Transcript Common Chiropractic Conditions - Near North District School Board

COMMON
CHIROPRACTIC CARE
By: Brian Blunt
INTRODUCTION
INTRODUCTION
 During my co-op with
Dr.Wolfe at Wolfe
Chiropractic Center, I had
the chance to see many
different injuries and
treatments. All injuries
had different causes, some
due to accidents, while
others due to poor
treatment of the body.
Some of the patients that I
helped treat were there
almost everyday, while
others were there from
once a month to once
every 3 months.
INTRODUCTION
 My Independent Study Project is an overall
look at the top five injuries that I saw
treated, including a description of what the
injury is, how it may occur, how it can be
treated, and the length of time it may take a
person to recover from this injury.
INTRODUCTION
The top five injuries that I saw and will be
speaking about today are:
1. Cervicogenic Cephalgia
2. Costoclavicular Syndrome
3. Cervical Spondylosis
4. Lumbar Facet Syndrome
5. Lumbosacral Strain/Sprain
CERVICOGENIC
CEPHALGIA
WHAT IS IT?
 Steady, aching headache
in the suboccipital and
temporal region of the
brain
 Pain described as steady
and aching and may last
from 4 hours to 2 days
 May encircle the entire
head, beginning in the
occipital region and
moving to the frontal
region of the brain
 Pain may increase with
forward flexion of the
neck
WHAT IS THE CAUSE?
There are several different causes for cervicogenic
cephalgia. They include:
 Cervical subluxations (partial dislocations of
cervical vertebrae)
 Trauma
 Postural strain
 Myofascial trigger points
 TMJ (temporomandibular joint) syndrome
 Tension
Stress, fatigue, noise, and glare can all make the
headaches worsen.
HOW CAN IT BE TREATED?
First the case must be diagnosed as cervicogenic
cephalgia. This is done by :
 Checking tension of masticatory and
submandibular muscles
 Ruling out TMJ involvement
 Look for hyperalgesia of skin zones in the cervical
region and trigger points on the neck and thorax
 Check cervical and thoracic spine, AC joint, and
sternoclavicular joint for impaired function
 Check for anterior weight bearing
HOW CAN IT BE TREATED?
Once diagnosed,
cervicogenic cephalgia
can be treated using the
following methods:
 Massaging of the occipital
and paraspinal muscles
 Ultrasound of upper
trapezius and lower
cervical paraspinal
muscles, following with
moist heat
HOW CAN IT BE TREATED?
 Icing the neck
 Adjustments of cervical
and thoracic subluxations
 Check for food allergies
and remove those foods
from the diet
 Valerian root, Passion
flower,Magnesium, and
Calcium may also help
HOW LONG WILL THE
TREATMENT TAKE?
The length of
treatment depends on
who is being treated
and how sever the
headaches are.
Treatment length
varies from case to
case.
COSTOCLAVICULAR
SYNDROME
WHAT IS IT?
 Neurovascular
compression of the
shoulder girdle
 Pain is increased by
abduction and retraction
of the shoulder as is
paresthesia
 Pain is most severe during
the night and early
morning
 Effects include pain,
numbness, and paresthesia
of the neck, upper
extremities, and anterior
chest wall
WHAT IS THE CAUSE?
 Narrowing of the
space between the first
rib and the clavicle
 Compression of the
subclavian artery and
brachial plexus
 Poor posture, trauma,
fatigue, or emotional
stress can all be
relating factors
HOW CAN IT BE TREATED?
First the injury must be defined as costoclavicular
syndrome. This is done by checking for:
 Trigger points around the neck and clavicular
region
 Diminished or absent pulse unilaterally or
bilaterally of the neck and clavicular regions
 Sensory impairment over the regions of C8 to T1
 Cyanosis, edema, Raynod’s phenomenon, and
distal gangrene of the upper limbs
HOW CAN IT BE TREATED?
Once diagnosed, costoclavicular syndrome can be
treated using the following methods:
 Moist heat and ultrasound
 Muscle stripping
 Stretching of the involved muscles
 Trigger point therapy to reduce muscles spasms
 Check for impaired function and anterior weight
bearing of the cervicothoracic spine, AC joint, and
sternoclavicular joint
HOW CAN IT BE TREATED?
