, ISSUE 9, P645-650, NOVEMBER 01, 2008 John J. Triano, DC, PhD Abstract Objective The purpose of this project was to initiate an iterative process for systematic review of the literature involving a broad spectrum of individuals with experience across multiple domains (clinicians, educators, clinical scientists, and politically active) within the chiropractic profession. Methods The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with developing literature| Continue reading
- [What Constitutes Evidence for Best Practice?](https://clinicalcompass.org/other-good-stuff/what-constitutes-evidence-for-best-practice/): What Constitutes Evidence for Best Practice? Journal of Manipulative and Physiological Therapeutics | VOLUME 31, ISSUE 9, P637-643, NOVEMBER 01, 2008 John J. Triano, DC, PhD Abstract The guiding principles, methods, and common factors that serve as the foundation for the Commission of the Council on Chiropractic Guidelines and Practice Parameters best practices initiative are discussed in the context of the chiropractic practice environment. FULL ARTICLE: What Constitutes Evidence for Best Practice?
- [Chiropractic Management of Low Back Disorders: Report from a Consensus Process](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-low-back-disorders-report-from-a-consensus-process/): Chiropractic Management of Low Back Disorders: Report From a Consensus Process Journal of Manipulative and Physiological Therapeutics | Council on Chiropractic Guidelines and Practice Parameters | VOLUME 31, ISSUE 9, P651-658, NOVEMBER 01, 2008 Gary A. Globe, MBA, DC, PhD  |  Craig E. Morris, DC  |  Wayne M. Whalen, DC  |  Ronald J. Farabaugh, DC  |  Cheryl Hawk, DC, PhD Abstract Objective Although a number of guidelines addressing manipulation, an important component of chiropractic professional care, exist, none to date have incorporated a broad-based consensus of chiropractic research and clinical experts representing mainstream chiropractic practice into a practical document designed| Continue reading
- [Chiropractic Management of Low Back Pain and Low Back-Related Leg Complaints: A Literature Synthesis](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-low-back-pain-and-low-back-related-leg-complaints-a-literature-synthesis/): Chiropractic Management of Low Back Pain and Low Back-Related Leg Complaints: A Literature Synthesis Journal of Manipulative and Physiological Therapeutics | Council on Chiropractic Guideline and Practice Parameters | VOLUME 31, ISSUE 9, P659-674, NOVEMBER 01, 2008 Dana J. Lawrence, DC, MMedEd  |  William Meeker, DC, MPH  |  Richard Branson, DC  |  Gert Bronfort, DC, PhD  |  Jeff R. Cates, DC, MS  |  Mitch Haas, DC, MA  |  Michael Haneline, DC, MPH  |  Marc Micozzi, MD, PhD  |  William Updyke, DC  |  Robert Mootz, DC  |  John J. Triano, DC, PhD  |  Cheryl Hawk, DC, PhD Abstract Objectives The purpose| Continue reading
- [Manipulative Therapy of Lower Extremity Conditions: Summary of Clinical Practice](https://clinicalcompass.org/other-good-stuff/manipulative-therapy-of-lower-extremity-conditions-summary-of-clinical-practice/): Manipulative Therapy of Lower Extremity Conditions: Summary of Clinical Practice Recommendations Commission of the Council on Chiropractic Guidelines and Practice Parameters Process and Methods The Council on Chiropractic Guidelines and Practice Parameters (CCGPP), was formed in 1995 at the behest of the Congress of Chiropractic State Associations (COCSA) and with assistance from the American Chiropractic Association, Association of Chiropractic Colleges, Council on Chiropractic Education, Federation of Chiropractic Licensing Boards, Foundation for the Advancement of Chiropractic Sciences, Foundation for Chiropractic Education and Research, International Chiropractors Association, National Association of Chiropractic Attorneys and the National Institute for Chiropractic Research. The CCGPP’s mission| Continue reading
- [Manipulative Therapy for Lower Extremity Conditions: Expansion of Literature Review](https://clinicalcompass.org/other-good-stuff/manipulative-therapy-for-lower-extremity-conditions-expansion-of-literature-review/): Manipulative Therapy for Lower Extremity Conditions: Expansion of Literature Review Journal of Manipulative and Physiological Therapeutics | VOLUME 32, ISSUE 1, P53-71, JANUARY 01, 2009 James W. Brantingham, DC, PhD  |  Gary Globe, DC, MBA, PhD  |  Henry Pollard, DC, PhD  |  Marian Hicks, MSLS  |  Charmaine Korporaal, MTech:Chiropractic  |  Wayne Hoskins, BChSc, MChiro Abstract Objective The purpose of this study was to conduct a systematic review on manipulative therapy for lower extremity conditions and expand on a previously published literature review. Methods The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with developing| Continue reading
