Subluxation

Cerebral Perfusion in Patients with Chronic Neck and Upper Back Pain: Preliminary Observations

By Frank M. Painter|March 3, 2012|Spinal Manipulation, Subluxation|

Cerebral Perfusion in Patients with Chronic Neck and Upper Back Pain: Preliminary Observations

SOURCE: J Manipulative Physiol Ther. 2012 (Feb); 35 (2): 76-85

Maxim A. Bakhtadze, MD, PhD, Howard Vernon, DC, PhD, Anatoliy V. Karalkin, MD, PhD, Sergey P. Pasha, MD, PhD, Igor O. Tomashevskiy, MD, PhD, David Soave, MS

Center for Manual Therapy, Moscow, Russia.

OBJECTIVE: The purpose of this study was to determine the correlation between cerebral perfusion levels, Neck Disability Index (NDI) scores, and spinal joint fixations in patients with neck pain.

METHODS: Forty-five adult patients (29 were female) with chronic neck/upper thoracic pain during exacerbation were studied. The subjects were grouped according to NDI scores: mild, moderate, and severe. The number of painful/blocked segments in the cervical and upper thoracic spine and costovertebral joints, pain intensity using the visual analog scale, and regional cerebral blood flow of the brain using single-photon emission computed tomography (SPECT) were obtained. The SPECT was analyzed semi-quantitatively. Analysis of variance tests were conducted on total SPECT scores in each of the NDI groups (P < .05). Univariate correlations were obtained between blockage, pain, and SPECT scores, as well as age and duration. A multivariate analysis was then conducted.

RESULTS: Group 1 (mild) consisted of 14 patients. Cerebral perfusion measured by SPECT was normal in all 8 brain regions.

Group 2 (moderate) consisted of 16 patients. In this group, a decrease in cerebral perfusion was observed (range, 20%-35%), predominantly in the parietal and frontal zones. (more…)

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Dump Subluxation? Give Me a Break!

By Frank M. Painter|September 25, 2011|Subluxation|

Dump Subluxation? Give Me a Break!

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By William Meeker, DC, MPH, FICC

President of Palmer College of Chiropractic West,
and former director of the Palmer Center for Chiropractic Research

The front-page headline of the September issue (volume 13, no. 12) of the Chiropractic Journal reads “Research Conference Urges Profession to Dump Subluxation.” (Ed: No longer available online) Well, I’m here to tell you that nothing even remotely of the kind happened, and I still find it hard to understand why one person, Matthew McCoy, chose to spin the story so inaccurately, especially after (silently) sitting through only one morning of an extensive three-day meeting (the Research Agenda Conference, aka RAC 4) at my invitation (and Palmer’s expense). A responsible journalist who didn’t hear the whole story would have checked not only his facts, but his context as well.

For example, McCoy took me to task for not defending a “hapless Palmer grad.” This person turned out to be Dr. Chuck Henderson, a graduate of Western States Chiropractic College and a member of the faculty at the Palmer Center for Chiropractic Research. Dr. Henderson doesn’t need my help; he does quite well on his own, thank you. Dr. Henderson is currently being funded by the Foundation for Chiropractic Education and Research for a $250,000 study of the effects of spinal subluxation in rats. (Ed. NOTE: This FCER grant led to the publication of 4 very important subluxation studies.) [1-4] The Palmer Center for Chiropractic Research has many other projects that focus on subluxation, health and adjustments, but I’ll save those descriptions for another column.

We’re not talking responsibility here, and we certainly aren’t talking journalism. What we are talking about is the artificial creation of intraprofessional fighting. If external forces seem beyond our control, why not start some altercations closer to home? It’s a heck of a lot easier, but why? What I have come to understand, after my first shock of disbelief at being so thoroughly and deliberately misrepresented, and after having so many of my colleagues assume that McCoy’s version was accurate, is that one easy way to build up a position is with negativity. Henry Kissinger’s memoirs make the point that Nixon knew very well how to politically help himself by defining his enemies’ positions for them, regardless of their true positions. (more…)

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Subluxation Reviewed, Revisited, Revitalized

By Frank M. Painter|April 5, 2011|Research, Subluxation|

Subluxation Reviewed, Revisited, Revitalized

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Malik Slosberg, DC, MS

Our understanding of the biomechanics and neurology of the subluxation continues to evolve as more research is published which helps explain the nature of this lesion. Historically, the subluxation has been at the heart of the identity and purpose of the chiropractic profession.

Contemporary models provide new insights into this elusive and sometimes mysterious problem which we attempt to find by various clinical means and correct by the application of high-velocity, low-amplitude thrusts. Let’s review past models, but focus primarily on the latest evidence concerning the subluxation published in the recent scientific literature in order to improve our understanding, insight, and application of clinical interventions to improve patient outcomes with chiropractic care.

Older Models of Subluxation: Static Malposition and Pathology

Over the 115-year history of chiropractic, there have been many varied attempts to explain and clarify the subluxation. In the past, descriptions of this lesion were phrased in pathological terms and often included malposition, distortion of the intervertebral foramen and impingement of nerves as primary components. Henderson, et al., [1] described early notions of subluxation as static mechanical lesions, a misalignment or a bone out of place, as seen on a neutral radiograph. The authors explain that this static model has been vigorously challenged in the scientific literature.

