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Frank M. Painter

About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.
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Vertebral Artery Dissection in a Patient Practicing Self-manipulation of the Neck

By |October 17, 2014|Vertebral Artery|

Vertebral Artery Dissection in a Patient Practicing Self-manipulation of the Neck

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2011 (Dec);   10 (4):   283–287

John S. Mosby, DC, MD, Stephen M. Duray, PhD

Division of Clinics,
Palmer College of Chiropractic,
Davenport, IA 52803, USA

OBJECTIVE:   The purpose of this case report is to describe a patient who regularly practiced self-manipulation of her neck who presented with shoulder and neck pain and was undergoing a vertebral artery dissection.

CLINICAL FEATURES:   A 42-year-old female patient sought care for left shoulder pain with a secondary complaint of left lower neck pain. Twelve days prior, she had had “the worst headache of her life,” which began in her left lower cervical spine and extended to her left temporal region. The pain was sudden and severe, was described as sharp and burning, and lasted 3 hours. She reported nausea, vomiting, and blurred vision.

INTERVENTION AND OUTCOME:   Initial history and examination suggested that the patient’s head and neck pain was not musculoskeletal in origin, but vascular. She repeatedly requested that an adjustment be performed, but instead was referred to the local emergency department for further evaluation. Magnetic resonance angiogram revealed a dissection of the left vertebral artery from C6 to the C2-C3 interspace and a 3-mm dissecting pseudoaneurysm at the C3 level. She underwent stent-assisted percutaneous transluminal angioplasty combined with antiplatelet therapy (clopidogrel) and experienced a good outcome.

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Stroke and Chiropractic Page

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Methicillin-resistant Staphylococcus aureus: An Overview for Manual Therapists

By |October 16, 2014|Continuing Education|

Methicillin-resistant Staphylococcus aureus:
An Overview for Manual Therapists

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2012 (Mar);   11 (1):   64–76

Bart N. Green, MSEd, DC, Claire D. Johnson, MSEd, DC,
Jonathon Todd Egan, DC, MPH, Michael Rosenthal, PT, DSc, ATC, CDR,
Erin A. Griffith, DO, Marion Willard Evans, DC, PhD

Chiropractor, Chiropractic Division,
Department of Physical and Occupational Therapy,
Naval Medical Center, San Diego, CA

OBJECTIVE:   Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.

METHODS:   PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors’ libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.

RESULTS:   Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.

CONCLUSION:   Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.

 

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Clinical Presentation of a Patient with Thoracic Myelopathy

By |October 15, 2014|Continuing Education, Myelopathy|

Clinical Presentation of a Patient with Thoracic Myelopathy at a Chiropractic Clinic

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2012 (Sep);   11 (2):   115–120

Charles W. Gay, Mark D. Bishop, and Jacqueline L. Beres

Graduate Research Assistant,
Rehabilitation Science Doctoral Program,
University of Florida, Gainesville, FL.

INTRODUCTION:   The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic.

CASE REPORT/METHODS:   After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult.

RESULTS:   Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement.

CONCLUSION:   It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment.

KEYWORDS:   Spinal stenosis; Thoracic vertebrae

 

From the FULL TEXT Article:

Introduction

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Manipulative and Rehabilitative Therapy as a Treatment of Idiopathic Scoliosis Without Psychological Sequelae

By |October 10, 2014|Continuing Education, Scoliosis|

Manipulative and Rehabilitative Therapy as a Treatment of Idiopathic Scoliosis Without Psychological Sequelae

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2012 (Jun);   11 (2):   109–114

Jorge H. Villafañe, PT, MSc, PhD, Guillermo B. Silva, MSc, PhD, Andrea Dughera, MSc

Physical Therapist, Department of Physical Therapy,
Residenze Sanitarie Assistenziali
“A. Maritano,” Sangano, Italy.

OBJECTIVE:   The purpose of this case report is to describe management and outcomes of a patient with scoliosis.

