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The Return of Color Vision Secondary to Macular

By Frank M. Painter|May 2, 2017|Macular Degeneration, Visual Disorders|

The Return of Color Vision Secondary to Macular Degeneration After Chiropractic Care

SOURCE: Chiropractic J Australia 2017; 45 (1): 38–43

Thomas A. Brozovich D.C

Palmer College of Chiropractic,
1000 Brady St,
Davenport, IA 52803, USA

Objective: To discuss the chiropractic management of a patient whose unilateral color vision loss associated with macular degeneration resolved after treatment.

Clinical Features: A 66-year-old female with a history of cervical, thoracic and lumbar pain and a four-year history of macular degeneration of the left eye resulting in a loss of color vision sought chiropractic care for primarily her spinal pain. Initially she was not requesting care for her loss of color vision. She reported having multiple recent traumas (falls) injuring her cervical, thoracic and lumbar region.

Intervention and Outcome: The patient was adjusted based on location of her subluxations (intersegmental joint dysfunction). She had 17 treatments over 8 month. A thermography study was performed of the face before and after treatment and a more symmetrical thermal pattern was obtained. Her spinal pain reduced. She also unexpectedly had a return of color vision in her left eye.

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Blindness and Other Visual Disorders Page

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For Bad Backs, It May Be Time to Rethink Biases

By Frank M. Painter|May 1, 2017|Chiropractic Care, Nonpharmacologic Therapies|

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

The Chiro.Org Blog

SOURCE: The New York Times ~ 5-01-2017

Aaron E. Carroll, MD, MS

Indiana University School of Medicine

About two of every three people will probably experience significant low back pain at some point. A physician like me might suggest any number of potential treatments and therapies. But one I never considered was a referral for spinal manipulation.

It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases.

Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.

Most back pain resolves over time, so interventions that focus on relief of symptoms and allow the body to heal are ideal. Many of these can be nonpharmacological in nature, like the work done by chiropractors or physical therapists.

Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors and also because a few chiropractors have claimed they can address conditions that have little to do with the spine. Patients with back pain haven’t seemed as skeptical. A large survey of them from 2002 through 2008 found that more than 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.

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Spinal Manipulative Therapy Has an Immediate Effect

By Frank M. Painter|May 1, 2017|Pain Relief, Spinal Manipulation, Thermal Pain Sensitivity|

Spinal Manipulative Therapy Has an Immediate Effect on Thermal Pain Sensitivity in People With Low Back Pain: A Randomized Controlled Trial

The Chiro.Org Blog

SOURCE: Phys Ther. 2009 (Dec); 89 (12): 1292–1303

Parvaneh Mohammadian, PhD, Antonio Gonsalves, DC, Chris Tsai, DC, Thomas Hummel, MD, and
Thomas Carpenter, DC

Department of Physical Therapy,
University of Florida,
Gainesville, FL 32610-0154, USA.

BACKGROUND: Current evidence suggests that spinal manipulative therapy (SMT) is effective in the treatment of people with low back pain (LBP); however, the corresponding mechanisms are unknown. Hypoalgesia is associated with SMT and is suggestive of specific mechanisms.

OBJECTIVE: The primary purpose of this study was to assess the immediate effects of SMT on thermal pain perception in people with LBP. A secondary purpose was to determine whether the resulting hypoalgesia was a local effect and whether psychological influences were associated with changes in pain perception.

DESIGN: This study was a randomized controlled trial.

SETTING: A sample of convenience was recruited from community and outpatient clinics.

PARTICIPANTS: Thirty-six people (10 men, 26 women) currently experiencing LBP participated in the study. The average age of the participants was 32.39 (SD=12.63) years, and the average duration of LBP was 221.79 (SD=365.37) weeks.

INTERVENTION AND MEASUREMENTS: Baseline demographic and psychological measurements were obtained, followed by quantitative sensory testing to assess temporal summation and Adelta fiber-mediated pain perception. Next, participants were randomly assigned to ride a stationary bicycle, perform low back extension exercises, or receive SMT. Finally, the same quantitative sensory testing protocol was reassessed to determine the immediate effects of each intervention on thermal pain sensitivity.

RESULTS: Hypoalgesia to A-delta fiber-mediated pain perception was not observed. Group-dependent hypoalgesia of temporal summation specific to the lumbar innervated region was observed. Pair-wise comparisons indicated significant hypoalgesia in participants who received SMT, but not in those who rode a stationary bicycle or performed low back extension exercises. Psychological factors did not significantly correlate with changes in temporal summation in participants who received SMT.

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Subluxation Neurology Section

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Areas of Capsaicin-Induced Secondary Hyperalgesia

By Frank M. Painter|April 29, 2017|Chiropractic Care, Pain Relief|

Areas of Capsaicin-Induced Secondary Hyperalgesia and Allodynia Are Reduced by a Single Chiropractic Adjustment: A Preliminary Study

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2004 (Jul); 27 (6): 381–387

Parvaneh Mohammadian, PhD, Antonio Gonsalves, DC,
Chris Tsai, DC Thomas Hummel, MD, Thomas Carpenter, DC

School of Medicine,
University of California,
Los Angeles, Calif 90024, USA.

