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/

PCA Email: 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

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

PCA Website: https://pennchiro.org/

PCA Email: 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

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.

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.

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.

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.

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/ PCA Email: pca@pennchiro.org

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:

Register for PCA Lobby Day on June 9:

Support the PCA PAC:

Learn more about HB 1106 and delegation restoration:

PCA: https://pennchiro.org/

Email the PCA: pca@pennchiro.org

PCA Study Spotlight: The Hidden Circuit of Chronic Pain

Stanford’s Hidden Chronic Pain Circuit: A Better Framework for Explaining Persistent Mechanical Pain

This episode of PCA Study Spotlight reviews a Stanford Nature study describing a “hidden” looping circuit between the spinal cord and brain that appears to selectively drive chronic mechanical pain in mice while remaining distinct from pathways involved in acute, protective pain and normal touch. In mouse models, silencing nodes in the loop reduced injury-induced mechanical hypersensitivity due to inflammation or nerve injury, whereas repeated activation could create lasting hypersensitivity in healthy mice. The host emphasizes this is basic science, not a chiropractic or manipulation study, but argues it offers chiropractors a clearer framework for communicating chronic pain: persistent pain may reflect altered nervous system processing and sensitization rather than ongoing tissue damage, supporting more accurate, respectful patient conversations and reinforcing the value of conservative care without overclaiming mechanisms.

00:00 Series Purpose

00:25 Study Overview

01:09 Important Caveats

01:40 Why Pain Persists

02:22 Mapping The Loop

03:52 Clinical Communication

04:45 Fear And Function

05:34 Beyond Structural Stories

06:00 Touch Versus Pain

06:55 Layered Pain Biology

07:31 Practical Takeaways

08:16 Read And Reflect

08:47 Closing Thoughts

Study Citation Wang, Q., Lee, J. H., Nachtrab, G., Yuan, Y., Yuan, L., Qi, W., Mohr, M. A., Xiong, J., Horowitz, M. A., & Chen, X. (2026). Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y. Official article:

Suggested Show Notes Format Study discussed in this episode: Wang, Q., Lee, J. H., Nachtrab, G., Yuan, Y., Yuan, L., Qi, W., Mohr, M. A., Xiong, J., Horowitz, M. A., & Chen, X. (2026). Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y. Read the study here:

Optional Short Version Wang Q, Lee JH, Nachtrab G, et al. Deconstruction of a spino-brain–spinal cord circuit that drives chronic pain. Nature. Published online April 1, 2026. DOI: 10.1038/s41586-026-10296-y.

PCA Contact information:

PCA Website: https://pennchiro.org/

PCA Email: pca@pennchiro.org

PCA Study Spotlight, Chiropractic Research, Chronic Pain, Pain Science, Central Sensitization, Neuroscience, Musculoskeletal Care, Conservative Care, Patient Communication, Spine Care

PCA March President’s Address with Dr. Andrew Heck | Legislative Progress, Advocacy & Northeast Chiro Summit

In this special Spinal Chat episode from the Pennsylvania Chiropractic Association, PCA President Dr. Andrew Heck shares the March President’s Address with updates on spring momentum and ongoing legislative, regulatory, and reimbursement challenges. He reports progress on delegation restoration through House Bill 1106, scope modernization, copay reform, and the sports working group’s efforts on return-to-play physicals and sideline care, as well as continued Capitol meetings led by PCA leadership and staff. Dr. Heck thanks nearly 70 members and non-members for supporting the postcard campaign and emphasizes that engagement from doctors, staff, patients, and communities strengthens chiropractic’s voice. He also previews the Northeast Chiro Summit (May 1–3) at the Kalahari Resort, noting record attendance and encouraging participation, membership, PAC support, and advocacy involvement.

00:00 Welcome and Setup

00:39 Springtime Reflection

01:13 Legislative Progress

01:56 Member Advocacy Push

02:27 Northeast Summit Preview

03:08 Conference Details

03:25 Closing Thanks

03:33 Get Involved Call

04:11 Final Sendoff

PCA Contact information:

PCA Website: https://pennchiro.org/

PCA Email: pca@pennchiro.org

Spinal Chat, Pennsylvania Chiropractic Association, Dr. Andrew Heck, President’s Address, Chiropractic Advocacy, HB1106, Scope Modernization, Copay Reform, Sports Chiropractic, PCA PAC, Northeast Chiro Summit, Pennsylvania Chiropractors

PCA Deep Dive: Covered but Not Accessible. The Chiropractic Copay Crisis in Pennsylvania

This episode argues that rising deductibles, copays, visit caps, and administrative barriers are pricing patients out of conservative musculoskeletal care, reshaping treatment choices, and increasing downstream costs. Citing the RAND Health Insurance Experiment, it notes chiropractic use drops about 50% with 25%+ cost sharing and that chiropractic demand is more price-sensitive than general medical care. Studies on high-deductible health plans show patients reduce spending largely by skipping care, disproportionately harming lower-wage workers. In contrast,e a Johns Hopkins study links higher out-of-pocket costs to reduced non-pharmacologic care without reducing opioid use. Evidence shows that removing copays reduces downstream physician services, surgeries, and injections, and that chiropractic coverage correlates with lower total spending. The script highlights Pennsylvania billing data, federal Medicare parity bills (HR 539/S 106), DOJ comments on ERISA misuse, Massachusetts’ prior-authorization ban for non-opioid pain care, and Pennsylvania’s proposed 20% cost-sharing cap and Medicare fee payment floor, concluding with a call to action.