- [Chiropractic Management of Tendinopathy: Summary of Clinical Practice](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-tendinopathy-summary-of-clinical-practice/): Chiropractic Management of Tendinopathy: Summary of Clinical Practice Recommendations Commission of the Council on Chiropractic Guidelines and Practice Parameters  
- [Chiropractic Management of Tendinopathy: A Literature Synthesis](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-tendinopathy-a-literature-synthesis/): Chiropractic Management of Tendinopathy: A Literature Synthesis Journal of Manipulative and Physiological Therapeutics | VOLUME 32, ISSUE 1, P41-52, JANUARY 01, 2009 Mark T. Pfefer, RN, MS, DC  |  Stephan R. Cooper, DC  |  Nathan L. Uhl, DC Abstract Objective Chronic tendon pathology is a soft tissue condition commonly seen in chiropractic practice. Tendonitis, tendinosis, and tendinopathy are terms used to describe this clinical entity. The purpose of this article is to review interventions commonly used by doctors of chiropractic when treating tendinopathy. Methods The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with| Continue reading
- [Chiropractic Management of Fibromyalgia Syndrome: Summary of Clinical Practice](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-fibromyalgia-syndrome-summary-of-clinical-practice/): Chiropractic Management of Fibromyalgia Syndrome: Summary of Clinical Practice Recommendations Commission of the Council on Chiropractic Guidelines and Practice Parameters Process and Methods: The Council on Chiropractic Guidelines and Practice Parameters (CCGPP), was formed in 1995 at the behest of the Congress of Chiropractic State Associations (COCSA) and with assistance from the American Chiropractic Association, Association of Chiropractic Colleges, Council on Chiropractic Education, Federation of Chiropractic Licensing Boards, Foundation for the Advancement of Chiropractic Sciences, Foundation for Chiropractic Education and Research, International Chiropractors Association, National Association of Chiropractic Attorneys and the National Institute for Chiropractic Research. The CCGPP’s mission is| Continue reading
- [Chiropractic Management of Fibromyalgia Syndrome: A Systematic Review of the Literature](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-fibromyalgia-syndrome-a-systematic-review-of-the-literature/): Chiropractic Management of Fibromyalgia Syndrome: A Systematic Review of the Literature Journal of Manipulative and Physiological Therapeutics | Council on Chiropractic Guidelines and Practice Parameters | VOLUME 32, ISSUE 1, P25-40, JANUARY 01, 2009 Michael Schneider, DC, PhD  |  Howard Vernon, DC, PhD  | Gordon Ko, MD  |  Gordon Lawson, MSc, DC  |  Jerome Perera Abstract Objective Fibromyalgia syndrome (FMS) is one of the most commonly diagnosed nonarticular soft tissue conditions in all fields of musculoskeletal medicine, including chiropractic. The purpose of this study was to perform a comprehensive review of the literature for the most commonly used treatment procedures| Continue reading
- [Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: Summary of Clinical Practice](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-myofascial-trigger-points-and-myofascial-pain-syndrome-summary-of-clinical-practice/): Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: Summary of Clinical Practice Recommendations Commission of the Council on Chiropractic Guidelines and Practice Parameters Process and Methods The Council on Chiropractic Guidelines and Practice Parameters (CCGPP), was formed in 1995 at the behest of the Congress of Chiropractic State Associations (COCSA) and with assistance from the American Chiropractic Association, Association of Chiropractic Colleges, Council on Chiropractic Education, Federation of Chiropractic Licensing Boards, Foundation for the Advancement of Chiropractic Sciences, Foundation for Chiropractic Education and Research, International Chiropractors Association, National Association of Chiropractic Attorneys and the National Institute for Chiropractic| Continue reading