Lantz [2] raised concerns about the strictly static, structural interpretation of vertebral subluxation and introduced his own hierarchical model including kinesiopathology, neuropathology, myopathology, connective tissue pathology, vascular abnormalities, as well as inflammatory response, histopathology, and biochemical abnormalities. Similarly, Dishman [3] described the vertebral subluxation complex in terms of various pathologies including neuropathology, myopathology, kinesiopathology, histopathology, and biochemical abnormalities.

Newer Terminology: Functional Spinal Lesion, Joint Dysfunction With Hypomobility, Joint Complex Dysfunction (more…)

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Is the Spinal Subluxation a Risk Factor?

By Frank M. Painter|March 25, 2011|Education, Subluxation|

Is the Spinal Subluxation a Risk Factor?

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Meridel I. Gatterman, MA, DC, MEd

Risk factors come in a variety of distinctions, from those for cardiovascular disease and some forms of cancer to those less than life-threatening but nonetheless undesirable conditions affecting the quality of a person’s life. A risk factor causes a person to be particularly vulnerable to an unwanted, unpleasant or unhealthful event. Risk factors predispose individuals to developing specific conditions. It has been suggested spinal subluxation could be considered such a risk factor. [1]

Subluxation As a Risk Factor

The following questions should be examined if the concept of subluxation as a risk factor is considered:

Is subluxation of one region of the spine a risk factor for different signs and symptoms as opposed to a subluxation in another spinal area?
If so, does a subluxation in one area create a different syndrome than when it occurs in a different region?
Does clinical observation suggest there are different subluxation syndromes associated with different spinal areas? [2]
Does a subluxation in the upper cervical region cause a different syndrome than a subluxation in the lower cervical region, and does a subluxation of the sacroiliac joint cause a different syndrome than one at a costovertebral joint? Does a patient’s symptomatic complaints and observable signs lead you to suspect a subluxation of one spinal region as opposed to another?

Subluxation Syndromes (more…)

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The Vertebral Subluxation Syndrome

By Frank M. Painter|March 24, 2011|Education, Subluxation|

The Vertebral Subluxation Syndrome

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Meridel I. Gatterman, MA, DC, MEd

The term subluxation has been used to describe the lesion treated by chiropractors since its inception. D.D. Palmer [1] described it in 1910 as “a partial or incomplete separation, one in which the articulating surfaces remain in partial contact.” Because of confusion by other professions, some within the chiropractic profession would have us abandon the term.

Others have promoted a teaching paradigm: the vertebral subluxation complex (VSC), which has grouped various components in a model focused around the dynamic component of the subluxation. Based on the works of Homewood, [2] Janse, [3] and Faye, [4] this model began being taught at CMCC in the mid-1970s and was later popularizing through the Motion Palpation Institute. [5] Other authors have revised Faye’s early model. The vertebral subluxation complex forms a paradigm for teaching the basic principles of chiropractic theory. By taking the VSC model one step further, the vertebral subluxation syndrome can be used to describe the primary clinical entity treated by chiropractors. [6-9]

Syndrome has been traditionally used to describe the aggregate of signs and symptoms associated with any morbid process and constituting together the picture of disease. [10] The focus for chiropractors today should not remain the terminology used to describe the vertebral subluxation syndrome, but rather the specific mechanisms whereby this complex aggregate of signs and symptoms is produced by altered spinal joint motion.

Recently, the primary fibromyalgia syndrome has replaced the controversial term fibrositis used to describe a condition that has been written off as psychological at best, with the physiological manifestations either denied or ignored. [11] When the multiple complaints and varied systemic complaints of this condition were recognized as a syndrome, objective investigation was fostered to the benefit of the many patients suffering from the condition.

Viewing the classic chiropractic subluxation in a similar manner would allow us to develop and objectively test the diagnostic features of the vertebral subluxation syndrome.

There are more articles like this at our:

The Chiropractic Subluxation Section

SOURCE: Read the rest of this Full Text article now!

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Historical Overview and Update on Subluxation Theories

By Frank M. Painter|January 7, 2011|Research, Subluxation|

Historical Overview and Update on Subluxation Theories

The Chiro.Org Blog

SOURCE: J Chiropractic Humanities 2010 (Dec); 17 (1): 22–32

By Howard Vernon, DC, PhD

Introduction

Manual therapy has, arguably, best been described by a Polish medical manipulation practitioner, Arkuszewski, [1] as “a mechanical therapy with reflex effects.” The phrase mechanical therapy can be further characterized by noting that it is performed in the musculoskeletal (MSK) system. The phrase reflex effects can be further qualified, at the very least, to indicate that these are “health-beneficial.” Therefore, a revised version would read as follows:

“a manually-performed mechanical therapy to the MSK system with health-beneficial reflex effects.”

This formulation also provides a basis for describing the primary disorder posited by chiropractic theory: subluxation. Recognizing that, for chiropractic, the subluxation has always been viewed as the “thing for which adjustment (manual therapy) is done,” a first-pass definition of subluxation, a la Arkuszewski, would be:

“a mechanical problem in the musculoskeletal system with health-deleterious reflex effects.”

Since the founding of chiropractic and the other manual therapy professions, 2 fundamental issues have vexed us:

What kind and location of mechanical problem in the MSK system qualifies as a subluxation (or any of the other terms used as synonyms within and outside of chiropractic)?
What kind of health-deleterious effects are specifically associated with subluxation?

The author recognizes that numerous others have attempted to review the subluxation concept, including recent excellent reviews by Gatterman, [2] Peters, [3] and Ebrall. [4] These previously published discussions are not reviewed here. What follows is a nonsystematic overview of selected developments in the profession that have addressed these 2 questions.

Discussion (more…)

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