 Reduce subluxations in the occipital, cervical, and
thoracic regions
 Posture and shoulder elevation exercises
 Stretching of involved muscles
 Ischemic pressure techniques applied for 5 to7
seconds on myofascial trigger points in the
cervical, upper thoracic and shoulder muscles
 Valerian root, passion flower, magnesium and
calcium may help to stop muscle spasms
HOW LONG WILL
TREATMENT TAKE?
Depending on the
severity of the case,
treatment time for
costoclacivular
syndrome is always
different.
LUMBAR FACET
SYNDROME
WHAT IS IT?
 Rotational and
compression injury of
the facet joints in the
lumbar spine
 Also known as
posterior joint
syndrome or acute
locked back
WHAT IS IT?
 Characterized by low back pain that is
relieved by motion but aggravated by
lumbar extension and rotations, prolonged
sitting, and repetitive movements
 Pain may move to , upper thighs, groin, hip
and buttocks.
 Pain may also move to sacroiliac joints and
superior iliac spine.
WHAT IS THE CAUSE?
 Trauma
 Microtrauma
 Obesity causing excessive weight bearing
by lumbar spine
 Decreased disk height
HOW DOES IT OCCUR?
 Increased lumbosacral lordosis (forward
curvature of the lumbar spine)
 Disk degeneration
 Poor posture
 Tear or pinch of facet capsule caused by
hyperextension of hyperflexion of lumbar
spine
HOW CAN IT BE TREATED?
The injury must first be
diagnosed as Lumbar
Facet Syndrome. It can be
identified mostly by the
pain it is characterized by,
but also by tenderness of
the lumbar spinous
processes and transverse
processes when touched.
HOW CAN IT BE TREATED?
Once diagnosed, lumbar facet syndrome
can be treated in two fashions, one for an
acute case, and another for chronic or
subacute cases.
ACUTE TREATMENT
 Icing the lumbar
region
 Ice massage of the
lumbar region
 High-volt sinusoidal
interferential current
 Ultrasound
SUBACUTE OR CHRONIC
TREATMENT
 Moist hot packs
 TENS machine used to
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

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block pain
Short wave diathermy
Manipulation
Flexion/ distraction and
traction
Pelvic flattening and
strengthening of the
abdominal muscles to
correct the anterior pelvic
tilt and to flatten the
lumbar curve
SUBACUTE OR CHRONIC
TREATMENT
 McKenzie exercises to help strengthen
stabilize the lumbar spine
 Proteolytic enzymes, Bioflavanoids, and
various herbals to relieve acute pain and
inflammation
 Amino acids, Glucosamine sulfate, Vitamin
C, Alpha-ketoglutaric acid, calcium,
Vitamin E, Zinc, Copper, and Manganese
can be taken to help with tissue healing.
HOW LONG WILL
TREATMENT TAKE?
Treatment time varies
from person to person,
depending on the
severity of the case
and whether or not it
is acute or subacute/
chronic.
LUMBOSACRAL
STRAIN-SPRAIN
WHAT IS IT?
 Injury involving the
combination of
stretching, rupturing,
or separating the
muscles and
supporting ligaments
of the lumbosacral
spine.
WHAT IS IT?
 Pain is immediate
 Pain begins as transitory and is followed by
pain free intervals
 Pain is localized to the lumbosacral region
but may move to the buttocks and thoracic
spine
WHAT IS IT?
 Accompanied by stiffness, muscle spasms,
and restricted motion in all planes
 Pain may worsen with forward flexion
 Strains painful with active and isometric
movements
 Sprains painful in active and passive ranges
of motion
WHAT IS THE CAUSE?

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


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Work injuries
Sports injuries
Car accidents
Continuous use
Microtrauma
Leg length
Muscle imbalance
Excessive foot
pronation
HOW CAN IT BE TREATED?
Before treatment a patient must be diagnosed as
having a Lumbosacral Strain-Sprain. The
following are signs used to diagnose:
 Slow,guarded gait
 Antalgic posture
 Tenderness of the involved muscles, spinous tips
and transverse processes
 Edema
 Joint fixation
 Tenderness over the paravertebral muscles
HOW CAN IT BE TREATED?
