The Metabolic Vulnerability Index
Anti Aging / Healthy Aging

The Metabolic Vulnerability Index

An Inexpensive Lab Test That Can Revolutionize Clinical Practice

In 2025, a new blood test, developed by LabCorp, was released – the Metabolic Vulnerability Index or MVX Plus. The MVX Plus was established through research, aimed at quantifying combined metabolic and inflammatory vulnerability. It is a novel, nuclear magnetic resonance (NMR) spectroscopy-based approach to evaluating mortality risk through the lens of metabolic dysfunction, malnutrition and inflammation.

Darren Schmidt, DC
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Billing / Fees / Insurance
Should You Be In-Network or Out-of-Network With Insurance?
Should You Be In-Network or Out-of-Network With Insurance?

It’s a new year and many chiropractors are evaluating what will enhance their respective practices, particularly as it relates to their bottom line. One of the most common questions I get is: “Do I need to be credentialed to bill insurance, and what are the best plans to join?” It’s a loaded question – but one every DC ponders. Whether you're already in-network or pondering whether to join, here's what you need to know.

Samuel A. Collins
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X-ray / Imaging / MRI
Radiologist-Missed Spinal Tumor Found by Chiropractor
Radiologist-Missed Spinal Tumor Found by Chiropractor

A 36-year-old female presented on Nov. 18, 2025, with lumbar pain and left lower extremity radiculopathy. Following a comprehensive history, physical examination, and radiographic evaluation to assess anatomical and biomechanical factors, an immediate lumbar MRI was ordered due to the patient’s radiculopathic symptoms and clinical findings.

Mark Studin, DC, FPSC, FASBE(C), DAAPM; Timothy Clare, DC, FPSC(C)
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Billing / Fees / Insurance
Guidelines vs. Care: Bridging the Gap
Guidelines vs. Care: Bridging the Gap

What happens when best practices for patient care fall outside what guidelines endorse or insurance will cover? More importantly, how can clinicians ethically and effectively integrate non-reimbursed services that improve function, reduce disability and support long-term outcomes? These are not just clinical questions; they are economic and policy challenges that directly affect practice viability and patient access.

Christopher Proulx, DC, PhD(ABD), CSCS
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News / Profession
The Best of Times, the Worst of Times (Pt. 3)
The Best of Times, the Worst of Times
How Chiropractors Can Make It the Best of Times

Imagine an environment in which DCs are tightly integrated with their local healthcare system; a trusted resource for PCPs, specialists and self-insured employers; are reimbursed in alignment with value created; use modern technology enabling them to fully engage with their patients; are self-governed; and are able to maintain a fulfilling work-life balance. In the final part of this three-part series, we explore three areas for chiropractors to focus on to leave the current foolishness behind and create “the best of times” for DCs and their patients.

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Back Pain
Physical Activity and LBP: Transient and Long-Term Risks
Physical Activity and LBP: Transient and Long-Term Risks
 New Study Findings Can Help Guide Patient Conversations

Evidence consistently shows that physical activity and exercise are fundamental to long-term recovery from LBP. However, many patients avoid engaging in activities that they fear will make their LBP worse. A new study directly addressed this dichotomy by analyzing both the transient and longer-term risks of 10 everyday physical activities for adults with LBP. 

Wren Burton, DC, MPH; Christine Goertz, DC, PhD
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Analgesics & Other Therapies
Pain & Rash on the Low Back: What's Your Diagnosis?
lower back rash

I generally don't discuss dermatological problems, but this case has a rather interesting history and a lesson about which we should all be aware. A 61-year-old patient presents with pain and a rash on his lower back and torso. Patient is not aware of any allergies and does not have a history of psoriasis or eczema. He has seen two different MD clinicians and neither one knows what it is. The patient's wife is the one who finally figures out the mystery.

Deborah Pate, DC, DACBR
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Featured

Chronic Sciatica: Ending the Relapse Cycle

A 46-year-old male presented to our clinic with a seven-year history of recurrent low back pain with sciatica. He reported stiffness and discomfort that worsened with prolonged sitting both at his desk job and during evening television time. The patient had seen multiple chiropractors over the years. In every case, spinal manipulation and other passive treatments would bring gradual symptom relief over 2-3 months. However, within another 3-6 months, the symptoms would return. Frustrated – and now considering a spinal injection and possibly surgery if that failed, he came to our office seeking a different approach.

Ronald Feise, DC
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Reader Favorites
Healthcare / Public Health
More Pervasive Than Back Pain – But You Are Still the Perfect Doctor to Help
More Pervasive Than Back Pain – But You Are Still the Perfect Doctor to Help

While back pain holds the title as the leading cause of disability and high healthcare costs, with nearly two of five U.S. adults experiencing back pain in the previous three months as of 2021 (39%), an even more pervasive health threat has now been recognized. A new cross-sectional study of data from the Global Burden of Disease 2021 reveals that 180.3 million people in the U.S. were impacted by disorders affecting their nervous-system health in 2021. That’s over 54% of that population.

Donald Petersen Jr., BS, HCD(hc), FICC(h)
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Healthcare / Public Health  |  DIGITAL EXCLUSIVE
Chiropractic Is Failing With Utilization Despite Outcome Validation
Chiropractic Is Failing With Utilization Despite Outcome Validation

Outcome studies show the efficacy of chiropractic care vs. all other mechanical low back pain therapies; yet the profession lags in utilization despite overwhelming statistical outcomes in direct care and drugs. We must close the awareness gap by educating the public, primary care physicians, and specialists about the proven efficacy of chiropractic care through outcome studies, patient success stories, and evidence-based data. Through statistical and financial outcomes, we also must seek mandatory integration into care paths.

Mark Studin, DC, FPSC, FASBE(C), DAAPM
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Anti Aging / Healthy Aging
Squaring the Geriatric Curve
Squaring the Geriatric Curve
A Five-Part Strategy to Promote Patient “Livegevity”

The geriatric curve – the progressive decline in our health, fitness, mental capacity, and overall constitution – graphically appears as a downward sloping line over time. It is a culmination of the effects of sarcopenia, postural deterioration, frailty, and chronic noncommunicable diseases that occur as we age. While aging cannot be reversed, the goal is to reduce the negative slope or “square off” the curve, thus avoiding a steady decline in health. Here are five ways to get your patients started.

Donald DeFabio, DC, DACBSP, DABCO
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Rehab / Recovery / Physiotherapy
The Future of Recovery: A Roadmap
The Future of Recovery: A Roadmap
Integrating Innovation, Collaboration & Precision in Soft-Tissue Injury Care

The days of simply treating pain are fading. Today’s clinicians must prevent injury, identify dysfunction early, and design recovery pathways that are personalized, data-driven and team-based. The future of recovery is now – and chiropractors have a vital role to play. With the rise of wearable technologies, regenerative therapies, tele-rehab platforms, and collaborative care models, we can intervene earlier, manage more complex cases and track outcomes more precisely than ever before.

Ken Kaufman, DC
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Carpal Tunnel / Extremities / Neuropathy
Unlock Relief: Nerve Flossing for CTS
Unlock Relief: Nerve Flossing for CTS

It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.

Charles Annunziata, DC, CFMP