Spinal Chat with The PCA

PCA Deep Dive: The Pill-First Problem; Ibuprofen, Joint Pain, and Conservative Care

PCA Deep Dive: The Pill-First Problem; Ibuprofen, Joint Pain, and Conservative Care In this Spinal Chat Deep Dive, the Pennsylvania Chiropractic Association explores why joint and musculoskeletal pain often pushes patients toward a medication-first pathway, and why modern care should include earlier access to conservative, non-drug musculoskeletal options. This episode uses recent public-facing articles, patient education resources, federal safety information, and chiropractic research discussions to examine the risks of frequent or long-term NSAID use, the role of movement in joint health, and where chiropractic care fits responsibly within conservative musculoskeletal care. This episode is not anti-medication. Ibuprofen and other medications may be appropriate for some patients. Patients should speak with their healthcare provider before changing medication use. Key Themes: * Over-the-counter does not mean risk-free. * Frequent or long-term NSAID use can carry gastrointestinal, kidney, cardiovascular, respiratory, fall-risk, and medication-interaction concerns. * Movement and exercise are central to joint health and osteoarthritis care. * The strongest evidence for chiropractic care is in spine-related pain, especially low back and neck pain. * Patients need better pathways, not fewer choices. * Conservative care should be easier to access, not harder. Sources and Credits: 1. “A Common Joint Pain Medicine Has Risks Many People Overlook” Author: Anthony Paul Smith Publisher: ScienceAlert, republished from The Conversation Date: June 4, 2026 2. “Beyond Ibuprofen: Conservative Care for Joint Health” Source Type: Text excerpt focused on conservative care and reducing unnecessary reliance on medication-heavy pathways. 3. “How New Research Is Advancing the Field of Chiropractic Medicine” Author: Dr. Gregory Cramer Publisher: National University of Health Sciences Date: June 7, 2023 4. “Joint Pain: An Expert Reveals the Really Effective Remedy... Not the One You Think” Publisher: Thot Cursus Date: Published and updated November 25, 2025 5. “Millions With Joint Pain and Osteoarthritis Are Missing the Most Powerful Treatment” Author: Clodagh Toomey Publisher: ScienceDaily, based on materials provided by The Conversation Date: March 4, 2026 6. NCHM Key Messages / Talking Points Publisher: American Chiropractic Association 7. “Pain and Arthritis Products Containing Hidden Ingredients” Publisher: U.S. Food and Drug Administration Content current as of June 1, 2026 8. “The Best Medicine For Joint Pain Isn’t What You Think, Experts Say” Author: Carly Cassella Publisher: ScienceAlert Date: May 23, 2026 9. “Treating Osteoarthritis Pain: What Works, What Doesn’t” Author: Rachel Nania Publisher: AARP Updated December 22, 2025 10. “Pain Medication and Fall Risks Among Community-Dwelling Older Adults With Arthritis” Authors: Aya Yoshikawa and Richard Fortinsky Source: Academic abstract included in igad104.2564.pdf PCA Note: Spinal Chat Deep Dive is a service of the Pennsylvania Chiropractic Association. These episodes are designed to be shared with patients, healthcare colleagues, elected officials, employers, and the public as educational resources. PCA Website: https://pennchiro.org/ [https://pennchiro.org/] PCA Email: pca@pennchiro.org [pca@pennchiro.org] Created and produced by Mike Barba for the Pennsylvania Chiropractic Association. AI-assisted tools were used in the production of this content. Final content was reviewed and approved by PCA.

PCA May President's Address with Dr. Kris Arnold

PCA May President's Address with Dr. Kris Arnold PCA President Dr. Kris Arnold’s First Address: Unity, Communication, CE, and Advocacy In the first President’s Address on Spinal Chat, Pennsylvania Chiropractic Association President Dr. Kris Arnold outlines goals to strengthen chiropractic in Pennsylvania through greater unity, improved communication, member engagement, and a stronger shared voice. He highlights the sold-out Northeast Chiropractic Summit at Kalahari, encourages members to attend the next Summit on May 1–2, 2027, in Seven Springs, and urges participation via PCA emails, social media, the members-only Facebook page, YouTube, and the Spinal Chat podcast. Dr. Arnold reminds doctors that it is a CE renewal year, requiring 24 credits plus two child abuse credits, and promotes PCA-approved in-person and online options, including PCCI billing/documentation training. He notes upcoming insurance pre-authorization changes affecting United, Highmark, and UPMC, invites members to fill open board seats, recognizes the sports working group’s involvement in the Pittsburgh Marathon, and references upcoming legislative victories in Harrisburg. 00:00 Welcome and Episode Setup 00:51 Meet Dr Kris Arnold 01:25 Unity and Summit Highlights 02:16 Next Summit Save the Date 02:53 Better Member Communication 03:43 CE Credits and Renewal 05:07 Insurance Preauth Changes 05:37 Open Board Seats 06:07 Sports Group Community Outreach 06:53 Legislative Wins and Wrap Up 07:24 PCA Community Call to Action PCA Website: https://pennchiro.org/ [https://pennchiro.org/] PCA Email: pca@pennchiro.org [pca@pennchiro.org] Created and produced by Mike Barba for the Pennsylvania Chiropractic Association. AI-assisted tools were used in the production of this content. Final content was reviewed and approved by PCA.