- [Chiropractic Management of  Myofascial Trigger Points and Myofascial Pain Syndrome: A Systematic Review of the Literature.](https://clinicalcompass.org/other-good-stuff/chiropractic-management-of-myofascial-trigger-points-and-myofascial-pain-syndrome-a-systematic-review-of-the-literature/): Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: A Systematic Review of the Literature Journal of Manipulative and Physiological Therapeutics | Council on Chiropractic Guidelines and Practice Parameters | VOLUME 32, ISSUE 1, P14-24, JANUARY 01, 2009 Howard Vernon, DC, PhD  |  Michael Schneider, DC Abstract Objectives Myofascial pain syndrome (MPS) and myofascial trigger points (MTrPs) are important aspects of musculoskeletal medicine, including chiropractic. The purpose of this study was to review the most commonly used treatment procedures in chiropractic for MPS and MTrPs. Methods The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP)| Continue reading
- [Chiropractic Care for Nonmusculoskeletal Conditions: A Systematic Review with Implications for Whole Systems Research](https://clinicalcompass.org/other-good-stuff/chiropractic-care-for-nonmusculoskeletal-conditions-a-systematic-review-with-implications-for-whole-systems-research/): Chiropractic Care for Nonmusculoskeletal Conditions: A Systematic Review with Implications for Whole Systems Research The Journal of Alternative and Complementary Medicine | Vol. 13, No. 5 Cheryl Hawk |  Raheleh Khorsan  |  Anthony J. Lisi  |  Randy J. Ferrance  |  Marion Willard Evans Abstract Objectives: To evaluate the evidence on the effect of chiropractic care, rather than spinal manipulation only, on patients with nonmusculoskeletal conditions To identify shortcomings in the evidence base on this topic, from a Whole Systems Research perspective. Design: Systematic review. Methods: Databases included were PubMed, Ovid, Mantis, Index to Chiropractic Literature, and CINAHL. Search restrictions were| Continue reading
- [Consensus Terminology for Stages of Care: Acute, Chronic, Recurrent, and Wellness](https://clinicalcompass.org/other-good-stuff/consensus-terminology-for-stages-of-care-acute-chronic-recurrent-and-wellness/): Consensus Terminology for Stages of Care: Acute, Chronic, Recurrent, and Wellness Journal of Manipulative and Physiological Therapeutics | VOLUME 33, ISSUE 6, P458-463, JULY 01, 2010 Mark D. Dehen, DC  |  Wayne M. Whalen, DC  |  Ronald J. Farabaugh, DC  |  Cheryl Hawk, DC, PhD Abstract Objective As the chiropractic profession delineates its role in the emerging health care marketplace, it will become increasingly important that the scope of appropriate chiropractic care is clearly defined relative to overall patient case management. Therefore, the Council on Chiropractic Guidelines and Practice Parameters engaged in a multidisciplinary consensus process addressing the terminology related| Continue reading
- [Management of Chronic Spine-Related Conditions: Consensus Recommendations of a Multidisciplinary Panel](https://clinicalcompass.org/other-good-stuff/management-of-chronic-spine-related-conditions-consensus-recommendations-of-a-multidisciplinary-panel/): Management of Chronic Spine-Related Conditions: Consensus Recommendations of a Multidisciplinary Panel Journal of Manipulative and Physiological Therapeutics | VOLUME 33, ISSUE 7, P484-492, SEPTEMBER 01, 2010 Ronald J. Farabaugh, DC  |  Mark D. Dehen, DC  |  Cheryl Hawk, DC, PhD Abstract Objective Chronic spine-related conditions are very problematic in terms of treatment and indemnity costs, diagnostic complexity, and appropriate case management. Currently no chiropractic-directed guideline exists related to chiropractic management of the chronic spine pain patient. The purpose of this project was to develop a broad-based multidisciplinary consensus of medical and chiropractic clinical experts representing mainstream medical and chiropractic practice| Continue reading
- [Diagnostic Imaging Report](https://clinicalcompass.org/other-good-stuff/diagnostic-imaging-report/): Diagnostic Imaging Report Council on Chiropractic Guideline and Practice Parameters Lawrence H. Wyatt, DC, DACBR (Team Lead): Professor of Clinical Sciences, Texas Chiropractic College Dana J. Lawrence, DC, MMedEd: Senior Director, Center for Teaching and Learning, Palmer College of Chiropractic Timothy Mick, DC, DACBR: President, Imaging Consultants, Inc., St. Paul, MN; Spine Radiologist, Center for Diagnostic Imaging, St. Louis Park, MN Eugene A. Lewis, DC, MPH: Private practice, Greensboro, NC; Vice Chair, North Carolina State Radiation Protection Commission; Member, Executive Committee, CCGPP Patrick J. Farrell, DC, DACBR: Chiropractic Radiologist, Farrell Radiology Consultants, Frederick, MD; Private practice, Gaithersburg, MD INTRODUCTION The| Continue reading
