The Northwestern Health Advocate

Center for Healthcare Innovation and Policy

Stay current with the latest policy and research news in integrative health care

Thanks for reading! The Center for Healthcare Innovation and Policy at Northwestern Health Sciences University is gearing up for a lot of legislative activity in the new year. As such, we've added a regular feature to highlight bills that might be of interest to you, and ideas for how to get engaged. Check out our Call To Action, below!

Healthcare Practice

Herbal Remedies to Alleviate Back Pain

A recent Cochrane review evaluated the effectiveness of herbal therapies for nonspecific low back pain. Based on the findings of 14 randomized controlled trials, cayenne (capsicum frutescens), devil’s claw (Harpagophytum procumbens), white willow bark (Salix alba), comfrey (Symphytum officinale L.), Brazilian amica (Solidago chilensis) and lavender essential oil all reduced back pain in patients more than placebo. Notably, no significant adverse events were reported in the trials.

More high quality research is needed to confirm these findings, as well as compare herbal treatments to other standard therapies for back pain. However, given initial evidence of effectiveness and a relatively low risk profile, these herbs may provide important treatment options for managing back pain.

A clinical note from one of my esteemed Northwestern colleagues from the College of Acupuncture and Oriental Medicine:

"comfrey used in the two included studies was in the form of an ointment in one case and a gel in the other...Comfrey should never be taken internally due to the potential for causing veno-occulsive liver disease from pyrrolizidine akaloids. See


National Medicare Equality Petition

The Time for Change is NOW

The American Chiropractic Association (ACA) has launched a major grassroots campaign to enact federal legislation that would achieve full physician status for doctors of chiropractic in Medicare. This initiative would significantly improve the health and wellness of our nation's aging population -- and your support is urgently needed.

The National Medicare Equality Petition will raise awareness of how the current Medicare system shortchanges seniors who want and need the essential services provided by doctors of chiropractic (DCs) to stay healthy, pain free and mobile, and how DCs can be a part of the solution for what ails the U.S. health care system.

ACA is encouraging doctors of chiropractic across the country to ask their patients and other chiropractic supporters to sign the petition (links below) and add their names to a growing list of Americans who want rightful access to and full reimbursement for services provided by doctors of chiropractic for themselves or their loved ones who are Medicare patients. The plan is to let signers of the petition have their voice heard in Washington through a series of targeted grassroots campaigns to contact their members of Congress and demand a solution to this problem. The ultimate goal is to create a groundswell of support that Congress cannot ignore.

Sign the Petition


"Myth Exploded"

A doctor of chiropractic recently reported the detection of a vertebral artery dissection in progress during one of his patient visits. The case study, published in BMJ Case Reports, describes the presentation of a 30 year-old women with neck pain, 2 days after release from an emergency room, with transient loss of left peripheral vision. The report describes the evaluation, diagnosis, successful referral and ongoing management of this individual.

This case study is an excellent example of keen diagnostic skills and responsible conservative patient care. The chiropractor in this case likely saved his patient’s life. His meticulous evaluation despite an “all clear” report from a medical physician spared him a career altering event, should his patient’s stroke have progressed under his care. This case report was published under the banner "Myth Exploded", likely due to the misplaced negative exposure the chiropractic profession typically faces due to an association between stroke and manipulative therapy.

Case studies have a complicated reputation in the world of research: championed by clinicians for reflecting “real world practice”, and jeered by many research scientists as low quality evidence that clutters the literature. What is the utility of a case report, particularly in the era of big data and comparative effectiveness research?

Case studies provide important evidence when

· Events are extremely rare or emergent

· New treatment, health care technology, or models of care delivery are being developed

Case reports are an excellent way for field clinicians to participate in research. Although the generalizability of results from a case study is limited because of its design, there are steps authors can take to minimize bias when reporting and increase the usefulness of the report. Several resources exist to guide an author through the process of writing a case study, including some with instructions tailored specifically to acupuncturist, chiropractic, and massage therapy audiences.

Call To Action

Minnesota Massage and Bodywork Therapy Act

Have you contacted your legislator?

Welcome to 2016! We hope you had a wonderful holiday season. Now that your rested, we need your help to really dig in and make the MN Massage and Bodywork Act pass into law!

You might be thinking, "How can I help?" That's probably the easiest part. We need each one of you to contact the legislators in the district where you live (found here), write them a letter/email or call them to voice your support for the MN Massage and Bodywork Act. At the bare minimum, that's how you can help.

Want to take it a step further? We have been publishing opinion pieces by those of you willing share why the MN Massage and Bodywork Therapy Act matters. Scroll down to find out more and read our most recent stories.

In Capitol News, our government relations team continues to meet with key legislators to prepare for the 2016 Legislative Session, which starts March 8, 2016. The next key legislators they will meet with are Rep. Peggy Scott, chair of the Civil Law and Data Practices committee, and Rep. Tim Sanders, chair of the Government Operations and Election Policy committee. Please communicate your support to Reps. Scott and Sanders if you are from their districts! You can also contact Susan Tietjen.
--courtesy the Alliance for Legislation of Massage Therapy

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Center for Healthcare Innovation and Policy

Michele Maiers, DC, MPH, PhD
Executive Director of Research and Innovation