Twenty-two chiropractic doctors and students joined at the beautiful Hyatt Boston Harborside Hotel for a weekend of hands-on and academic experience. Lead by Dr. Ralph Kruse, the doctors from Norway to Illinois to Connecticut to Canada heard about the history of Cox Technic, saw videotaped cases of Dr. James Cox, the developer of Cox Technic Flexion Distraction and Decompression spinal manipulation, applying Cox Technic protocols from the spinal manipulation to ancillary therapies and exercise, gained insights into the biomechanics of flexion distraction based on federally funded HRSA grant studies and the clinical outcomes of flexion distraction, and felt how the proper application of Cox Technic should feel as both the doctor and patient. Always an amazing finding is how small the motion is to get the desired effect. One to 2 inches of motion from the treatment starting point is all it takes. There is no need or desire for 16° of flexion when applying flexion distraction properly. Further, dropping intradiscal pressures on the DRG is important. Pain is when there is more than 20mm of pressure on the DRG nerves according to Takahashi.

“You get the latest research presented in concise form, as well as individual hands-on with the technique that is invaluable. When’s the last time a seminar day flew by? Good stuff.”

– Boston Part I (7/11) attendee comment on evaluation form

So consider joining the next Cox Technic Part I Certification Course in San Diego on September 9-10, 2011. You’ll be amazed at today’s 21^st century, gentle, evidence-based, effective clinical protocols of Cox Technic that have evolved since you took it in school or heard about it from a colleague!

Check the website for more information on Cox Technic and on the seminars we offer. Then, contact us with any questions.

Just posted to the website and on YouTube, a new video about Cox Technic Flexion Distraction and Decompression with its developer, Dr. James Cox, is ready. Highlighting a demonstration of the proper protocols of Cox Technic, the video also emphasizes the research, the educational opportunities to learn more about it for doctors and patients, the tools availables to enhance the use of flexion distraction as well as the referral directory to certified Cox Technic physicians.

Check out the video today!

The 2009 National Board of Chiropractic Examiners Survey results have been published. Survey participants reported that 63.7% use flexion-distraction.

Past years' surveys revealed

1991    53.7%   (It is termed "Cox flexion-distraction" in the list of techniques.)

1998    58.0%   (It is termed "Cox flexion-distraction" in the list of techniques.)

2003    56.5%   (It is termed "Cox flexion-distraction" in the list of techniques.)

2009    63.7%   (It is termed "flexion-distraction" in the list of passive adjunctive procedures.)

* from Practice Analysis of Chiropractic 2010, page 134.

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

More details will come, but the date has been set.

February 19-20, 2011 at the beautiful Hyatt Regency Maui Resort & Spa where millions of dollars of renovations are to finish up by December 2010, just in time for our visit!

Plan to join Dr. James Cox as he makes a unique weekend presentation on current clinical and research topics influential to your Cox® spinal pain practice.

Check this link for the latest news and details on the Cox® Technic Seminar in Maui, Hawaii.

Cox® Technic (aka flexion-distraction) clinical outcomes published in European Spine Journal. Flexion-Distraction provided more low back pain relief than did medical conservative active exercise. 

Patients with radiculopathy (leg pain) did significantly better with flexion-distraction than active exercise. 

article link: http://www.springerlink.com/content/f32603l877144k77/?p=1ba95a15a905467b8ed4080941ee22e6&pi=4

Cox® Seminars teach the biomechanics, examination, diagnosis and treatment of spinal pain conditions. Treatment is focused on Cox® flexion-distraction and decompression protocols performed by chiropractic physicians who use their hands and their palpatory skills to adjust the spine. Cox® Seminars emphasize the role of the chiropractic physician and his/her trained hands in caring for spinal pain conditions.

60% of chiropractors reported to the National Board of Chiropractic Examiners that they use Cox® Technic.

Chiropractic research projects funded by various organizations from NIH to HRSA to FCER continue to investigate chiropractic flexion distraction. Projects are underway at Palmer Research Center (Gudavalli et al), National University of Health Sciences (Gudavalli & Cambron), New York College of Chiropractic (Dougherty) among others. These projects' goals and outcomes as available are shared.

Cox® Seminars teach the proper application of flexion-distraction protocols. Attending doctors are often taken aback at the low amount of force and at the depth of flexion that is actually required (only 1 to 2 degrees when the protocol is applied correctly). There is nothing like hands-on experience training to really grasp what a technique is all about.

For more information on Cox® Seminars, please click here.

Cox® Technic Flexion-Distraction and Decompression Adjusting is doctor-administered and doctor-controlled spinal manipulation.  Certified chiropractic physicians in Cox® Technic are trained to treat patients using defined protocols which stem from carefully observed and documented  outcomes.

In federally funded research studies (conducted between chiropractic and medical research centers:

• National University of Health Sciences
• Palmer College of Chiropractic Research Center
• Loyola Stritch School of Medicine
• Auburn University (grad student)
• University of Iowa
• University of Illinois
• Hines VA Hospital
• etc.),

 flexion-distraction (F/D) has been shown to

• drop intradiscal pressures to as low as -39mmHg to -192mmHg, and
• increase the foraminal area by 28%.

F/D is a chiropractor-administered adjustment, delivered to the specific spinal level required. This is necessary to deliver the spinal decompression and chiropractic adjustment to the specific segment involved and to relieve the hypomobility and altered segmental dysfunction of disc herniation and spinal stenosis condition.

Consider this paper on "decompression traction" and compare to F/D clinical outcomes:

source: Schimmel, JJP; de Kleuver, M; Horsting, PP; Spruit, M; Jacobs, WCH; van Limbeek, J. No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy. EUROPEAN SPINE JOURNAL 18 (12). DEC 2009. P.1843-1850