Education

Nerve Root Pain, Dermatomes, and Evidence…Oh My!

By Frank M. Painter|October 3, 2009|Education|

Nerve Root Pain, Dermatomes, and Evidence…Oh My!

It is commonly believed that nerve root pain would be expected to appear in a specific dermatome, and that this information is useful for making the diagnosis of radiculopathy. There is little evidence in the literature that confirms or denies this statement.

A new article in the journal Chiropractic & Osteopathy (Sep 21, 2009), a peer-reviewed journal listed on PubMed, challenges that supposition.

In reviewing two hundred twenty-six “irritated” nerve roots in 169 patients, pain related to cervical nerve roots was found to be non-dermatomal in over two-thirds (69.7%) of cases!

In the lumbar spine, the pain was non-dermatomal in 64.1% of cases.

The majority of nerve root levels involved non-dermatomal pain patterns except C4 (60.0% dermatomal) and S1 (64.9% dermatomal). The sensitivity (SE) and specificity (SP) for dermatomal pattern of pain are low for all nerve root levels with the exception of the C4 level (Se 0.60, Sp 0.72) and S1 level (Se 0.65, Sp 0.80), although in the case of the C4 level, the number of subjects was small (n = 5).

I hope you will enjoy reading this FULL TEXT article.

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Physical Examination of the Neck and Cervical Spine

By Frank M. Painter|October 2, 2009|Cervical Spine, Diagnosis, Education|

Physical Examination of the Neck and Cervical Spine

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 8 from RC’s best-selling book:

“Spinal and Physical Diagnosis”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 8: Physical Examination of the Neck and Cervical Spine

In general, the neck viscerally serves as a channel for vital vessels and nerves, the trachea, esophagus, spinal cord, and as a site for lymph and endocrine glands. From a musculoskeletal viewpoint, the neck provides stability and support for the cranium, and a flexible and protective spine for movement, balance adaptation, and housing of the spinal cord and vertebral artery. Cervical flexion, extension, and rotation contribute to one’s scope of vision.

From a biomechanical viewpoint, primary cervical dysarthrias may reflect themselves in the total habitus; from a neurologic viewpont, insults many manifest themselves throughout the motor, sensory, and autonomic nervous systems. Many peripheral nerve symptoms in the shoulder, arm, and hand will find their origin in the brachial plexus and cervical spine. Nowhere in the spine is the relationship between the osseous structures and the surrounding neurologic and vascular beds as intimate or subject to disturbance as it is in the neck.

Neck pain must be differentiated as to its date of onset and chronology, site and distribution, type (intermittent, constant), duration (acute, chronic), character (sharp, dull, lanciating), relation to posture (rest, occupation, recreation), and associated problems. Nonpharyngeal pain on swallowing may be traced to an anterior cervical spinal pathology such as bony protuberance or osteophytes, infection, mass or tumor. Pain is often referred to the neck from the TMJ, mandibular or dental infection, or sinus infection.

Inspection of the Neck (more…)

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Sports Management: Basic Spinal Subluxation Considerations

By Frank M. Painter|October 1, 2009|Diagnosis, Education, Subluxation|

Sports Management:
Basic Spinal Subluxation Considerations

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 19 from RC’s best-selling book:

“Chiropractic Management of Sports and Recreational Injuries”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 19: Basic Spinal Subluxation Considerations

The concept that an “off centered” vertebral or pelvic segment parallels a unique effect upon the neuromuscular bed which may be the cause of, aggravation of, or “triggering” of certain syndromes is a major contribution to the field of functional pathology and clinical biology by the chiropractic profession.

This section discusses the basic biomechanics and effects of vertebral subluxations as related to the management of sports-related and recreational injuries.

Spinal Biomechanics

While the erect spinal column is a concern in static postural equilibrium, it is never actually in a static state in life. It is alternately changing from a state of “quiet dynamics” in the static postural attitude to a state of “active dynamics” in movement. These kinetic aspects of normal spinal biomechanics are an important consideration since the totality of spinal function is the sum of its individual component parts.