CLINICAL FEATURES:   A 9-year-old female patient with a double curve pattern with Cobb angles of 18° and 24° (thoracic/thoracolumbar) compatible with scoliosis presented for physical therapy treatment.

INTERVENTION AND OUTCOME:   Physiotherapy treatment with a combination of manipulative and rehabilitation techniques was used. After finishing the treatment, the patient had Cobb angles of 7° and 11°, an improvement of 55% and 54%, respectively. After 6 months, these effects were maintained, as the patient had Cobb angles of 11° and 11°. The clinical appearance of the patient improved after the course of care. The patient was evaluated for psychological outcomes by applying the following tests: Scoliosis Research Society 22, Bad Sobernheim Stress, and the Brace Questionnaire The patient had the maximum score in all tests at the conclusion of therapy.

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Scoliosis and Chiropractic Page

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Pulmonary Embolism in a Female Collegiate Cross-country Runner Presenting as Nonspecific Back Pain

By |October 9, 2014|Continuing Education, Pulmonary Embolism|

Pulmonary Embolism in a Female Collegiate Cross-country Runner Presenting as Nonspecific Back Pain

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2012 (Sep);   11 (3):   215–220

Warren H. Landesberg, DC, DACBSP

Doctor of Chiropractic, Private Practice,
Briarcliff Manor, NY.

OBJECTIVE:   The purpose of this case report is to describe a female athlete with back and right scapular pain due to pulmonary embolism.

CLINICAL FEATURES:   A 20-year-old female collegiate cross-country runner presented to a chiropractic clinic with pain in the right scapular area that was severe, stabbing, and worsened with respiration. She had a cough and experienced difficulty lying on her right side. She had an elevated d-dimer. Chest radiograph demonstrated pleural effusion, prompting a thoracic computed tomographic angiogram that showed a large right lower lobe embolus and pulmonary infarct.

INTERVENTION AND OUTCOME:   The patient was hospitalized, prescribed anticoagulant therapy, and monitored for 6 months. She was able to return to competitive running 8 months later.

CONCLUSION:   This case raises awareness of the occurrence of birth control medication for the purpose of enhanced performance in female athletes and the associated risks of using this medication for enhanced performance.

 

From the FULL TEXT Article:

Introduction

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Resolution of Hearing Loss After Chiropractic Manipulation

By |October 8, 2014|Chiropractic Care, Hearing Loss|

Resolution of Hearing Loss After Chiropractic Manipulation

The Chiro.Org Blog

SOURCE:   Topics in Integrative Health Care 2014 (Sep 30); 5 (3)

Melissa Ferranti, DC, Kimberly Keene, DC,
Chelsea Prothero, DC

Assistant Professor and Faculty Clinician
Palmer College of Chiropractic
Port Orange, FL, USA

Introduction:   While chiropractic care is often associated with the treatment of musculoskeletal conditions, there are other, non-musculoskeletal conditions which may benefit from spinal manipulation (SM). This paper reports on the return of hearing in a woman treated with chiropractic adjustments after 8 months of lack of improvement through allopathic care. Pre and post audiograms were used for comparison.

Case Presentation:   In this report, a 46 year old white female with neck pain, tinnitus, and hearing loss was treated with cervical spinal manipulation with positive results. A pre-treatment audiogram indicated low-frequency hearing loss, worse in the left ear.

Intervention and Outcomes:   After being unsuccessfully medically treated over an 8 month period, she sought chiropractic care for the above symptoms. After 3 chiropractic adjustments, her hearing and associated symptoms were significantly improved. She received 12 treatments over a 4-month period. When asked to rate her hearing and fullness sensation in the ear on a Patient Specific Functional Scale with a 0-10 measure, where 0 is no deficits and 10 is completely impaired, initially she rated her symptoms as 7, and 5 months after the conclusion of care, her rating dropped to 1. Following treatment her audiogram was normal.

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Deafness and Chiropractic Page

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