Frank M. Painter

A QUIZ: Identifying Common and Dangerous Neck Masses

By Frank M. Painter|June 8, 2012|Continuing Education Credit, Education|

A QUIZ: Identifying Common and Dangerous Neck Masses

SOURCE: MedScape
Note: Registration is free

Accurate diagnosis of neck masses is critical to minimize morbidity and mortality. However, differentials vary greatly and can be challenging for the physician.

Neck masses are common presenting complaints, but differential diagnoses vary considerably based on patient age and the location of the neck mass. Most neck masses in the pediatric population have an infectious etiology, whereas an adult neck mass is considered to be a malignancy until proven otherwise. Evaluation of a neck mass depends on the history and physical examination; evaluation may also include observation, antibiotics, fine-needle aspiration, open biopsy, neck dissection, or wide local excision.

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The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

By Frank M. Painter|June 7, 2012|Chiropractic Care, Subluxation|

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Chiro.Org Blog

SOURCE: J Electromyogr Kinesiol. 2012 (Apr 16)

By Charles N.R. Henderson, DC, PhD

Palmer Center for Chiropractic Research, FL, United States

It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments. In chiropractic practice, the vertebral subluxation has been the historical raison d’etre for SM. Vertebral subluxation is a biomechanical spine derangement thought to produce clinically significant effects by disturbing neurological function. (more…)

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Where the U.S. Spends its Spine Dollars

By Frank M. Painter|June 6, 2012|Chiropractic Care, Cost-Effectiveness, Public Health, Spinal Manipulation|

Where the U.S. Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

The Chiro.Org Blog

SOURCE: Spine (Phila Pa 1976). 2012 (Mar 16)

Davis, Matthew A. DC, MPH; Onega, Tracy PhD;
Weeks, William MD, MBA; Lurie, Jon MD, MS

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA

Study Design Serial, cross-sectional, nationally representative surveys of non-institutionalized adults.

Objective To examine expenditures on common ambulatory health services for the management of back and neck conditions.

Summary of Background Data Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

Methods We used the Medical Expenditure Panel Survey (MEPS) to examine adult (age ≥ 18 years) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

Results Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008).

Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. (more…)

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Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

By Frank M. Painter|June 5, 2012|Chiropractic Care, Post-isometric Relaxation, Radiculopathy|

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

The Chiro.Org Blog

SOURCE: J Canadian Chiropractic Assoc. 2012 (Mar); 56 (1): 9-17

Peter Emary, BSc, DC

Private practice: Parkway Back Clinic, 201C Preston Parkway, Cambridge, Ontario, N3H 5E8. Phone: 519-653-2101. E-mail: drpeter@parkwaybackclinic.ca

Introduction

Cervical radiculopathy (CR) is an impingement or inflammatory irritation of the cervical spine nerve root(s), resulting in pain (or numbness) radiating along nerves of the upper extremity; [1,2] the C6 and C7 levels are most often affected. [1,3] Limited research is available on the incidence and prevalence of CR; however, the incidence rate (in Rochester, Minnesota) has been reported at 83.2 cases per 100,000 people per year (107.3/100,000 for males vs. 63.5/100,000 for females), with peak incidence in those aged 50–54 years. [1] A history of physical exertion or major trauma precedes the onset of symptoms in less than 15% of cases. The most common causes are cervical spondylosis and intervertebral disc herniation, [1,3] accounting for approximately 70% and 20% of cases, respectively. [1] In the former, posterior vertebral body osteophytes and/or facet joint/ligamentum flavum hypertrophy encroach upon the intervertebral foramen; posterolateral herniation of disc material results in foraminal encroachment in the latter. In either case, cervical nerve root pain and dysfunction can occur. [4]

There are other similar articles at the:

Radiculopathy and Chiropractic Page

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Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

By Frank M. Painter|June 4, 2012|Chiropractic Care, Patient Satisfaction, Radiculopathy|

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

The Chiro.Org Blog

SOURCE: J Can Chiro Assoc. 2012 (Mar); 56 (1): 18–28 ~ FULL TEXT

Robert J. Rodine, BSc, DC, Howard Vernon, DC, PhD, FCCS(C)

Graduate Education and Research Programs,
Canadian Memorial Chiropractic College,
Toronto, Ontario.

Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

There are other similar articles at the:

Radiculopathy and Chiropractic Page

From the FULL TEXT Article

Introduction

Cervical radiculopathy (CR) can be a significant cause of neck pain and disability. The reported annual incidence of CR is 83.2/100,000 persons [1], while the reported prevalence is 3.5/1000 persons. [2] Gender preference varies. [2, 3] Individuals are most commonly affected in the 5th and 6th decades of life. [1, 4] Physical exertion or trauma at onset is rare, involving less than 15%. [1] Causal relationship to an automobile accident ranges from 3–23%. [1, 4] (more…)

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Visceral Responses to Spinal Manipulation

By Frank M. Painter|June 3, 2012|Chiropractic Care, Research, Spinal Manipulation, Subluxation|

Visceral Responses to Spinal Manipulation

The Chiro.Org Blog

SOURCE: J Electromyogr Kinesiol. 2012 (Mar 20)

Philip S. Bolton, Brian Budgell

School of Biomedical Sciences & Pharmacy,
Faculty of Health, University of Newcastle,
Callaghan NSW 2308, Australia;

Centre for Brain and Mental Health Research at the
Hunter Medical Research Institute,
Newcastle, Australia

While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function. (more…)

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About Frank M. Painter

A QUIZ: Identifying Common and Dangerous Neck Masses

A QUIZ: Identifying Common and Dangerous Neck Masses

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

Where the U.S. Spends its Spine Dollars

Where the U.S. Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

Visceral Responses to Spinal Manipulation

Visceral Responses to Spinal Manipulation