00:00 Why Care Costs More

00:51 The Bill Fear Factor

01:59 Rand Experiment Lessons

04:35 Smart Shopper Myth

06:25 Deductibles And Visit Caps

08:31 Maintenance Care Gap

10:06 When Patients Switch To Pills

11:05 Proof Reform Saves Money

14:02 Pennsylvania Billing Shock

14:59 Medicare Parity Fight

16:48 State Reforms In Motion

17:44 Pennsylvania Copay Blueprint

19:35 What You Can Do Now

20:35 Final Call To Action

References

Baicker, K., & Chandra, A. (2015). JAMA Internal Medicine.

Johns Hopkins University study evaluating the impact of high deductible health plan enrollment on nonpharmacologic treatments. (2023).

Legorreta, A. P., et al. (2004). JAMA Internal Medicine. Also referenced as: Comparative Analysis of Individuals With and Without Chiropractic Coverage.

Lentz, T. A., et al.; ATI Physical Therapy and Duke Clinical Research Institute. (October 2025). Physical Therapy & Rehabilitation Journal.

RAND Health Insurance Experiment. (1974–1982). Findings later analyzed in: Shekelle, P. G., Rogers, W. H., & Newhouse, J. P. (1996). Medical Care.

Smith, M., & Stano, M. (1997). Journal of Manipulative and Physiological Therapeutics.

Swedish randomized controlled trial on maintenance care. (2018).

Texas A&M study evaluating employee behavior in high deductible health plans.

University of California, Berkeley, and Harvard study on high deductible health plans.

USC Schaeffer Center study on the financial burden of high deductible health plans. (2023).

Whedon, J. M., et al. (2024). Journal of Integrative and Complementary Medicine.

JAMA Network Open clinical trial analyzing the addition of chiropractic care to standard military medical care.

Government, Legislative, and Policy Documents

American Chiropractic Association. Chiropractic Medicare Coverage Modernization Act Talking Points. (2025).

Chiropractic Future. Comments submitted to the Department of Justice Anticompetitive Regulations Task Force. (June 2025).

Massachusetts Session Law, Chapter 285. (2024).

Medicare. 2025 Physician Fee Schedule.

PCA Website: https://pennchiro.org/

PCA Email: pca@pennchiro.org

PCA Deep Dive: Beyond the Adjustment, Why Functional Nutrition Matters in Modern Conservative Care

This episode of PCA Deep Dive introduces the Functional Nutrition Working Group 100-Hour Certification in Functional Nutrition, developed by the Pennsylvania Chiropractic Association in academic partnership with the University of Bridgeport.

The conversation makes the case that today’s patients are more inflamed, more metabolically compromised, and more clinically complex, making chronic disease and dietary inflammation central to musculoskeletal recovery and recurrence. Using Pennsylvania obesity data and the concept of cytokine-driven “chemical casts,” the episode explains why a technically sound adjustment may not hold when biology is working against healing.

The episode also highlights a profession-wide gap in nutrition counseling. Nearly 90% of chiropractors already provide some form of nutrition guidance, yet 65% of respondents in a New York survey said they did not feel adequately prepared for in-depth nutritional counseling. This program is presented as structured, academically grounded education, not as scope expansion or a supplement sales model.

Topics include systems biology, functional blood chemistry trends, gut-immune pathways, cardiometabolic risk, herb-drug interactions, referral awareness, and the program’s two-part design, Phase I foundations and Phase II clinical integration.

Episode Timeline

00:00 Welcome and Mission

00:20 Modern Patient Complexity

01:23 Why Mechanics Fail

02:09 Metabolic Dysfunction Explained

04:10 Four Pillars Framework

04:25 Inflammation Locks Joints

06:30 Training Gap in Nutrition

08:35 Not Scope Expansion

11:23 Program Structure and Rigor

12:26 Deep Curriculum Highlights

14:36 Future of Conservative Care

16:25 How to Get Involved

Functional Nutrition Working Group 100 Hour Certification in Functional Nutrition: https://fnwg-functional-nutritio-drmknx5.gamma.site/

PCA Website: https://pennchiro.org/

PCA Email: pca@pennchiro.org