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Clinical Examination Findings as Prognostic Factors in Low Back Pain

By Frank M. Painter|November 24, 2017|Clinical Decision-making|

Clinical Examination Findings as Prognostic Factors in Low Back Pain: A Systematic Review of the Literature

SOURCE: Chiropractic & Manual Therapies 2015 (Mar 23); 23: 13

Lisbeth Hartvigsen, Alice Kongsted, and Lise Hestbaek

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Odense, Denmark.

BACKGROUND: There is a strong tradition of performing a clinical examination of low back pain (LBP) patients and this is generally recommended in guidelines. However, establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors. The aim of this review of the literature was to systematically assess the association between low-tech clinical tests commonly used in adult patients with acute, recurrent or chronic LBP and short- and long-term outcome.

METHODS: MEDLINE, Embase, and MANTIS were searched from inception to June 2012. Prospective clinical studies of adult patients with LBP with or without leg pain and/or signs of nerve root involvement or spinal stenosis, receiving non-surgical or no treatment, which investigated the association between low-tech clinical tests and outcome were included. Study selection, data extraction and appraisal of study quality were performed independently by two reviewers.

RESULTS: A total of 5,332 citations were retrieved and screened for eligibility, 342 articles were assessed as full text and 49 met the inclusion criteria. Due to clinical and statistical heterogeneity, qualitative synthesis rather than meta-analysis was performed. Associations between clinical tests and outcomes were often inconsistent between studies. In more than one third of the tests, there was no evidence of the tests being associated with outcome. Only two clinical tests demonstrated a consistent association with at least one of the outcomes: centralization and non-organic signs.

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Happy Thanksgiving (2017)

By Frank M. Painter|November 22, 2017|Announcement|

Happy Thanksgiving (2017)

The Chiro.Org Blog

All of us at Chiro.Org want to wish our readers and friends
a very happy Thanksgiving.

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JFK’s assassination aided by his bad back, records show

By John Wiens DC|November 22, 2017|Back Pain|

Source CNN

Every November the United States remembers Camelot: a shining time of promise led by John F. Kennedy, the nation’s youngest president brought to an abrupt and bloody end on this day in 1963. While conspiracy theorists debate who pulled the trigger, there’s another culprit that often goes unmentioned: Kennedy’s lifelong struggle with back pain.

It was his habit of wearing a tightly laced back brace that may have kept him from recoiling to the floor of his car after the assassin’s first bullet struck him in the neck.

“The brace was a firmly bound corset, around his hips and lower back and higher up,” said Dr. Thomas Pait, a spinal neurosurgeon who co-authored a paper about Kennedy’s failed back surgeries and other treatments such as manipulation under anesthesia. “He tightly laced it and put a wide Ace bandage around in a figure eight around his trunk. If you think about it, if you have that brace all the way up your chest, above your nipples, and real tight, are you going to be able to bend forward?”

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The Infant with Dysfunctional Feeding Patterns

By Frank M. Painter|November 21, 2017|Breastfeeding Dysfunction|

The Infant with Dysfunctional Feeding Patterns – The Chiropractic Assessment

The Chiro.Org Blog

SOURCE: J Clin Chiropractic Pediatrics 2016 (May); 15 (2)

Sharon Vallone, DC, FICCP and
Faraneh Carnegie-Hargreaves, DC

Private practice,
South Windsor,
Connecticut, USA

The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life, followed by the introduction of complementary foods while breastfeeding for 2 years and beyond. Early and consistent breastfeeding support can often make the difference in a dyad’s ability to establish a functional breastfeeding relationship. While challenged dyads can sometimes accomplish competent breastfeeding given appropriate support, necessary interventions, and an opportunity to learn; timing is critical when a neonate has not been transferring adequate milk volume or is managing feeding in a passive or compensatory manner.

Chiropractors should be most familiar with the diagnosis and treatment of musculoskeletal dysfunctions that could result in an inability to feed. They should also recognize and treat the compensatory changes that will develop in a healthy, neurotypical neonate who is challenged by an inability to feed efficiently in order to prevent the evolution of long term physiologic and postural ramifications.