PCA Strategic Business Member Spotlight: North Payment Processing with Ryan Moss

PCA Strategic Business Member Spotlight: North Payment Processing with Ryan Moss In this PCA Strategic Business Member Spotlight, Mike Barba of the Pennsylvania Chiropractic Association interviews Ryan Moss, Senior Director of Enterprise Sales at North, a payment processing company vetted by PCA to help chiropractors understand and reduce credit card processing costs. North, in payment processing since 1992, specializes in medical merchants, owns its in-house processing platform, and emphasizes dedicated service, integrations with practice management software, and a user-friendly portal for statements, deposits, and transaction visibility. The discussion highlights how hidden “junk fees,” padded interchange, and unclear statements can drive effective rates to 4–5%, while understanding total fees divided by monthly volume helps identify overpaying; North aims for transparent pricing and offers options including traditional pricing and a dual pricing “Edge” program that can pass acceptance costs to patients. Members are encouraged to review agreements, watch for long-term contracts and cancellation fees, and contact Moss for statement-based comparisons; using PCA partners also supports PCA advocacy and education, with a portion of transactions benefiting the association. 00:00 Member Spotlight Intro 00:57 Meet Mike and North 02:09 What North Does 03:11 Why Switch Processors 04:33 Technology and Service 05:49 Hidden Fees Explained 07:18 Reading Your Statement 10:15 Payment Options for Clinics 11:19 Training and Support 12:47 Comparing Providers 15:23 Contracts to Avoid 17:18 How to Get Started 18:21 Partnering Supports PCA 18:54 Final Pitch and Wrap 21:15 Key Takeaways Outro Contact North, Ryan Moss Senior Director, Enterprise Sales P: 818-825-7500 E: ryan.moss@north.com [ryan.moss@north.com] PCA Website: https://pennchiro.org/ [https://pennchiro.org/] PCA Email: pca@pennchiro.org [pca@pennchiro.org] Created and produced by Mike Barba for the Pennsylvania Chiropractic Association. AI-assisted tools were used in the production of this content. Final content was reviewed and approved by PCA.

PCA Study Review: Shoulder Pain, Rotator Cuff Tears, and the Problem with One Test Thinking