- [Literature Synthesis: Chiropractic Management of Upper Extremity Pain](https://clinicalcompass.org/other-good-stuff/literature-synthesis-chiropractic-management-of-upper-extremity-pain/): Literature Synthesis: Chiropractic Management of Upper Extremity Pain A Systematic Review by the Research Commission of the Council on Chiropractic Guidelines and Practice Parameters Thomas Souza, DC  |  Ed Feinberg, DC, MS  |  Susan Holm, DC, MS  |  Michael Carnes, DC, MS  |  Michael Reed, DC  | Phyllis Harvey, MLS A literature synthesis is an academically rigorous analysis of all the available scientific literature on a specific topic. Reviewers use internationally accepted tools to rate each article according to specific criteria. These include the type of study (randomized controlled trial, case series, etc), the quality of the study, size of| Continue reading
- [Algorithms for the Chiropractic Management of Acute and Chronic Spine-Related Pain](https://clinicalcompass.org/other-good-stuff/algorithms-for-the-chiropractic-management-of-acute-and-chronic-spine-related-pain/): Algorithms for the Chiropractic Management of Acute and Chronic Spine-Related Pain Topics in Integrative Health Care 2012, Vol. 3(4) ID: 3.4007 Gregory A. Baker, DC  |  Ronald J. Farabaugh, DC  |  Thomas J. Augat, DC, MS, CCSP, FASA  |  Cheryl Hawk, DC, PhD, CHES Introduction The complexity of clinical documentation and case management for health care providers has increased along with the rise of managed care. Keeping up with the policies of different insurers and third party administrators can be a daunting task. To address these issues for doctors of chiropractic (DCs) and policymakers, the Council for Chiropractic Guidelines and| Continue reading
- [Review of Methods Used by Chiropractors to Determine the Site for Applying Manipulation](https://clinicalcompass.org/other-good-stuff/review-of-methods-used-by-chiropractors-to-determine-the-site-for-applying-manipulation/): Review of Methods Used by Chiropractors to Determine the Site for Applying Manipulation Chiropractic & Manual Therapies volume 21, Article number: 36 (2013) John J Triano, Brian Budgell, Angela Bagnulo, Benjamin Roffey, Thomas Bergmann, Robert Cooperstein, Brian Gleberzon, Christopher Good, Jacquelyn Perron & Rodger Tepe Abstract Background With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care| Continue reading
- [Clinical Practice Guideline: Chiropractic Care for Low Back Pain](https://clinicalcompass.org/other-good-stuff/clinical-practice-guideline-chiropractic-care-for-low-back-pain/): Clinical Practice Guideline: Chiropractic Care for Low Back Pain Journal of Manipulative and Physiological Therapeutics | VOLUME 39, ISSUE 1, P1-22, JANUARY 01, 2016 Gary Globe, PhD, MBA, DC  |  Ronald J. Farabaugh, DC  |  Cheryl Hawk, DC, PhD  |  Craig E. Morris, DC  |  Greg Baker, DC  |  Wayne M. Whalen, DC  |  Sheryl Walters, MLS  |  Martha Kaeser, DC, MA  |  Mark Dehen, DC  |  Thomas Augat, DC Abstract Objective The purpose of this article is to provide an update of a previously published evidence-based practice guideline on chiropractic management of low back pain. Methods This project updated| Continue reading
- [Wellness, Prevention and Health Promotion - 2019](https://clinicalcompass.org/evidence-center-research-summaries/wellness-prevention-and-health-promotion-2019/): A literature synthesis of Wellness, Prevention, and Health Promotion — an academically rigorous analysis of all the available scientific literature using internationally accepted tools to rate each article according to specific criteria indicating only what we can conclude with supportable, scientific evidence.
- [Safety and Adverse Events - 2019](https://clinicalcompass.org/evidence-center-research-summaries/safety-and-adverse-events-2019/): A literature synthesis of Safety & Adverse Events — an academically rigorous analysis of all the available scientific literature using internationally accepted tools to rate each article according to specific criteria indicating only what we can conclude with supportable, scientific evidence.
- [Non-Musculoskeletal Conditions - 2019](https://clinicalcompass.org/evidence-center-research-summaries/non-musculoskeletal-conditions-2019/): A literature synthesis of Non-Musculoskeletal Conditions — an academically rigorous analysis of all the available scientific literature using internationally accepted tools to rate each article according to specific criteria indicating only what we can conclude with supportable, scientific evidence.
