Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Oct 1999
ReviewA proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle.
To examine the neurophysiologic basis and anatomic relationship between the dura mater and the rectus capitis posterior minor muscle in the etiologic proposition of cervicogenic headache. ⋯ A sizable body of clinical studies note the effect of manipulation on headache. These results support its effectiveness. The dura-muscular, dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the cervicogenic headache. This proposal would further explain manipulation's efficacy in the treatment of cervicogenic headache. Further studies in this area are warranted to better define the mechanisms of this anatomic relationship.
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J Manipulative Physiol Ther · May 1999
Review Case ReportsManagement of acute lumbar disk herniation initially presenting as mechanical low back pain.
To describe the clinical management with spinal manipulation of a male patient with risk factors for lumbar disk herniation initially suffering from what appeared to be mechanical low back pain that evolved into radiculopathy; also to review issues pertinent to chiropractic/manipulative management of disk herniation. ⋯ Risk factors for the development of disk herniation should be considered when assessing patients suffering from what appears to be mechanical low back pain. The role played by manipulation in the development of disk herniation in this case was believed to be circumstantial rather than causal. Manipulation was used in the treatment of this patient over a period of approximately 2 months; after this time, clinical and partial computed tomography imaging resolution was evident. Ongoing clinical (neurologic) evaluation of patients with manifest or suspected disk herniation is an important aspect of management. Good-quality trials of manipulation for patients with disk herniation are imperative for the chiropractic profession.
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J Manipulative Physiol Ther · Feb 1999
ReviewLow back pain and the lumbar intervertebral disk: clinical considerations for the doctor of chiropractic.
Low back pain exists in epidemic proportions in the United States. Studies that demonstrate innervation to the intervertebral disk provide evidence that may account for instances of discogenic low back pain encountered in general medical and chiropractic practice. Many patients and health care practitioners believe that intervertebral disk lesions require surgery as the only method of treatment that will result in satisfactory outcome. Surgery rates vary widely across geographic regions. Only one randomized prospective study exists that compares surgical and nonsurgical treatment; it demonstrated essentially equal outcomes in the long run. ⋯ Patients should be screened for "red flags" to determine whether they are candidates for conservative treatment. Magnetic resonance imaging is perhaps the most practical imaging study for evaluation of lumbar disk lesions because it involves no use of ionizing radiation and because magnetic resonance imaging has other advantages over computed tomographic scanning such as excellent delineation of soft tissue structures, direct multiplanar imaging, and excellent characterization of medullary bone. Provocation computed tomography-diskography is an invasive procedure and should be reserved for patients with normal magnetic resonance imaging findings and continuing severe pain who have not been helped by conservative treatment attempts and for whom surgical intervention is contemplated. Both conservative and surgical interventions have been shown to be effective in the treatment of discogenic and radicular pain syndromes.
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J Manipulative Physiol Ther · Nov 1997
ReviewThe sacroiliac joint: a review of anatomy and biomechanics with clinical implications.
To examine the biomedical literature pertaining to the anatomy and biomechanics of the sacroiliac (SI) joint to update current concepts and treatment of SI joint dysfunctions. ⋯ Treatment of the SI articulation is difficult and all known SI joint tests have questionable validity, with the exception of pain provocation tests. Clinical treatment should be aimed at improving the stability of the surrounding soft tissues and at reducing mechanical stresses and strains from poor posture or using orthotics to level the sacral base. Much more research is needed in the treatment of this area.
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J Manipulative Physiol Ther · Oct 1996
Meta AnalysisThe effectiveness of chiropractic for treatment of low back pain: an update and attempt at statistical pooling.
To determine the effectiveness of chiropractic treatment for patients with low back pain by means of a systematic review of the literature. ⋯ There is certainly a need for correctly executed trials. In future research on the effectiveness of chiropractic, guidelines for uniform execution and reporting of RCTs should first be established to enable subsequent statistical pooling in systematic reviews of chiropractic trials.