Osteopath & chiropractor services papers

Osteopath & chiropractor services papers

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Masterclass: Axial spondyloarthritis for osteopaths and manual therapists.

Macmillan A, Corser A, Clark ZE, McCrum C, Gaffney K. Masterclass: Axial spondyloarthritis for osteopaths and manual therapists. International Journal of Osteopathic Medicine. 2021, Volume 41. https://www.sciencedirect.com/science/article/abs/pii/S1746068921000213
Axial Spondyloarthritis (axial SpA) is an inflammatory arthritis primarily affecting the sacroiliac joints (SIJ) and spine and is a spectrum of disease which includes the more commonly known Ankylosing Spondylitis. Axial SpA is often missed in musculoskeletal assessments, and mismanaged and treated as chronic low back pain. Early diagnosis and intervention are essential to improve outcomes and so it is vital that people presenting with back pain are screened for axial SpA.
This masterclass aims to improve clinicians’ understanding and awareness of axial SpA, including screening, recognition and when to refer to rheumatology. This article will familiarise clinicians with typical clinical features, appropriate investigation and interpretation, referral pathways in line with UK National Institute of Clinical Excellence (NICE) guidelines and advise on best practice for clinicians managing axial SpA.

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Awareness of axial spondyloarthritis among chiropractors and osteopaths: findings from a UK Web-based survey.

Yong CY, Hamilton J, Benepal J, Griffiths K, Clark ZE, Rush A, et al. Awareness of axial spondyloarthritis among chiropractors and osteopaths: findings from a UK Web-based survey. Rheumatology advances in practice. 2019;3(2):rkz034-rkz. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785804/

Large web-based survey of 237 chiropractors and 145 osteopaths demonstrated that although overall knowledge of ankylosing spondylitis is good among chiropractors and osteopaths, the term axial SpA is poorly understood. Specific learning needs include gender preponderance, awareness of acute anterior uveitis and the availability of biological therapies. There is lack of confidence in the onward referral process to rheumatology via the GP. Only 63% and 25% were familiar with the terms axial SpA and non-radiographic axial SpA, respectively. Only 29% recognized that axial SpA was common in women.  Seventy-seven per cent were confident with inflammatory back pain. Respondents routinely asked about IBD (91%), psoriasis (81%), acute anterior uveitis (49%), peripheral arthritis (71%), genitourinary/gut infection (56%), enthesitis (30%) and dactylitis (20%). Forty-three per cent were confident with the process of onward referral to rheumatology via the GP. The principal perceived barrier to onward referral was reluctance by the GP to accept their professional opinion.

Symptoms starting slowly

Pain in the lower back

Improves with movement

Night time waking

Early onset (under 40)