Expectation and Pain
07/12/11 11:32 Filed in: From the Research
I have written previously about the role that expectation plays in clinical practice. Indeed, mastering 'expectation management' is a core part of effective 'doctoring' and can easily make the difference between the success and failure of most forms of treatment, particularly when pain is involved. But there's more to this phenomenon than simply recognising the possibility of placebo analgesia. Recent studies have shown that a patient's expectation of treatment success influences their nociceptive system all the way from the cortex to the brainstem and spinal cord...
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Scoliosis - Mechanical or Neurological?
30/07/11 21:07 Filed in: From the Research
Scoliosis is a condition that chiropractors are often called upon to identify and then manage. While there is significant awareness of scoliosis in the general population, it is not accompanied by much understanding of the underlying mechanisms that bring about spinal curvature. As such, there has been considerable room for unproven, or even disproven, treatment strategies - as well as theories of aetiology that just don't make sense. Is scoliosis a mechanical condition? Or is there something else at play?
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What Does an Adjustment Do?
05/05/11 12:03 Filed in: From the Research
One of the most common questions that we are asked is, "What does an adjustment actually do?"
Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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Knuckle Cracking and Arthritis
24/03/11 12:45 Filed in: From the Research
One of the most common questions that a chiropractor is likely to be asked is, "What's that cracking sound?" Typically, you'd have no trouble explaining the mechanism of cavitation and its relevance to an adjustment. Often this line of questioning is followed by a secondary probe such as, "But doesn't it cause arthritis?" Again, you may have no difficulty refuting the suggestion, but do you actually have any evidence for your assertion?
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Tell Me Where it Hurts? Part II
22/03/11 21:39 Filed in: Clinical Pearls
In our last blog posting we looked at the significance of midline lumbar pain as a sensitive and specific predictor of internal disc disruption. But intervertebral disc disease is not the only disorder in which pain distribution can be a useful indicator of its origin. A paper by Clark et al in the journal Rheumatology looked at whether a unique pattern of pain accompanied thoracic osteoporotic compression fractures.
The possibility of osteoporotic compression fracture is usually raised in post-menopausal women suffering from thoracic pain. But is the pain typically felt in the midline, or even over the spine at all?
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The possibility of osteoporotic compression fracture is usually raised in post-menopausal women suffering from thoracic pain. But is the pain typically felt in the midline, or even over the spine at all?
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