INTRODUCTION: The aim of the study was to investigate the hypoalgesic effects of a single spinal manipulation treatment on acute inflammatory reactions and pain induced by cutaneous application of capsaicin.

METHODS: Twenty healthy subjects participated in the experiment, which consisted of 2 sessions. In both sessions, following control measurements, topical capsaicin was applied to the right or left forearm to induce cutaneous inflammatory reactions. The cream was removed after 20 minutes. Then subjects received either spinal manipulation treatment (SMT) or “nonspinal manipulation treatment” (N-SMT), respectively. In control as well as pretreatment and posttreatment intervals, the following tests were performed: measurement of the areas of mechanical hyperalgesia and stroking allodynia, assessment of spontaneous pain, and measurement of blood flow.

RESULTS: The results confirmed that topical capsaicin induced inflammatory reactions based on occurrence of hyperalgesia and allodynia, augmented pain perception, and increased blood flow following capsaicin application compared with the control session. When compared with N-SMT, spontaneous pain was rated significantly lower post-SMT (P <.014). In addition, areas of both secondary hyperalgesia and allodynia decreased after SMT (hyperalgesia: P <.007; allodynia: P <.003). However, there was no significant treatment effect for local blood flow.

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The Influence of Expectation on Spinal Manipulation

By Frank M. Painter|April 27, 2017|Hypoalgesia, Patient Expectations|

The Influence of Expectation on Spinal Manipulation Induced Hypoalgesia: An Experimental Study in Normal Subjects

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2008 (Feb 11); 9: 19

Joel E Bialosky, Mark D Bishop,
Michael E Robinson, Josh A Barabas,
and Steven Z George

University of Florida Department of Physical Therapy,
Gainesville, Florida, USA.

BACKGROUND: The mechanisms thorough which spinal manipulative therapy (SMT) exerts clinical effects are not established. A prior study has suggested a dorsal horn modulated effect; however, the role of subject expectation was not considered. The purpose of the current study was to determine the effect of subject expectation on hypoalgesia associated with SMT.

METHODS: Sixty healthy subjects agreed to participate and underwent quantitative sensory testing (QST) to their leg and low back. Next, participants were randomly assigned to receive a positive, negative, or neutral expectation instructional set regarding the effects of a specific SMT technique on pain perception. Following the instructional set, all subjects received SMT and underwent repeat QST.

RESULTS: No interaction (p = 0.38) between group assignment and pain response was present in the lower extremity following SMT; however, a main effect (p < 0.01) for hypoalgesia was present. A significant interaction was present between change in pain perception and group assignment in the low back (p = 0.01) with participants receiving a negative expectation instructional set demonstrating significant hyperalgesia (p < 0.01).

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Chiropractic and Spinal Pain Management

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Individual Expectation: An Overlooked Factor

By Frank M. Painter|April 26, 2017|Hypoalgesia, Musculoskeletal Pain, Patient Expectations|

Individual Expectation: An Overlooked, But Pertinent, Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain

The Chiro.Org Blog

SOURCE: Phys Ther. 2010 (Sep); 90 (9): 1345–1355

Joel E. Bialosky Mark D. Bishop Joshua A. Cleland

Department of Physical Therapy,
University of Florida,
Gainesville, FL 32610-0154, USA

Physical therapists consider many factors in the treatment of patients with musculoskeletal pain. The current literature suggests expectation is an influential component of clinical outcomes related to musculoskeletal pain for which physical therapists frequently do not account. The purpose of this clinical perspective is to highlight the potential role of expectation in the clinical outcomes associated with the rehabilitation of individuals experiencing musculoskeletal pain. The discussion focuses on the definition and measurement of expectation, the relationship between expectation and outcomes related to musculoskeletal pain conditions, the mechanisms through which expectation may alter musculoskeletal pain conditions, and suggested ways in which clinicians may integrate the current literature regarding expectation into clinical practice.

From the Full-Text Article:

Background

Physical therapy interventions for musculoskeletal pain conditions often address impairments with the implication that pain and function will improve in response to stretching a tight muscle or strengthening a weak muscle. Realistically, the mechanisms through which physical therapy interventions alter musculoskeletal pain are likely multifaceted and dependent upon a variety of factors related to the therapist, the patient, and the environment. [1] The current literature indicates factors other than the correction of physical impairments influence clinical outcomes in the conservative management of patients experiencing musculoskeletal pain. For example, psychological factors such as fear are useful in directing treatment. [2, 3] Similarly, factors related to patient expectations are associated with both clinical outcomes, [4, 5] satisfaction with treatment, [6, 7] and influence of behavior. [8, 9]

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Chiropractic and Spinal Pain Management

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