PCA Study Review: Shoulder Pain, Rotator Cuff Tears, and the Problem with One Test Thinking In this episode of PCA Study Review, a service of the Pennsylvania Chiropractic Association, we review research on shoulder exams, rotator cuff tears, and subacromial impingement. Shoulder exams can get crowded quickly: Neer, Hawkins, Jobe, Drop Arm, Lift Off, Painful Arc, and lag signs. Most doctors know the names. The deeper issue is whether we understand what each test actually tells us. The literature reinforces one clear point: no single shoulder test is perfect. This review focuses on lag signs, particularly the External Rotation Lag Sign at 90 Degrees and the Internal Rotation Lag Sign, to identify full-thickness rotator cuff tears. The larger lesson is not that doctors need one magic test. Better clinical reasoning requires test clusters, context, documentation, and knowing when referral, imaging, or co-management may be appropriate. For chiropractors, this matters because musculoskeletal care depends on skilled examination early in the care pathway. The opportunity is to evaluate carefully, recognize red flags, document clearly, and treat conservatively when appropriate. In This Episode * Why one test thinking can weaken the shoulder diagnosis * Why lag signs deserve attention in shoulder evaluation * How high specificity and low sensitivity should affect interpretation * Why familiar tests are not always the strongest tests * How test clusters improve clinical reasoning * When shoulder findings may require referral, imaging, or co-management * Why evidence-informed documentation strengthens care and credibility Reference Articles Zhao, Q., Palani, P., Kassab, N. S., Terzic, M., Olejnik, M., Wang, S., Tomassini-Lopez, Y., Dean, C., & Shellenberger, R. A. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 25, Article 1028, 2024. [https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-024-08144-z] Hermans, J., Luime, J. J., Meuffels, D. E., Reijman, M., Simel, D. L., & Bierma-Zeinstra, S. M. A. Does This Patient With Shoulder Pain Have Rotator Cuff Disease? The Rational Clinical Examination Systematic Review. JAMA, 310(8), 837–847, 2013. [https://jamanetwork.com/journals/jama/fullarticle/1733724] Castoldi, F., Blonna, D., & Hertel, R. External rotation lag sign revisited: Accuracy for diagnosis of full-thickness supraspinatus tear—Journal of Shoulder and Elbow Surgery, 18(4), 529–534, 2009. [https://www.sciencedirect.com/science/article/pii/S1058274609000081] Miller, C. A., Forrester, G. A., & Lewis, J. S. The Validity of the Lag Signs in Diagnosing Full-Thickness Tears of the Rotator Cuff: A Preliminary Investigation. Archives of Physical Medicine and Rehabilitation, 89(6), 1162–1168, 2008. [https://www.sciencedirect.com/science/article/pii/S0003999308002098] The shoulder is complex. Rotator cuff disease is common. Pain provocation tests can mislead when used carelessly. The opportunity is to read the research, revisit the exam, and sharpen the clinical reasoning that protects patients and strengthens the profession. PCA Website: https://pennchiro.org/ [https://pennchiro.org/] PCA Email: pca@pennchiro.org [pca@pennchiro.org]

PCA Deep Dive: Pennsylvania’s Chiropractic Scope Fight; Modern Care vs. Outdated Laws

PCA Deep Dive: Pennsylvania’s Chiropractic Scope Fight; Modern Care vs. Outdated Laws In this episode of PCA Deep Dive, we examine one of the most important questions facing chiropractic in Pennsylvania: What happens when modern chiropractic education, modern patient needs, and conservative care collide with an outdated scope-of-practice law built for another era? Pennsylvania’s chiropractic scope of practice is nearly 50 years old. While the profession, patient expectations, education standards, and healthcare delivery models have changed dramatically, Pennsylvania law has not kept pace. This episode explores the real-world impact of that mismatch, including restricted practice authority, rural access challenges, workforce pressure, delegation barriers, insurance friction, and the hidden cost of limiting conservative, non-pharmacological care. We also discuss research from West Virginia University showing that Pennsylvania ranks among the most restrictive states in the country for chiropractic scope of practice. The result is a paradox: highly trained doctors operating under low autonomy. But this is bigger than one bill. This is the scope fight. It is about whether Pennsylvania’s chiropractic law will finally reflect modern education, modern patient needs, and modern conservative care. In This Episode * Why Pennsylvania’s chiropractic scope of practice is nearly 50 years old * How outdated scope laws affect access, efficiency, and patient choice * Why does Pennsylvania rank among the most restrictive states for chiropractic scope * How regulatory ambiguity can function like a practical ban * Why rural communities feel these restrictions more sharply * How workforce shortages and limited training pipelines affect access * Why HB 1106 matters for delegation and clinic efficiency * How scope modernization connects to non-opioid care and the future of chiropractic in Pennsylvania Get Involved Policy does not change from the sidelines. PCA’s Lobby Day is June 9 in Harrisburg, and we need chiropractors from across Pennsylvania to show up, meet with elected officials, and help tell the story of this profession. We know it is a practice day. But this is one of the most important opportunities we have to show the strength, seriousness, and unity of chiropractic in Pennsylvania. If you cannot attend, please consider supporting the PCA PAC. One hundred percent of PCA PAC donations go directly toward supporting chiropractic advocacy and the future of the profession in Pennsylvania. WVU study on Pennsylvania’s outdated scope of practice: [https://knee.wvu.edu/publications/knee-center-research/2026/04/16/chiropractic-scope-of-practice-and-provider-distribution-in-pennsylvania] Register for PCA Lobby Day on June 9: [https://docs.google.com/forms/d/e/1FAIpQLSf6J5wmpJiZI6xMTwu5i7kmgQauR0IUW32S6YcIu5LAQsfcNw/viewform] Support the PCA PAC: [https://pca.ce21.com/donations] Learn more about HB 1106 and delegation restoration: [https://pennchiro.org/hb1106/] PCA: https://pennchiro.org/ [https://pennchiro.org/] Email the PCA: pca@pennchiro.org [pca@pennchiro.org]