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Evaluation and Treatment of Breastfeeding Difficulties

By Frank M. Painter|November 18, 2017|Breastfeeding Dysfunction|

Evaluation and Treatment of Breastfeeding Difficulties Associated with Cervicocranial Dysfunction:
A Chiropractic Perspective

The Chiro.Org Blog

SOURCE: J Clin Chiropractic Pediatrics 2016 (Dec); 15 (3): 1301

Sharon Vallone, DC, FICCP

Private Practice,
KIDSPACE Adaptive Play and Wellness,
South Windsor, Connecticut, USA

Increasingly, parents are presenting to the chiropractic office with the chief complaint of breastfeeding dysfunction. Early and consistent breastfeeding support is paramount to the dyad’s ability to establish a functional breastfeeding relationship. It is critical that chiropractors treating this population recognize feeding dysfunction and understand the mechanics of breastfeeding, what might alter those mechanics, and the importance of the role of the International Board Certified Lactation Consultant (IBCLC) in supporting the restoration of functional breastfeeding after the chiropractic adjustments have reduced the neuromusculoskeletal (NMSK) dysfunction. This paper outlines some of the mechanical dysfunctions that might interfere with the normal transfer of milk for a neonate.

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Prevalence of Musculoskeletal Dysfunction in Infants

By Frank M. Painter|November 17, 2017|Musculoskeletal Dysfunction|

Prevalence of Musculoskeletal Dysfunction in Infants Presenting for Chiropractic Care in Norway: A Cross-sectional Study

The Chiro.Org Blog

SOURCE: J Clin Chiropractic Pediatrics 2017 (Sep); 16(1): 1355

Catherin Alvestad Slettebo, DC, MSc, Joyce E. Miller, DC, PhD

AECC University,
Bournemouth, UK

Background: Musculoskeletal (MSK) injuries are common though considered under-recognized at birth. There are no gold standard routines for examination of the musculoskeletal system in infants, and very little research that investigates clinical examination and MSK findings in infants under the age of six months.

Objectives: The objectives were to determine the prevalence of neck dysfunction, postural spine problems, and their possible association with parent reported behavioral problems such as suboptimal breastfeeding and supine sleeping in infants younger than six months of age. The aim of this study was to observe any associations between MSK problems of infancy and common behavioral and public health issues. Methods: This is a cross sectional questionnaire based observational study in a clinical population. Mothers of infants presented to chiropractic clinics in Norway filled in a questionnaire on the first visit, and this was followed by a clinical examination and questionnaire completed by the Doctors of Chiropractic on the same day.

Results: In total, 90 infants enrolled in the study. A total of 56 infants (66%) had postural problems. Favorite side of cervical rotation (N=41; 75%) was the most common dysfunction in supine lying. Neck hyperextension was present in 21 infants (38%). The inability to rotate their head equally side to side was present in 49 children (54%). In total 22 (24%) of the infants did not have the ability to sleep or lie comfortably supine. Suboptimal breastfeeding was reported by 22 (25%) parents, and 10 (12%) of the mothers reported pain during feeding. TMJ imbalance was identified in 16 infants (19%). There were statistically significant associations between suboptimal breastfeeding and TMJ imbalance, suboptimal rooting/sucking reflexes, inability to turn head and neck equally and painful breastfeeding, respectively.

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Clinical Examination Findings as Prognostic Factors in Low Back Pain

Clinical Examination Findings as Prognostic Factors in Low Back Pain: A Systematic Review of the Literature

Happy Thanksgiving (2017)

Happy Thanksgiving (2017)

JFK’s assassination aided by his bad back, records show

The Infant with Dysfunctional Feeding Patterns

The Infant with Dysfunctional Feeding Patterns – The Chiropractic Assessment

Evaluation and Treatment of Breastfeeding Difficulties

Evaluation and Treatment of Breastfeeding Difficulties Associated with Cervicocranial Dysfunction: A Chiropractic Perspective

Prevalence of Musculoskeletal Dysfunction in Infants

Prevalence of Musculoskeletal Dysfunction in Infants Presenting for Chiropractic Care in Norway: A Cross-sectional Study

Evaluation and Treatment of Breastfeeding Difficulties Associated with Cervicocranial Dysfunction:
A Chiropractic Perspective