Putting YOU First – Evidence Based Practice

One of the defining concepts of Central Ohio Spine and Joint is that we are a patient-centered healthcare facility. So what exactly does that mean to us and what should it mean to you?  We strive to provide the most outcomes driven, cost effective care possible.  A concept surfaced in the early ‘90s that described adding relevant research findings to the clinical decision making process and was termed Evidence Based Practice.  That is using what the literature says in determining the how, what and why we treat patients the way we do.

EBPEvidence based Practice or EBP describes how a practice aligns patient care with the best practices available. EBP integrates four key components into the clinical decision making process: patient values, patient circumstances, clinical expertise and relevant clinical research.

Patient Values: We understand each patient that walks through our door has their own personal preference and concerns.  Dr. Leonard has worked extremely hard to equip himself with a large, effective skill set.  We regularly get patients that request we do not use manipulation as part of their treatment, and we completely respect that and have options for those patients.

Patient Circumstance: The state of the patient is obviously a key competent in the clinical decision making process.  We strive to provide individualized care, not a cookie cutter approach.  In the rehab world it is common to see patients taken through a “low back” protocol which consist of core exercises and a pat on the back.  We take each patients circumstance and condition into consideration when developing a treatment plan.

Clinical Expertise: Clinical expertise includes clinical skills, critical thinking, and proficiency in clinical reasoning. As I am sure you know each condition that walks in the office is different and the demands of the clinical process change.  If everyone walked in with the same aliment and they went right along with what the text books says things would be much easier, but unfortunately this is not how it works. Having a solid clinical background is essential in this whole process.

Relevant Research: Clinical research can be broken down into a few different categories that are all equally important.  While research is a pillar in our treatment approaches it is not the sole factor in the clinical decision making process.

Guidelines: In management of conditions like low back pain and neck pain researchers have developed guidelines that have been proven to be the effective and should “guide” the treatment proposed.  Just like supplements or exercise the term dosage is used is determining the amount of care that will be recommend.  Within the last year new research has been released looking at dosage of treatment in regards to low back and neck pain.

Best Practices: A method or treatment approach that has consistently shown to be superior to other options.

Clinical Research: When a certain condition comes into the office we know from a research stand point what combination of treatment is most effective.  For example we know for mechanical low back pain the combination of manipulation, manual therapy and exercise is extremely effective based on current research.  Again, not every patient that walks in the door has the same body type, healing ability, etc. and thus this where clinical expertise comes in and drives the clinical treatment strategy.

Central Ohio Spine and Joint and Dr. Daniel Leonard are committed to providing the best care possible.  Being an evidence based practice is extremely important to us but as you see it takes a combination of all these attributes to make it possible.  Reading a few research papers here and there does not equate to being evidence based.

We will continue to be at the cutting edge of research and will continue to put our patients first in order to meet the vision of Central Ohio Spine and Joint: Provide a team of highly trained healthcare professionals determined to meet the needs of the individual.



Central Ohio Spine and Joint and Westerville’s Serving our Seniors Event

The Westerville Community held their annual Serving our Seniors event at Westerville South High School.  This is a wonderful event for the residents of Westerville, providing resources and educational opportunities.  This is the second year Central Ohio Spine and Joint and Dr. Daniel Leonard have had the pleasure of participating.  We are always happy to help educate the community on current health trends and options.  Conservative spine care is essential as research states around 80 percent of people will experience back pain at one point in their life and this number is certainly higher as we age.  We provide very effective care for common conditions seen in the elderly population like arthritis, spinal stenosis, degenerative disk disease and osteoporosis.


What to expect as a new patient

What to Expect on Your First Visit

Many new patients are not sure what to expect during their first visit, here at Central Ohio Spine and Joint we are committed to making this process as easy as possible so we have broken down what to expect.

Our Commitment to You: We place our patients first. Each patient that walks through our door is treated like an individual.  We take the time to learn about your unique condition and make our recommendations specific to your health goals. We will only accept your case if we feel we can help.

Consultation: Our providers will start by taking a thorough history of your current complaint as well as a review of your current and past medical history.  We will review any available imaging (x-ray, MRI etc) and/or lab studies that have previously been performed.

Examination:  We will provide an extremely detailed evaluation including a review of systems, neurological, musculoskeletal, and orthopedic tests. Throughout the evaluation process we will also be looking at how efficiently you move. For example, we may have you perform a gait evaluation or a squat test to help us understand why you are experiencing the symptoms

Preliminary Diagnosis:  The combination of the medical history, examination, and diagnostic studies (if available) will enable us to reach a preliminary diagnosis. We will review in detail the etiology of your pain and injury.  At that time, we will also discuss treatment options, treatment frequency and duration.  Patients may also receive advice on home care, lifestyle modifications, exercise instruction and nutritional advice.

You will walk out of your first visit knowing the following:

What is wrong.

            How are we going to fix it.

            How long is this going to take.

If we determine you would be more appropriately managed or co-managed by another health care professional, we will make the proper referral.

Do we perform x-rays on the first visit?

We only recommend imaging studies if it is clinically indicated by your medical history and or examination findings.  It has been a common trend over the years in the chiropractic profession to x-ray every patient prior to treatment.  Based on the current literature and medical research, routine x-rays of this nature are deemed medically unnecessary.  We follow the guidelines and research as closely as we can to provide the highest quality care, in a safe environment for our patients.  If we feel x-rays or other imaging studies are necessary we will make the proper referral to obtain this information.

Will I get treated on my first visit?

Based on your thorough consultation, review of your medical history and examination we will determine the most appropriate route of care.  Most patient that consult our office we be treated on day one. If we feel we need additional medical information and or feel your safety if at risk we will discuss additional treatment options at that time.


Letter to our patients on our move

This is Dr. Daniel Leonard from Performance Sports and Spine Center.  I wanted to take this opportunity to first and foremost thank you for your continued support and trust over the last two years.  We wouldn’t be where we are today without your help and without your referrals.  Everyone that walks in the door is truly like family to us.

We have two big changes occurring in the next few weeks.  As of April 2, 2014 Performance Sports and Spine Center will become Central Ohio Spine and Joint.

We feel this new name captures the essence of what we do here in the clinic and where we are headed in the future.  It has always been a goal of mine to put together a team of healthcare professionals to provide exceptional care to our patient base, and Central Ohio Spine and Joint captures this vision.  We will continue to be a progressive evidence based healthcare practice that specializes in individualized care through non-surgical treatment, rehabilitation, and nutrition.

Along with the new name, we will also be relocating on April 2, 2014.  We will be moving to a 6,000 sqft. medical center building just three miles down the street.  With the new name and new location we have the opportunity to offer our patients a wider selection of services that will enable them to attain a better quality of life.  We will continue to be the most cost effective out-comes driven option for musculoskeletal injuries.

Our services will include:


Progressive rehabilitation

Spinal Decompression Therapy

Massage Therapy


Evidence Based Nutritional Testing

Group training


Comprehensive Wellness

For more information, please check out our new website www.COspineandjoint.com

Our continued mission is to provide exceptional care and empower our patients to play an active role in their own healthcare.  We are so excited about these changes and look forward to providing you with care into the future.  If you have any questions about the upcoming move and name change please do not hesitate to contact me personally.

Yours in Health,

Daniel B. Leonard, DCNew Logo



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