The Vertebral Motor Unit

An intervertebral motor unit consists of two vertebrae and their contiguous structures forming a set of articulations at one intervertebral level. Thus, what is called a vertebral “subluxation” in chiropractic is the alteration of the normal dynamics, anatomical or physiological relationships of contiguous articular structures. The components of the spinal column (the vertebral motor units) confer a quality and quantity of motoricity to the relationship of two vertebrae. They are firmly interconnected by the intervertebral disc and restraining ligaments, which are activated by muscles which respond to both sensory and motor stimulation. (more…)

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Whiplash Trauma and “New School” Isometrics

By Frank M. Painter|September 25, 2009|Education|

Whiplash Trauma and “New School” Isometrics

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Jeffrey Tucker, DC, DACRB

When I was in chiropractic college more than 25 years ago, I was taught to use isometric exercises for whiplash trauma recovery. The technique was pretty simple: Place one hand on the back of your head and push the hand and the head against each other. Keep the neck in a neutral position and don’t let the head move backward. Build up to tension in 2 seconds, hold the tension for 6 seconds and gradually relax over 2 seconds, and then repeat for 10 reps. The exercise was also performed in flexion, rotation and lateral bending.

This form of exercise involves the static contraction of a muscle without any visible movement in the angle of the joint; the length of the muscle does not change. We’ll call that technique “old school” because the old German model (Hettinger and Muller) of 6-second actions was used in the original experiments and was adequate for strength gains, but was insufficient to cause hypertrophy in muscles. If you were looking to get big, this was not the technique.

(more…)

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Clinical Biomechanics: Body Alignment, Posture, and Gait

By Frank M. Painter|September 23, 2009|Diagnosis, Education, Gait Analysis, Posture|

Clinical Biomechanics: Body Alignment, Posture, and Gait

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 4 from RC’s best-selling book:

“Clinical Biomechanics:
Musculoskeletal Actions and Reactions”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 4: Body Alignment, Posture, and Gait

With the background material offered in the basic principles of the musculoskeletal system, statics, dynamics, and joint stability, this chapter discusses how these factors are exhibited in body alignment and posture during static and dynamic positions.

Gravitational Effects

Improper body alignment limits function, and thus it is a concern of everyone regardless of occupation, activities, environment, body type, sex, or age. To effectively overcome postural problems, therapy must be based upon mechanical principles. In the absence of gross pathology, postural alignment is a homeostatic mechanism that can be voluntarily controlled to a significant extent by osseous adjustments, direct and reflex muscle techniques, support when advisable, therapeutic exercise, and kinesthetic training.

In the health sciences, body mechanics has often been separated from the physical examination. Because physicians have been poorly educated in biomechanics, most work that has been accomplished is to the credit of physical educators and a few biophysicists. Prior to recent decades, much of this had been met with indifference if not opposition from the medical profession.

Posture Analysis (more…)

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2 and 2 is? [Humor Alert!]

By Frank M. Painter|September 22, 2009|Education, Health Care, Media, News, Politics, Safety|

2 and 2 is? [Humor Alert!]

The Chiro.Org Blog

The news media has been having a LOT of fun reporting on the Congressional Health Care Overhaul lately, so I will too.

Chiropractic’s *scientific critics* state we don’t have the kind of statistics they (grin) rely on, so we shouldn’t toot our own horn like they do. Hmmm? Well, let’s take a closer look at them. Here’s some amazing scientific statistics about modern medicine:

1. The total number of iatrogenic deaths caused by conventional medicine is an astounding 783,936 deaths per year at a cost of $282 billion dollars. That is a mind-boggling 2147 people killed every day. That’s as if 7 jumbo jet planes crashed every day. That’s a 9-11 incident, happening every other day…FOREVER. God help us all. [1]

2. A report by the British Medical Journal correlated a strike by medical doctors with lower death rates during the strike. Hmmm?

3. Recent surveys suggest that “45% Of Doctors (MDs) Would Consider Quitting If Congress Passes Health Care Overhaul.” [3]

So, if we put that all those facts together, supporting Congress’s new Health Care Plan could reduce the medical population by up to 45%, thus significantly reducing the incidence of medically-induced iatrogenic illness and death, and all the money they would save ($126.9 billion dollars) would help to pay for the new Plan.

And, perhaps with some of those savings, they could even consider adding conservative chiropractic care as another cost-saving option. [4, 5]

REFERENCES

1. http://www.chiro.org/LINKS/FULL/Death_By_Medicine.html

2. http://tinyurl.com/lzdq7a

3. http://www.investors.com/NewsAndAnalysis/Article.aspx?id=506199

4. http://www.chiro.org/LINKS/Cost_Effectiveness.shtml

5. http://www.chiro.org/LINKS/Safety.shtml

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