The Musculoskeletal Biomechanics Research Laboratory at the Loyola University Medical Center, endearingly known as the Windy City Lab, is a site of federally funded research into the biomechanical and clinical studies of flexion-distraction, the technique also known as Cox Technic developed by Dr. James M. Cox. The most current project involves the cervical spine.

At the Windy City Lab, Dr. Avinash G. Patwardhan directs a team of orthopaedic surgeons, engineers, medical researchers and statisticians whose publishing credits include over 100 papers in peer-reviewed journals like Spine, J of Bone and Joint Surgery and the J of Biomechanics. It's quite impressive what this small but mighty team has accomplished.

Dr. Ram Gudavalli, chiropractic researcher from Palmer Research Center and director of the chiropractic clinicians and researchers in this particular project under the direction of Christine Goertz, DC, PhD, works closely with Dr. Patwardhan and his team. Consulting chiropractic clinicians who volunteer their time and travel to this project include

• James M. Cox, DC, DACBR
• George Joachim, DC, DACRB
• Ralph Kruse, DC, DABCO
• Robert Rowell, DC 
• Michael Seidman, DC
• Robert Vining, DC

Each time these researchers and clinicians assemble, excitement abounds at the ability to document what happens during this flexion distraction procedure and at the collaborative efforts of all involved.

Please check out the new website for Loyola's Musculoskeletal Biomechanics Research Laboratory, www.WindyCityLab.com. (Watch the image rotator on the homepage to see if you recognize the research team for this flexion distraction research project!)

We have our secure portal and can now start sharing some of the recorded Cox Technic related webinars from the past year. Some are free and presented by Cox Technic Complete (the program for online outreach for flexion-distraction physicians) and some are fee-based as they are academic presentations by Dr. James Cox.

The free webinars include case report presentations of actual patient cases from exam through treatment and outcome as well as discussions of the latest statistics in the world of spinal pain management. Dr. Cox's passion for spinal pain care and research shines in these and his passion will inspire you! Demonstrations of how the Cox Technic Complete program highlights these research and scientific advances and findings for spinal care for the subscriber. Cox Technic Complete pulls it all together from clinical office materials that are downloadable to the website that is personalized for your practice and optimized for internet SEO and localization telling your community that you are a back pain specialist with the treatment to help them get rid of pain.

The educational, academic fee-based webinars are on topics like pathologies in the chiropractic practice, FBSS patients, Cox Technic research studies and patient documentation. Dr. Cox shares his clinical practice style and his passion for chiropractic and research are evident and will likely inspire you.

More online recorded Cox Technic webinars are in the editting stage and will be uploaded over the next few weeks. Enjoy these for now!

Contact us if you have any questions or suggestions for future webinars!

Healthcare costs and healthcare demands are all the talk today. Families struggle with healthcare decisions. Politicians and insurance companies are changing the system. Doctors are changing their office protocols to meet the new guidelines. It's hard to keep up for everyone. But for your health, you know that evidence-based protocols are those that you want for your loved ones when they hurt.

Evidence-based protocols come from documentation by clinicians and researchers seeking an answer to help sufferers. When it comes to back pain and lower back pain and neck pain sufferers, Cox Technic strives to provide the evidence-based protocols to make a difference in your lives. Researchers from prestigious universities and research centers (click here to see some of the federally funded projects and who is involved) work together to document the biomechanical (answering the question: what happens during Cox Technic?) and clinical (answering the question: how long does it take to get relief?) of Cox Technic.

Systematically, researchers and clinicians work to define the evidence-based protocols that will relieve back pain and neck pain without surgery or drugs when possible. When a doctor implements evidence-based protocols in his or her clinical practice, patients can feel a bit more assured that there is a level of science and understanding behind those protocols and find reasonable relief of pain. All persons involved know what to expect and what to do when those expectations are not met.

Evidence-based medicine and clinical protocols are the present and the future of healthcare. If something works, it will likely be used and paid for. If it doesn't, it likely won't.

If you suffer with back pain or related extremity pain or neck pain, contact a Cox Technic certified physician to discuss your condition and expectation of relief. Cox Technic treatment protocols are safe and gentle.

If you are physician seeking to implement an evidence-based protocol in your spine pain practice, contact us for information on educational opportunities and training seminars, research, and publications about the evidence-based protocols of Cox Technic.

Chiropractic and Back Pain. Chiropractic and Neck Pain. Chiropractic and Spine Pain. The public thinks of chiropractic for back pain by and large.

• 33% of 27,810 people chose chiropractors as their treating physician for low back pain in the National Health and Nutrition Examination Survey. (NHANE) [in Deyo R: Spine 12(3)]
• Spine care delivery is 60% by the medical model and 40% by the chiropractic model. [Saal, Spine 22(14)]
• The total number of US adults who went to a chiropractor increased 57% from 2000-2003. [Davis, Health Svcs Research 45(3)]
• Paid costs for back pain care started with a chiropractor were 40% less than care started with a MD. [Liliedahl, JMPT 33(9)]

Chiropractic is reknown for its back pain care. Chiropractic has evidence-based technique to relieve and control back pain like Cox Technic.

The federally funded studies document Cox Technic Flexion-Distraction and Decompression's biomechanical effects on the spine as well as its clinical outcomes:

• intradiscal pressure drops to as low as -192mm Hg in the lumbar spine
• 28% widening of the area of the intervertebral canal
• flexion distraction is superior in relieving pain due to radiculopathy (leg pain) compared to medical care. (Gudavalli, Euro Sp J 2006) 
• 29 days and  12 visits are the averages for relief of low back pain when not taking into account specific conditions of back pain. [Cox, Topics in Clinical Chiropractic 1996, 3(3)]
• 13.2 treatments is the average for relief of neck pain radiculopathy. [Schliesser, Kruse, JMPT 26(9)]

Back pain and chiropractic fit together. The chiropractic physician is skilled in the diagnosis, examination and treatment of back pain as well as its prevention with nutrition, exercise and lifestyle choices. The chiropractic back pain research continues to evolve in support. Chiropractic physicians train specially to keep abreast of the latest research and Cox Technic treatment application in seminars. Back pain patients find Cox Technic physicians for their back pain relief when they search the referral directory of certified Cox Technic physicians.

