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Imaging Considerations

Imaging Considerations

According to Chou et al. in Annals of Internal Medicine 2007; “providers should not consider X-rays, MRI’s, or CT’s unless there is nerve damage or other red flags.  We should focus on the results of our history and examination to guide us through treatment and...
Who Benefits Most From Cervical Traction

Who Benefits Most From Cervical Traction

Raney (1) identified 5 variables to predict the success of cervical traction: 1. Peripheralization with lower cervical spine (C4–7) mobility testing 2. Positive shoulder abduction test (relief of symptoms with arm overhead) 3. Age ≥55 4. Positive upper extremity nerve...

Cost Effective Option

Peterson CK, et al. concluded that patients with radicular low back pain and magnetic resonance imaging–confirmed disk herniation, reported significant and similar improvements through either SMT or Nerve Root Injection- however, SMT was less expensive. Clinical...

Where Do Lumbar Disc’s Herniate?

In a soon to be published Spine Journal study of 181 subjects (1), Rajasekaran found that Lumbar Disc Herniation (LDH) due to End Plate Junction Failure (EPJF) was more common (65%) than annulus fibrosis rupture. The EPJF presented radiographically as a vertebral...

Use These Four Tests for Improvement in Lumbar Stabilization

Hicks et al. submitted patients with LBP to an 8-week stabilization exercise program. Eighty-three percent of the subjects reported functional improvement in terms of the Oswestry score. The predictors of success were: age lower than 40 average straight-leg raising...

What’s In Your Toolbox?

Have you ever heard the question, “Will my disc ever heal?” Well the answer may be yes. According to a JMMT case report by Takasaki in 2010; migration of the nucleus pulposus is possible using McKenzie Directional Therapy. “The McKenzie management strategy of...

Does Your Evaluation And Treatment Carry Over To Real Life

If your patient has pain upon standing up; then watch them stand up. In this study from David Frost it becomes apparent that people choose different movement patterns to perform different tasks.  In this study, fifty-two firefighters performed a battery of general and...
Practice Safe Tech

Practice Safe Tech

While cell phones and other modern technology devices have given us the ability to be productive from almost anywhere, it has also transformed the way we hold our bodies. You may not be aware of how much strain you are placing on your neck while using these devices....

Do You Classify Pain?????

In a recent meta-analysis of 23 randomized trials involving more than 2,000 patients in which epidural steroid injections were compared with placebo for sciatica, epidural steroid injections produced small, statistically insignificant short-term improvements in leg...

Comparing Symptomatic and Asymptomatic Flatfeet

“Hence, despite a lack of symptoms, flatfoot deformity in asymptomatic flat feet affected function. Yet, contrary to what was expected, symptomatic flat feet did not show greater deviations in 3D foot kinematics than asymptomatic. Symptoms may rather depend on...

Pain will cause many changes

In the recent Journal of Electromyography and Kinesiology, author Paul Hodges attempts to explain the changes we see both in the acute and chronic stages of pain syndromes. Pain creates condition specific patterns of excessively tight or weak muscles. In essence, the...

Find it, fix it, leave it alone

“Find it, fix it, leave it alone” may be more accurate if someone added “repeat ad infinitum”. Addressing joint restrictions without addressing the biomechanical fault that likely created the problem is like beginning fire restoration before the fire is out. A key to...

The Root of the Problem

Chiropractors proudly tell patients “we don’t just mask the symptoms- we treat the cause!”- And then go on to adjust C5 fourteen visits in a row because it keeps “going out”. Treating the site of a patient’s pain should not be confused with addressing the cause of...