- [Neck Pain](https://clinicalcompass.org/evidence-center-research-summaries/neck-pain/): Spinal manipulative therapy (SMT) for neck pain and associated disorders in adults This page only includes articles published in the last 5 years Guidelines A 2016 clinical practice guideline1 for the treatment of neck pain and associated disorders (NAD) and whiplash-associated disorders (WAD) concluded that in general, a multimodal treatment approach is an effective strategy for both acute and chronic neck pain. The strength of all recommendations in the following is weak: Acute NAD (0-3 months) Low-quality evidence: For grades I to II, manipulation or mobilization based on patient preference Moderate-quality evidence: For grades I to II, ROM home exercises,| Continue reading
- [Lower Extremity](https://clinicalcompass.org/evidence-center-research-summaries/lower-extremity/): Lower Extremity This page only includes articles published in the last 5 years Osteoarthritis and Pain of the Lower Extremity A 2015 review on osteoarthritis (OA) found that land-based exercise for the hip reduced pain and improved physical function immediately after treatment with improvements sustained for 3-6 months. Additionally, exercise is recommended for the treatment of knee OA with improvement in muscle strength, short-term pain benefits and physical function including walking ability. This review also discussed biomechanical interventions for knee OA including braces and orthoses but did not report substantive evidence for their use.1 A 2013 systematic review evaluated the| Continue reading
- [Low Back Pain](https://clinicalcompass.org/evidence-center-research-summaries/low-back-pain/): Low Back Pain This page only includes articles published in the last 5 years Guideline A 2016 evidence-informed and consensus-driven guideline provided an update of the best practice recommendations for chiropractic management of low back pain (LBP). To substantiate care, a definite improvement in a patient’s functional capacity should be documented using a measurable outcome, such as the following:1 Pain scales such as the visual analog scale and the numeric rating scale. Pain diagrams that allow the patient to demonstrate the location and character of their symptoms. Validated ADL measures, such as the Revised Oswestry Back Disability Index, Roland Morris| Continue reading
- [Integrative Care](https://clinicalcompass.org/evidence-center-research-summaries/integrative-care/): Integrative Care This page only includes articles published in the last 5 years A 2016 survey of nurse practitioners (NPs) and physician assistants (PAs) found conflicting results as to whether respondents viewed chiropractic as mainstream or alternative. Most participants reported having a lack of awareness of current scientific evidence for chiropractic but also indicated a positive interest in learning more about the profession. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice.1 A 2016 study described a multidisciplinary survivorship care model for oncology patients. Each Patient Empowered Care (PEC) team includes a| Continue reading
- [Headache](https://clinicalcompass.org/evidence-center-research-summaries/headache/): Headache This page only includes articles published in the last 5 years In an update of the Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders, the authors examined the effectiveness of conservative interventions for the management of headaches associated with neck pain.1 They concluded that all management should include exercises. For cervicogenic headache, manual therapy may benefit. Relaxation training combined with stress-coping therapy or multimodal care (mobilization, exercise, postural correction) should be considered for chronic tension-type headache. Tension-type headache (TTH) A 2015 meta-analysis evaluated the efficacy of manual therapy (MT) involving spinal manipulative therapy (SMT)/mobilization,| Continue reading
- [Special Populations — Geriatrics](https://clinicalcompass.org/evidence-center-research-summaries/special-populations-geriatrics/): Special Populations–Geriatrics This page only includes articles published in the last 5 years General A 2017 update of a set of “best practices” recommendations for chiropractic care for older adults described a comprehensive approach to chiropractic care for older adults.1 Physical Activity and Exercise A 2012 expert commentary found that aerobic exercise and strength training have positive effects on strength, balance and physical functioning.2 Fall prevention A 2016 randomized controlled trial investigated the effects of 12 weeks of chiropractic care vs no intervention on proprioception (ankle joint position sense), postural stability (static posturography) sensorimotor function (choice stepping reaction time), multisensory| Continue reading
- [Diagnostic Imaging](https://clinicalcompass.org/evidence-center-research-summaries/diagnostic-imaging/): Diagnostic imaging This page only includes articles published in the last 5 years. Current recommendations The most current evidence-based diagnostic imaging practice guidelines for chiropractors1 and primary care physicians2, 3 do not recommend the routine use of imaging for patients seeking an evaluation of their low back pain (LBP). Even though management approaches are different between the professions, the imaging guidelines are comparable. For chiropractors, current guidelines maintain that x-rays are not initially indicated for non-specific acute, subacute or persistent back and neck pain in the absence of red flags.1 Also, radiographs are not useful for screening for contraindications or| Continue reading
- [Cost-Effectiveness](https://clinicalcompass.org/evidence-center-research-summaries/cost-effectiveness/): Cost-effectiveness and utilization of chiropractic care This page only includes articles published in the last 5 years. Cost effectiveness Low back and/or neck pain Combined physical and psychological treatments, medical yoga, information and education programs, spinal manipulation and acupuncture are likely to be cost-effective options for low back pain (LBP).1 A 2016 cohort study found that workers who first saw a chiropractor experienced shorter first episodes of 100% wage compensation compared with those who first saw a medical physician and workers who first saw a physiotherapist experienced a longer episode of 100% compensation. The odds of having a second episode| Continue reading