Research leads the way in evidence-based care and in Cox Technic.

Contact Cox Technic if you have any questions.

Certified doctor, Dr. Joseph D'Angiolillo, is in a feature article about his using Cox Technic in practice - gentle, non-invasive treatment for disc, neck, headache ("no cracking"). Complete with pictures! Nice article. 

http://www.mycentraljersey.com/apps/pbcs.dll/article?AID=201011090304

The Oregon Chiropractic Association is kindly co-sponsoring this Cox® Seminar on September 18-19, 2010. Dr. Lee Hazen leads this weekend in the discussion of the research support for Cox® flexion-distraction and decompression protocols as well as guides your hands-on practice with the protocols.

Some things to consider about Cox® Technic's being RESEARCHED and SUPPORTED:

June 23, 2010

For release:    Immediately

Contact:          Lori Leipold, Media Relations; Palmer College of Chiropractic; phone (563) 884-5726; fax (563) 884-5225; e-mail lori.leipold@palmer.edu; College website at www.palmer.edu

Palmer College of Chiropractic, Loyola University, Hines VA researchers and Dr. James Cox work together to understand Cox® distraction procedure for neck pain

In a ground-breaking study, medical and chiropractic researchers are joining efforts to study the effects of a form of non-surgical treatment for neck pain, more specifically Cox distraction manipulation. This study is one of three projects that are part of a four-year, $2.8 million grant awarded in 2008 to the Palmer Center for Chiropractic Research (PCCR), headquartered on the Palmer College of Chiropractic campus in Davenport, Iowa. The grant is from the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine to establish a multidisciplinary Developmental Center for Clinical and Translational Science in Chiropractic, and the principal investigator is Christine Goertz, D.C., Ph.D., who also serves as Palmer’s vice chancellor for Research and Health Policy. Co-leaders of the Cox distraction manipulation project are M. Ram Gudavalli, Ph.D., PCCR, and Avinash G. Patwardhan, Ph.D., Loyola University Stritch School of Medicine and Edward Hines Jr. Veterans Affairs Hospital.

This study is in progress and funded through May 30, 2012. It combines the efforts of medical doctors, chiropractors, biomechanists and clinical researchers, in order to document the effects of the Cox distraction chiropractic procedure on neck pain and develop sham and active treatment parameters for conducting clinical studies.

The project, titled Cervical Distraction Sham Development: Translating from Basic to Clinical Studies, consists of three main parts. After completing the pilot studies, the formal basic research study began in March 2010 on the Cox distraction procedure for neck pain at Edward Hines VA Hospital and Loyola University Stritch School of Medicine. This study is a collaborative effort between researchers at these facilities, researchers from Palmer College of Chiropractic, clinicians who perform this technique in their practices, and Dr. James Cox, the originator of the procedure. 

“As the manipulation procedure is performed, we are measuring the variability between four different clinicians trained in this procedure by measuring the loads and the controlled displacements of the table using a basic science approach as well as a clinical approach,” said Dr. Gudavalli from Palmer. “According to practicing doctors of chiropractic, this chiropractic procedure has provided relief for musculoskeletal conditions such as neck pain. However, there is a need for studies that provide information on the biomechanical characterization of such therapies, the biomechanics of normal and pathological joint and muscle systems, and the development of new technologies that study such biomechanics in real time. In other words, what physiological effect does the procedure have that is responsible for its clinical successes?”

The results of this study will aid in the planning and development of controlled procedures in the clinical setting, and test the validity of delivering the controlled procedures by conducting clinical studies and obtaining patients’ perception on the controlled intervention. This knowledge has the potential to guide the future conduct of clinical research in this area and impact training of students and doctors in the chiropractic profession.

- end -

Lori Leipold

Media Relations Manager

Palmer College of Chiropractic

Office: (563) 884-5726

Cell: (563) 343-0665

Join Dr. Ralph Kruse, our much published cervical spine and pregnancy back pain treatment author and instructor, in Boston this summer on July 17-18, 2010, for the Part I Cox® Technic Certification Course. Fro details on the hotel (the uniquely located Hyatt Harborside) and the fun to be found in Boston when you aren't studying with us, please click here.

The Part I course shares the foundation of Cox® protocols from the biomechanical influences to the diagnostic essentials to the treatment skills necessary to handle the disc herniation and stenosis patients as well as the non-disc related spine pain patients confidently. Treatment for lumbar spine and radiculopathy, cervical spine and arm pain, thoracic spine pain, pregnancy back pain are demonstrated. For a video description of the weekend, please click here.

Join us for the Cox® Technic Seminar in Boston!

                 Dr. Cox and Dr. Kruse

Drs. Gudavalli and Kruse report on a 33-year-old man who complained of severe neck pain and spasms, pain radiating down his left arm and upper back, and associated numbness in his fingers. Clinical examination and MRI radiological examination find that a moderate-sized left posterolateral disc herniation at C6/C7 which is causing severe foraminal stenosis.  The patient was treated a total of 15 times in 10 weeks. Subjective findings using a pain scale and objective examination findings supported a good clinical outcome. At 2-year follow-up, subjective and objective findings remained stable.

Description and image: http://www.spineuniverse.com/conditions/spinal-stenosis/what-spinal-stenosis