Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Sep 2003
Case ReportsChiropractic management of Ehlers-Danlos syndrome: a report of two cases.
To discuss 2 patients with Ehlers-Danlos syndrome seeking chiropractic evaluation and management of their disabling musculoskeletal pain and associated disorders. ⋯ Chiropractic care may be of benefit to some patients with connective tissue disorders, including Ehlers-Danlos syndrome. Low-force chiropractic adjusting techniques may be a preferred technique of choice in patients with tissue fragility, offering clinicians a viable alternative to traditional chiropractic care in attempting to minimize risks and/or side effects associated with spinal manipulation. Psychosocial issues, including patient desire to return to work, were important factors in work disability status and perceived outcome.
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J Manipulative Physiol Ther · Sep 2003
Onset and recovery of hyperalgesia and hyperexcitability of sensory neurons following intervertebral foramen volume reduction and restoration.
To investigate the relationships between L4 and L5 intervertebral foramen (IVF) stenosis (IVFS), as well as the restoration and onset and recovery of behavioral hyperalgesia and alterations in primary sensory neuron excitability. ⋯ The present study demonstrates that hyperalgesia and hyperexcitability of the primary sensory neurons can be induced following the IVF volume reduction produced by insertion of a stainless steel rod and mostly relieved by the rod withdrawal. The recovery of excitability of DRG cells to normal levels is associated with the abatement of hyperalgesia. These results support the hypothesis that increased excitability of DRG neurons is associated with the generation and maintenance of hyperalgesia and suggest that relief of the IVF stenosis, which could compress all of the normal constituents within the IVF (ie, DRG, nerve root, blood and lymph vessels, adipose, etc.), may help to alleviate chronic pain in humans.
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J Manipulative Physiol Ther · Jun 2003
Patient satisfaction, characteristics, radiology, and complications associated with attending a specialized government-funded multidisciplinary spinal pain unit.
To prospectively document the satisfaction of a random sample of patients attending a specialized multidisciplinary spinal pain unit in the Australian public health care system and to collect associated data on patient characteristics, radiological findings, treatment modalities used, and any significant complications. Design and setting Spinal pain syndrome patients attended the specialized Multidisciplinary Spinal Pain Unit at Townsville General Hospital and the Kirwan Community Health Centre (Queensland, Australia) for diagnosis and management (ie, chiropractic spinal manipulation, medication, or needle acupuncture). A patient satisfaction questionnaire was sent to a random sample of patients in this Queensland Government funded service that was approved by the health authority's Ethics Committee. ⋯ A public hospital or community health center based specialized spinal pain syndrome unit is useful for referring clinicians who wish to obtain a further opinion for challenging spinal pain syndrome patients in the lower socioeconomic group that cannot afford private health care.
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J Manipulative Physiol Ther · May 2003
ReviewIs low back pain part of a general health pattern or is it a separate and distinctive entity? A critical literature review of comorbidity with low back pain.
Research concerning the development of low back pain (LBP) has traditionally focused on risk factors in search of explanations. This review focuses on comorbidity as a first step in identifying a frail subpopulation with a higher risk of developing low back pain, in particular persistent low back pain. Research into comorbidity might yield a greater understanding of the underlying mechanism for low back pain. Data sources Medline was searched from the beginning of the data base to December 2000, followed by a search through the authors' personal collections of epidemiologic literature regarding low back pain. All articles written in English were included if they related LBP to at least one other physical disorder. Articles were excluded if the prevalence of such disorders could not be compared to that of a control group or to the expected prevalence in a normal population. Data extraction The retrieved articles were evaluated for quality based on predefined methodological criteria, whereupon information about associations between low back pain and other physical disorders was extracted. ⋯ The literature leaves no doubt that diseases cluster in some individuals and that low back pain is part of this pattern. However, the nature of the relationship between low back pain and other disorders is still unclear.
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J Manipulative Physiol Ther · May 2003
The course of low back pain in a general population. Results from a 5-year prospective study.
To investigate the course of low back pain (LBP) in a general population over 5 years. ⋯ Low back pain should not be considered transient and therefore neglected, since the condition rarely seems to be self-limiting but merely presents with periodic attacks and temporary remissions. On the other hand, chronicity as defined solely by the duration of symptoms should not be considered chronic.