Chiropractic Intervention in the Treatment of Joint and Soft Tissue Disorders

1999 ◽  
Vol 24 (3) ◽  
pp. 279-289 ◽  
Author(s):  
John P. Crawford
Keyword(s):  
Manual Therapy ◽  
Scientific Evidence ◽  
Spinal Nerve ◽  
Joint Function ◽  
Chiropractic Treatment ◽  
Skilled Practitioner ◽  
Spinal Segments ◽  
Ancient Civilizations ◽  
Intervertebral Foramina ◽  
Low Amplitude

The concept of manual therapy, specifically manipulation of the bodily joints as in the practice of chiropractic, can no longer be deemed an invalid system of health care. Practiced for over 2,000 years by a variety of ancient civilizations, the art of manipulation for the purpose of correcting and restoring joint function has continued to fluorish, despite opposition. The climate, however, is changing. The art of chiropractic is increasingly being seen as a uniquely devised and administered technique whereby high velocity, low amplitude thrusting maneuvers are specifically directed by the skilled practitioner toward spinal segments and peripheral articulations in an effort to correct aberrant mechanical function. The corrections are effected while utilizing the transverse and spinal processes of individual vertebrae as contacting levers. Hippocrates is credited with the advice to, "Look well to the spine for the cause of disease," as displaced or degenerative vertebrae may irritate spinal nerve roots while exiting the intervertebral foramina and, consequently, interfere with normal nerve function. Similarly, it is a fundamental precept of chiropractic philosophy that irritation of the nervous system by mechanical, chemical, or psychogenic means is considered as causative in the development of disease. The scientific evidence associated with chiropractic intervention in the treatment and management of musculoskeletal disorders and visceral diseases is growing. This paper discusses the history, philosophy, and efficacy of joint manipulation and its influence on the development of chiropractic treatment. Key words: manipulation, mobilization, manual therapy

Ligamentum flavum hematoma in the rigid thoracic spinal segments

2005 ◽  
Vol 2 (4) ◽  
pp. 495-497 ◽  
Author(s):  
Naohisa Miyakoshi ◽  
Yoichi Shimada ◽  
Kyoji Okada ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Ligamentum Flavum ◽  
Facet Joint ◽  
Axial Stress ◽  
Spinal Nerve ◽  
Content Type ◽  
First Case ◽  
Thoracic Spinal ◽  
Thoracolumbar Region ◽  
Spinal Segments

✓ Ligamentum flavum hematoma, a rare cause of spinal nerve root and canal compression, typically occurs in the mobile lumbar spine segments. A thoracic ligamentum flavum hematoma is extremely rare—only one such case of a thoracolumbar (T11–12) lesion has been reported. The thoracolumbar region with its floating ribs, however, is structurally and biomechanically similar to the lumbar spine and its mobility is greater than the higher thoracic levels. To the best of their knowledge, the authors report the first case of a ligamentum flavum hematoma in the region of the rigid thoracic spinal segments with the contiguous rib cage. A symptomatic T9–10 ligamentum flavum hematoma is described in the case of a 66-year-old woman with compensatory thoracic lordosis secondary to the lumbar degenerative kyphosis. The hematoma was removed and the diagnosis was histologically confirmed. The authors speculate that thoracic lordosis might have contributed to the development of the hematoma because the ligamentum flavum and the facet joint were subjected to greater axial stress than in individuals with normal spinal alignment.

scholarly journals Misinformation, chiropractic, and the COVID-19 pandemic

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Iben Axén ◽  
Cecilia Bergström ◽  
Marc Bronson ◽  
Pierre Côté ◽  
Casper Glissmann Nim ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Scientific Evidence ◽  
Collective Responsibility ◽  
Economic Consequences ◽  
Best Interests ◽  
World Health ◽  
Chiropractic Treatment ◽  
Health Organization ◽  
The Impact

Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

scholarly journals Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments

2020 ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background:The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.Methods: The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.Results: The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.Conclusions: Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

scholarly journals Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments

2020 ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking. Methods The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement. Results The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range. Conclusions Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

scholarly journals Biomechanical study of the C5–C8 cervical extraforaminal ligaments

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking. Methods The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement. Results The displacement of the C5, C6, C7, and C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p < 0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range. Conclusions Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

Traditional Osteopathy and the General Osteopathic Treatment: A Historical Concept and a Modern Application

2021 ◽  
Vol 31 (4) ◽  
pp. 39-46
Author(s):  
Pascal J. Grolaux ◽  
Timothy J. Sparrow ◽  
François Lalonde
Keyword(s):  
Scientific Evidence ◽  
Original Form ◽  
Osteopathic Medicine ◽  
British School ◽  
Somatic Dysfunction ◽  
Osteopathic Treatment ◽  
The Usa ◽  
Unique Approach ◽  
Modern Application ◽  
Low Amplitude

