tag:typepad.com,2003:weblog-1250480 2008-07-10T09:25:32-07:00 Research and opinion on causes and cures. Techniques and how-to's. TypePad tag:mpamedia.com,2008:post-54418 2010-01-15T12:00:32-07:00 2010-01-15T12:00:07-07:00

This article was inspired by a recent article by Robert Cooperstein, MA, DC. I find that I often end up being the physician of last resort, seeing patients who have not responded to previous chiropractic care, PT or medical management. I have realized that my model of what goes wrong in the lower back has really changed over the years. I used to think that my job was finding fixations and correcting them. I now have a broader understanding that often includes hypermobility as a primary issue. Once you recognize that functional instability has to be addressed, you know you have to both correct fixated joints and stabilize unstable joints.

By Marc Heller, DC This article was inspired by a recent article by Robert Cooperstein, MA, DC. I find that I often end up being the physician of last resort, seeing patients who have not responded to previous chiropractic care, PT or medical management. I have realized that my model of what goes wrong in the lower back has really changed over the years. I used to think that my job was finding fixations and correcting them. I now have a broader understanding that often includes hypermobility as a primary issue. Once you recognize that functional instability has to be addressed, you know you have to both correct fixated joints and stabilize unstable joints. tag:mpamedia.com,2008:post-54362 2009-12-16T12:00:32-07:00 2009-12-16T12:00:07-07:00

Chiropractors can easily recognize the pain that arrives from biological components of the back, but as anyone who has practiced more than six months realizes all pain has a psychological component as well.1 In contrast to the acute low back pain that we treat on a daily basis, patients with chronic pain may involve pathological processes affecting the nervous system that potentially can be a disease all its own.

By Joseph DiDuro, DC, MS, DABCN Chiropractors can easily recognize the pain that arrives from biological components of the back, but as anyone who has practiced more than six months realizes all pain has a psychological component as well.1 In contrast to the acute low back pain that we treat on a daily basis, patients with chronic pain may involve pathological processes affecting the nervous system that potentially can be a disease all its own. tag:mpamedia.com,2008:post-54373 2009-12-16T12:00:32-07:00 2009-12-16T12:00:07-07:00

I've had a recent series of tough thoracic cases. Most of them failed previous medical management, physical therapy and chiropractic care. I've found that if the patient does not begin to respond within two or three adjustments to the local area of pain, they probably will not respond to the fourth, fifth or sixth adjustment. Spinal pain is often referred pain. The thoracic spine is no different. Pain is a liar. The painful area may continue to feel restricted and tender, but that does not mean you should continue to aggravate it.

By Marc Heller, DC I've had a recent series of tough thoracic cases. Most of them failed previous medical management, physical therapy and chiropractic care. I've found that if the patient does not begin to respond within two or three adjustments to the local area of pain, they probably will not respond to the fourth, fifth or sixth adjustment. Spinal pain is often referred pain. The thoracic spine is no different. Pain is a liar. The painful area may continue to feel restricted and tender, but that does not mean you should continue to aggravate it. tag:mpamedia.com,2008:post-54326 2009-12-02T12:00:32-07:00 2009-12-02T12:00:07-07:00

Recently the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released another best-practices chapter for review and comment: a literature synthesis of chiropractic management of thoracic spine conditions. After reviewing this chapter, I've concluded that there are a number of interesting findings that can improve the way we practice and that support current clinical procedures and decision-making processes.

By David N. Taylor, DC, DABCN Recently the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released another best-practices chapter for review and comment: a literature synthesis of chiropractic management of thoracic spine conditions. After reviewing this chapter, I've concluded that there are a number of interesting findings that can improve the way we practice and that support current clinical procedures and decision-making processes. tag:mpamedia.com,2008:post-54317 2009-11-18T12:00:32-07:00 2009-11-18T12:00:07-07:00

In part I of this two-part series (Sept. 23 issue), I described a rear-impact motor-vehicle crash in which a man was rear-ended by a police cruiser and pushed into an SUV. His vehicle sustained moderate-plus damage to its front and rear portions, while the police car and SUV sustained only minor damage. The car driver, a 30-year-old man, complained immediately of low back pain and was transported to the hospital. In time he underwent bilevel lumbar fusion at L3-4 and L4-5 with PEEK (poly-ether-ether-ketone) cage placement. The procedure was via lateral approach and no additional instrumentation (rods or screws) was used in the procedure. Subsequently, the man developed a rather profound lumbosacral plexopathy with very severe atrophy in both lower extremities as a complication of surgery.

By Arthur Croft, DC, MS, MPH, FACO In part I of this two-part series (Sept. 23 issue), I described a rear-impact motor-vehicle crash in which a man was rear-ended by a police cruiser and pushed into an SUV. His vehicle sustained moderate-plus damage to its front and rear portions, while the police car and SUV sustained only minor damage. The car driver, a 30-year-old man, complained immediately of low back pain and was transported to the hospital. In time he underwent bilevel lumbar fusion at L3-4 and L4-5 with PEEK (poly-ether-ether-ketone) cage placement. The procedure was via lateral approach and no additional instrumentation (rods or screws) was used in the procedure. Subsequently, the man developed a rather profound lumbosacral plexopathy with very severe atrophy in both lower extremities as a complication of surgery.