- [Wellness Care](https://clinicalcompass.org/evidence-center-research-summaries/wellness-care/): Wellness, health promotion and prevention This page only includes articles published in the last 5 years General A 2012 analysis of National Health Interview Survey data on wellness-related use of complementary health care found that “users of natural product supplements and yoga were more likely to have reported using the approach for a wellness reason than for treatment of a specific health condition, whereas more spinal manipulation users reported using it for treatment rather than for wellness. The most common wellness-related reason reported by users of each of the three approaches was for ‘‘general wellness or disease prevention.’’ The majority| Continue reading
- [Non-Musculoskeletal](https://clinicalcompass.org/evidence-center-research-summaries/non-musculoskeletal/): Non-Musculoskeletal Conditions This page only includes articles published in the last 5 years Effect of mobilization on autonomic nervous system A 2014 systematic review found that evidence suggests that spinal mobilization in asymptomatic populations has an excitatory effect on the sympathetic nervous system, regardless of which segment is mobilized.1 Asthma The 2014 update of the 2010 UK report found that evidence is inconclusive rather than negative for SMT for asthma. It also found inconclusive but favorable evidence for osteopathic manual therapy and inconclusive favorable evidence for cranio-sacral therapy.2 Cervicogenic vertigo A 2016 analysis of National Health Interview Survey data indicated| Continue reading
- [Safety](https://clinicalcompass.org/evidence-center-research-summaries/safety/): Safety of Spinal Manipulative Therapy/Chiropractic Care This page only includes articles published in the last 5 years Cervical spine manipulation and stroke A 2015 systematic review stated: “We found no evidence for a causal link between chiropractic care and CAD [cervical artery dissection]. This is a significant finding because belief in a causal link is not uncommon, and such a belief may have significant adverse effects such as numerous episodes of litigation.”1 A 2015 case-control study found no significant association between the risk of vertebrobasilar artery (VBA) stroke and exposure to chiropractic care. The authors conclude, “manipulation is an unlikely| Continue reading
- [Soft Tissue](https://clinicalcompass.org/evidence-center-research-summaries/soft-tissue/): Soft Tissue This page only includes articles published in the last 5 years. Trigger points and myofascial pain syndrome A 2015 systematic review of randomized control trials (RCT) found seven studies that demonstrated that myofascial release (MFR) with conventional physiotherapy is more effective than a control group receiving no treatment for various conditions.1 A 2016 commentary recommends that due to current thought, in which trigger points feature significant hypoxia, induction of ischemia would be counterproductive and so the term “ischemic compression” should be replaced by “TrP compression.”2 Fibromyalgia Syndrome (FMS) A 2015 systematic review found that tai chi, yoga, meditation| Continue reading
- [Special Populations — Pregnancy](https://clinicalcompass.org/evidence-center-research-summaries/special-populations-pregnancy/): Special Populations—Pregnancy This page only includes articles published in the last 5 years Pelvic floor function A very small, preliminary, comparative study aimed to evaluate whether 1 session of spinal manipulative therapy (SMT) would alter pelvic floor muscle function.1 Eleven pregnant women in their 2nd trimester were compared to 15 non-pregnant women using ultrasonographic imaging as a measurement tool. Results showed no changes occurred in the control group following SMT, but the pregnant women were able to relax pelvic floor muscles. This suggests SMT could aid vaginal delivery if relaxation does not occur naturally. Low back pain (LBP) in pregnancy| Continue reading
- [Special Populations — Pediatrics](https://clinicalcompass.org/evidence-center-research-summaries/special-populations-pediatrics/): Special Populations—Pediatrics This page only includes articles published in the last 5 years General A 2015 analysis of National Health Interview Survey data found that use of CAM among children ages 4-17 did not increase between 2007 and 2012. Chiropractic or osteopathic manipulation; yoga, tai chi, or qi gong were the most commonly used CAM approaches.1 A 2012 systematic reviewed stated, “studies that monitored both subjective and objective outcome measures of relevance to both patients and parents tended to report the most favorable response to SMT, especially among children with asthma.”2 Infantile colic A 2016 review summarized current trends in| Continue reading
- [Canadian Chiropractic Guideline Initiative (CCGI) 5 Year Report](https://clinicalcompass.org/news/canadian-chiropractic-guideline-initiative-ccgi-5-year-report/): Be sure and check out the 5- year report from our friends and collaborators at the Canadian Chiropractic Guideline Initiative (CCGI). To find out more about CCGI and read the report click here
- [Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids: Journal of Alternative and Complementary Medicine:](https://clinicalcompass.org/news/association-between-utilization-of-chiropractic-services-for-treatment-of-low-back-pain-and-use-of-prescription-opioids-journal-of-alternative-and-complementary-medicine/): Objective: Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications. Design: The authors used a retrospective cohort design to analyze health insurance claims data. Setting: The data source was the all payer claims database administered by the State of New Hampshire. The authors chose New Hampshire because health claims data were readily available for research, and in 2015, New Hampshire had| Continue reading
- [Breakthrough study: Chiropractic can address the opioid crisis](https://clinicalcompass.org/news/breakthrough-study-chiropractic-can-address-the-opioid-crisis/): Does chiropractic care have a role in fighting the opioid crisis? Check out the latest information in this article in Chiropractic Economics
- [Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process](https://clinicalcompass.org/clinical-guidelines/chiropractic-integrated-care-pathway-for-low-back-pain-in-veterans-results-of-a-delphi-consensus-process/)
- [ACA Facebook Live Presents "Evidenced-based Care"](https://clinicalcompass.org/news/aca-facebook-live-presents-evidenced-based-care/): https://www.facebook.com/acatoday.org/videos/10154416639112609/
- [Spinal manipulative therapy for low back pain—time for an update](https://clinicalcompass.org/news/spinal-manipulative-therapy-for-low-back-pain-time-for-an-update/): Spinal manipulative therapy for low back pain—time for an update Check out the letter published in the September issue of Canadian Family Physician by our Canadian friends André E. Bussières, DC FCCS(C) MSc PhD, Claude A. Gauthier, DC, Gilles Fournier, MD DC, and Martin Descarreaux, DC PhD.  
