While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
The State of Global Chiropractic: Unfulfilled Opportunity?
A new survey of the global chiropractic workforce by the World Federation of Chiropractic reveals "a significant lack of provision in low- and middle-income countries" and "that of the 48 educational institutions offering chiropractic programs, the majority [are] in high-income countries."
"With low back pain being the biggest single cause of years lived with disability and an increasing ageing population, it is clear that there is a shortfall in the numbers of health workers globally who are trained to effectively manage spinal pain and disability," said WFC Secretary-General, Richard Brown.
An article in the World Health Organization's Bulletin supports Brown's comments, discouraging opioid use for back pain and advocating nondrug options ... but also warning of the lack of health system support for chiropractic and other nondrug therapies. So, the world needs more chiropractic ... but isn't filling the need. Something has to give.