Abstract Historically, Andrew Taylor Still, MD, DO, differentiated osteopathic medicine from allopathic medicine with its unique approach to treatment using manual therapy. Those treatments, known as osteopathic manipulative treatment (OMT), are currently used to treat somatic dysfunction. The Educational Council on Osteopathic Principles (ECOP) includes different treatment methods, such as muscle energy, high-velocity, low-amplitude, Still techniques, myofascial release, and counterstrain, amongst others, under the category of OMT. Conversely, osteopathic practitioners outside the USA, mostly from Europe, use some techniques that are not necessarily documented as OMT by the ECOP. This is the case of the General Osteopathic Treatment (GOT). The GOT found its origin with Dr. Still and was promoted, amongst his contemporaries, by Dr. John Martin Littlejohn, DO, who founded the British School of Osteopathy in London. The general treatment, based on a strong biomechanical background, was further spread in Europe by John Wernham, DO, a British osteopath and one of Littlejohn’s students. Wernham developed and taught the GOT in its original form based on the principles and philosophy of osteopathic medicine. The goals of this article are to give an historical perspective of the GOT, to describe the foundation and concepts behind it, and to provide a review of the scientific literature of this treatment approach. The GOT can be used to diagnose and directly treat somatic dysfunction using the TART principle in a clinical setting. Besides the recognized contra-indications of treating somatic dysfunction, there are no clear scientifically published findings of contraindications for the use of the GOT. Like other OMTs, the GOT needs more scientific evidence to better understand its clinical applications.

Biomechanics of the lumbar spinal nerve roots and the first sacral root within the intervertebral foramina

1989 ◽  
Vol 11 (3) ◽  
pp. 221-225 ◽  
Author(s):  
F. de Peretti ◽  
J. P. Micalef ◽  
A. Bourgeon ◽  
C. Argenson ◽  
P. Rabischong
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Lumbar Spinal ◽  
Intervertebral Foramina

Inhibition of Spinal Prostaglandin Synthesis Early after L5/L6 Nerve Ligation Prevents the Development of Prostaglandin-dependent and Prostaglandin-independent Allodynia in the Rat

2003 ◽  
Vol 99 (5) ◽  
pp. 1180-1188 ◽  
Author(s):  
Michael P. Hefferan ◽  
Darren D. O'Rielly ◽  
Christopher W. Loomis
Keyword(s):  
Glutamate Release ◽  
Spinal Nerve ◽  
Spinal Nerve Ligation ◽  
Sprague Dawley ◽  
Nociceptive Transmission ◽  
Withdrawal Threshold ◽  
Sham Surgery ◽  
Cyclooxygenase 1 ◽  
Sprague Dawley Rats ◽  
Spinal Segments

Background Prostaglandins, synthesized in the spinal cord in response to noxious stimuli, are known to facilitate nociceptive transmission, raising questions about their role in neuropathic pain. The current study tested the hypothesis that spinal nerve ligation-induced allodynia is composed of an early prostaglandin-dependent phase, the disruption of which prevents allodynia. Methods Male Sprague-Dawley rats, fitted with intrathecal drug delivery or microdialysis catheters, underwent left L5-L6 spinal nerve ligation or sham surgery. Paw withdrawal threshold, brush-evoked behavior, and the concentration of prostaglandin E2 (PGE2) in spinal cerebrospinal fluid ([PGE2]dialysate) were determined for up to 24 days. PGE2-evoked glutamate release from spinal slices was also determined. Results Paw withdrawal threshold decreased from at least 15 g (control) to less than 4 g, beginning 1 day after ligation. Brushing the affected hind paw evoked nociceptive-like behavior and increased [PGE2]dialysate (up to 257 +/- 62% of baseline). There was no detectable change in basal [PGE2]dialysate from preligation values. The EC50 of PGE2-evoked glutamate release (2.4 x 10-11 M, control) was significantly decreased in affected spinal segments of allodynic rats (8.9 x 10-15 M). Treatment with intrathecal S(+)-ibuprofen or SC-560, beginning 2 h after ligation, prevented the decrease in paw withdrawal threshold, the brush-evoked increase in [PGE2]dialysate, and the change in EC50 of PGE2-evoked glutamate release. R(-)-ibuprofen or SC-236 had no effect. Conclusions The results of this study provide solid evidence that spinal prostaglandins, synthesized by cyclooxygenase-1 in the first 4-8 h after ligation, are critical in the pathogenesis of prostaglandin-dependent and prostaglandin-independent allodynia and that their early pharmacologic disruption affords protection against this neuropathic state in the rat.

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