- [Q&A with NCLC 2018 Presenters: Dr. Jay Greenstein  Presentation Reviews the Relevance of Clinical Practice Guidelines to Better Patient Care and Proper Reimbursement](https://clinicalcompass.org/news/qa-with-nclc-2018-presenters-dr-jay-greenstein-presentation-reviews-the-relevance-of-clinical-practice-guidelines-to-better-patient-care-and-proper-reimbursement/): ACA’s annual meeting, the National Chiropractic Leadership Conference (NCLC), is packed with great educational content and world-class presenters. Join us Feb. 28-March 3 in Washington, D.C., to hear from some of the profession’s most compelling thought leaders. Here we pose several questions to one of our featured speakers: Jay Greenstein, DC… 
- [Alternative Pain Therapies Could Help Quell Opioid Crisis, but Barriers Remain](https://clinicalcompass.org/news/alternative-pain-therapies-could-help-quell-opioid-crisis-but-barriers-remain/): For many Americans struggling with opioid addiction, it didn’t start with drug-filled needles or fentanyl-laced heroin, but with something far more common and less sinister: pain. More than 30 percent of Americans experience acute or chronic pain, and as emphasis on pain treatment has grown in the last two decades, prescriptions for opioids have skyrocketed in tandem with the escalation of the opioid epidemic. The National Institute on Drug Abuse and the National Institutes of Health have identifiedboth opioid research and pain research as top priorities, and the epidemic has ushered in new thinking on how and when to use opioids in pain management.| Continue reading
- [2017 Clinical Compass Annual Report](https://clinicalcompass.org/news/2017-clinical-compass-annual-report/): On November 3rd 2017 the board of the Clinical Compass was very graciously hosted at Logan University in St. Louis for our annual meeting. Here is a brief year in review of 2016-2017.  Clinical Compass Annual Report 2017 Check out the video below
- [Performance Health Funds Expanded Study on  Chiropractic’s Impact on Reduction in Opioid Prescriptions](https://clinicalcompass.org/news/performance-health-funds-expanded-study-on-chiropractics-impact-on-reduction-in-opioid-prescriptions/): Performance Health Funds Expanded Study on Chiropractic’s Impact on Reduction in Opioid Prescriptions  Study will include over one million subjects.   Akron, Ohio – October 5, 2017 – Performance Health, the maker of Biofreeze® Professional, is pleased to announce its significant financial support of the Clinical Compass as part of its national Safer  Pain Relief campaign. These funds are earmarked for a second study on the impact of chiropractic care on opioid and drug use for large patient populations. This second study, as was the first, is being carried out by principle investigator Dr. James Whedon at Southern California University| Continue reading
- [American Chiropractic Association Releases Choosing Wisely® List of Tests, Procedures to Question](https://clinicalcompass.org/news/american-chiropractic-association-releases-choosing-wisely-list-of-tests-procedures-to-question/): Arlington, VA – The American Chiropractic Association (ACA) today released a list of five tests and procedures commonly ordered but not always necessary in chiropractic care. The list is part of the Choosing Wisely® campaign, an initiative of the ABIM Foundation and Consumer Reports®, which encourages conversations between patients and their clinicians about what care is really necessary and appropriate. To date, nearly 100 health care groups have participated in the Choosing Wisely® campaign to create lists identifying specific tests and procedures that evidence indicates may not always be necessary. ACA is the first chiropractic group to join the campaign. “The American Chiropractic Association (ACA) and its members support evidence-informed care as well as shared decision-making between patients and their doctors. For this reason, we are proud to partner with Choosing Wisely® in this effort to encourage important conversations between patients and chiropractors that may reduce unneeded or overused| Continue reading
- [Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions](https://clinicalcompass.org/clinical-guidelines/systematic-review-of-nondrug-nonsurgical-treatment-of-shoulder-conditions/)
- [Michigan Chiropractic Foundation Funds Significant Opioid Study](https://clinicalcompass.org/news/michigan-chiropractic-foundation-funds-significant-opioid-study/): Thanks to a very generous grant from the Michigan Chiropractic Foundation James Whedon DC, MS released the preliminary findings of his paper, Association between Utilization of Chiropractic Services and Use of Prescription Opioids among Patients with Low Back Pain. The final results of the study are currently under peer review for publication.
