Journal of manipulative and physiological therapeutics
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The neuroanatomical basis for cervicogenic headache is convergence in the trigeminocervical nucleus between nociceptive afferents from the field of the trigeminal nerve and the receptive fields of the first three cervical nerves. Only structures innervated by C1-C3 have been shown to be capable of causing headache. These are the muscles, joints and ligaments of the upper three cervical segments, but also include the dura mater of the spinal cord and posterior cranial fossa and the vertebral artery.
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J Manipulative Physiol Ther · Sep 1991
The Neck Disability Index: a study of reliability and validity.
Injuries to the cervical spine, especially those involving the soft tissues, represent a significant source of chronic disability. Methods of assessment for such disability, especially those targeted at activities of daily living which are most affected by neck pain, are few in number. A modification of the Oswestry Low Back Pain Index was conducted producing a 10-item scaled questionnaire entitled the Neck Disability Index (NDI). ⋯ These scores correlated at 0.60. Secondly, in a larger subset of 30 subjects, NDI scores were compared to scores on the McGill Pain Questionnaire, with similar moderately high correlations (0.69-0.70). While the sample size of some of the analyses is somewhat small, this study demonstrated that the NDI achieved a high degree of reliability and internal consistency.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Manipulative Physiol Ther · Mar 1991
The relationship between the medial branch of the lumbar posterior ramus and the mamillo-accessory ligament.
Gross dissection anatomical studies have investigated the course of the human lumbar posterior primary ramus and its branches. This nerve has frequently been associated with low back pain; however, the cross-sectional area of the space beneath the mamillo-accessory ligament, which is occupied by the medial branch of the posterior primary ramus, has not been clearly defined. ⋯ The main findings are that the medial branch of the posterior primary ramus occupies only a small percentage (approximately 3%) of the space enclosed by the mamillo-accessory ligament, and that it is surrounded by adipose tissue which provides an adequate protective "cushion" around it. Therefore, it is unlikely that the medial branch of the posterior primary ramus could be trapped beneath the mamillo-accessory ligament and cause pain.
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Two cases of low back pain from quadratus lumborum myofascial trigger points are presented. One of the patients suffered from an acute episode while the other had a chronic condition. This condition may be more common than previously believed. ⋯ Thoracolumbar joint dysfunction may often coexist with quadratus lumborum myofascitis and must be treated for optimal results. Myofascial therapy directed at restoring muscle length and function, coupled with joint manipulation to related dysfunctional areas, was implemented. Diagnosis and treatment are outlined.
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J Manipulative Physiol Ther · Sep 1990
Randomized Controlled Trial Clinical TrialChiropractic adjustive manipulation on subjects with acute low back pain: visual analog pain scores and plasma beta-endorphin levels.
The purpose of this study was to evaluate pain scores and plasma beta-endorphin levels following a single spinal adjustive manipulation in subjects with acute low back pain. Eighteen subjects were randomly assigned to either a control group, which received no treatment; a sham group, which received only light physical contact (touch); or an experimental group, which received an adjustive manipulation at a specific lumbar segment. ⋯ Analysis of the pain scores indicated that there was a slight, but significant, reduction of pain in the experimental group, but no similar reduction in the control or sham groups. Furthermore, this reduction of pain in the experimental group was not accompanied any significant change in the plasma beta-endorphin concentration.