- [Council on Chiropractic Guidelines and Practice Parameters Special Announcement:  New Cervical Spine Guidelines Relevant for Chiropractic Practice](https://clinicalcompass.org/other-good-stuff/council-on-chiropractic-guidelines-and-practice-parameters-special-announcement-new-cervical-spine-guidelines-relevant-for-chiropractic-practice/): Special Announcement: New Cervical Spine Guidelines Relevant for Chiropractic Practice The mission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is to gather and evaluate existing evidence-based practice information; to facilitate the development of new information where existing evidence is lacking; and to distribute and assist in implementation of evidence-based practice information that is relevant to the chiropractic profession. The Canadian Chiropractic Guideline Initiative (CCGI) has recently published a guideline on neck pain-associated disorders (NAD) and whiplash-associated disorders (WAD) in the Journal of Manipulative and Physiological Therapeutics (JMPT)1 . The CCGPP recognizes this document as a quality evidence-based| Continue reading
- [2017 Updated Mission, Vision and Values Executive Summary](https://clinicalcompass.org/news/2017-updated-mission-vision-and-values-executive-summary/): CCGPP Mission Vision Values Executive Summary 2017 At the fall 2016 annual meeting, a work group was assigned the task to review and update the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) Vision, Mission, and Values to make sure they are in line with current practices. The workgroup completed a modified Delphi process to identify and measure the value of key issues related to the mission, vision and values of the CCGPP. The results of these surveys are included in this report. The CCGPP board approved the changes outlined in this document.
- [Clinical Practice Guideline: Chiropractic Care for Low Back Pain](https://clinicalcompass.org/clinical-guidelines/clinical-practice-guideline-chiropractic-care-for-low-back-pain-2/)
- [Michigan Chiropractic Foundation](https://clinicalcompass.org/news/michigan-chiropractic-foundation/): MCF Awards $20k to CCGPP    Funds Will be Used to Provide Foundation for Rapid Response Team, Expand CCGPP’s Outreach to the Profession and Individual Practitioners
- [Algorithms for the chiropractic management of acute and chronic spine-related pain. Top Integrative Health Care](https://clinicalcompass.org/clinical-guidelines/algorithms-for-the-chiropractic-management-of-acute-and-chronic-spine-related-pain-top-integrative-health-care/)
- [Chiropractic Summit Together Video](https://clinicalcompass.org/news/chiropractic-summit-together-video/): Chiropractic Summit Together Video
- [Management of chronic spine-related conditions: consensus recommendations of a multidisciplinary panel](https://clinicalcompass.org/clinical-guidelines/management-of-chronic-spine-related-conditions-consensus-recommendations-of-a-multidisciplinary-panel-2/)
- [Consensus terminology for stages of care: acute, chronic, recurrent, and wellness](https://clinicalcompass.org/clinical-guidelines/consensus-terminology-for-stages-of-care-acute-chronic-recurrent-and-wellness-2/)
- [Chiropractic management of low back pain and low back-related leg complaints: a literature synthesis](https://clinicalcompass.org/clinical-guidelines/chiropractic-management-of-low-back-pain-and-low-back-related-leg-complaints-a-literature-synthesis-2/)
- [Literature syntheses for the Council on Chiropractic Guidelines and Practice Parameters: methodology](https://clinicalcompass.org/clinical-guidelines/literature-syntheses-for-the-council-on-chiropractic-guidelines-and-practice-parameters-methodology-2/)
- [What constitutes evidence for best practice?](https://clinicalcompass.org/clinical-guidelines/what-constitutes-evidence-for-best-practice-2/)
- [Chiropractic management of low back disorders: report from a consensus process](https://clinicalcompass.org/clinical-guidelines/chiropractic-management-of-low-back-disorders-report-from-a-consensus-process-2/)

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