Lumbosacral strains-sprains must be treated
in two different fashions, one being for
acute cases and the other being for subacute
cases.
ACUTE TREATMENT
 Ice packs to reduce
pain, edema and
muscle spasms
 Interferential current
to manage pain and
edema
 TENS machine used
to control pain
 Lumbosacral support
SUBACUTE TREATMENT
 Manipulation of
locked joints to
promote pain-free
ranges of motion ,
prevent fibrotic
adhesion, decrease
pain, and increase
facet joint movement.
SUBACUTE TREATMENT
 Moist hot packs
 Ultrasound
 Electric muscle
stimulation
 Whirlpool/ hot soaks
to reduce muscle
spasms and relieve
tension
SUBACUTE TREATMENT
 TENS machine to diminish pain
 To prevent fibrotic adhesions and to
recondition muscles, muscles may be
worked using trigger point therapy,
myofascial release, stretching, and massage.
 Abdominal muscles, low back, and
hamstring muscles must be reconditioned
using McKenzie exercises and stretching.
SUBACUTE TREATMENT
 Proteolytic enzymes, Bioflavanoids, and various
herbals to relieve acute pain and inflammation
 Amino acids, Glucosamine sulfate, Vitamin C,
Alpha-ketoglutaric acid, calcium, Vitamin E, Zinc,
Copper, and Manganese can be taken to help with
tissue healing.
 Valerian root, passion flower, magnesium, and
calcium and be used to relieve acute muscles
spasms.
HOW LONG WILL
TREATMENT TAKE?
 Mild strains:7-10 days
 Mild sprains:
1-4 weeks
 Moderate strains:
2-4 weeks
 Moderate sprains:
1 month – 1 year
 Sever sprains-strains
may require surgery
CERVICAL SPONDYLOSIS
WHAT IS IT?
 Osteoarthritic changes
of the facet joints
including the
narrowing of space
between disks, the
formation of
osteophytes,
sometimes
neurological
symptoms.
WHAT IS IT?
 Pain may be limited to the posterior neck or can
radiate to the occiput, anterior chest wall,
shoulders, arms, and/ or hands
 Diminished ranges of motion in the neck
 Can be associated with cervicogenic headaches
 Patient may have abnormal disk degeneration
which may cause vertebrobasilar ischemia, ataxia,
and vertigo.
WHAT IS THE CAUSE?
 Cervical strains/sprains
 Repetitive trauma
 Metabolic disorders of articular cartilage
 Postsurgical changes
HOW CAN IT BE TREATED?
First the condition must be diagnosed as
cervical spondylosis. This is most easily
done by taking x-rays which will show:
 Decreased cervical lordosis
 Decreased disk height
 Osteophytosis
 Osteophytes (posterior and anterior)
HOW CAN IT BE TREATED?
 Sclerosis
 Eburnation of the uncovertebral joints
 Subchondral osteoporosis
 IVF encroachment
HOW CAN IT BE TREATED?
Once diagnosed, cervical
spondylosis can be treated
by:
 Wearing a cervical collar
for the majority of the day
for up to two weeks to
separate the spaces
between joints
 Cervical traction
 Myofascial stripping
techniques may be used on
involved muscles
HOW CAN IT BE TREATED?
 Ultrasound may be used to
breakup fibrotic
adhesions, reduce muscle
spasms, and increase the
range of motion of the
neck
 Adjustments of
subluxations in the
cervical and thoracic spine
 ROM exercises
 Trigger point therapy
HOW CAN IT BE TREATED?
 Glucosamine sulfate, vitamin C, iron, and
alpha-ketoglutaric acid may be taken to
improve the production of collagen
 Calcium, vitamin E, zinc, copper, and
Manganese may be taken to act as free
radicals and remove cellular debris and
promote healing
HOW LONG WILL THE
TREATMENT TAKE?
The treatment time for
Cervical Spondylosis
varies from patient to
patient, depending on
the severity of the case
and how long it has
gone untreated.
CONCLUSION
CONCLUSION
As you can see, I saw a variety of different
injuries and treatments while working at Wolfe
Chiropractic Center. Although not all of these
injuries can be prevented, some can. Proper diet,
good exercise, and an ergonomic life style can
help you prevent some of these injuries. For the
people that chose not to do this, there will always
be chiropractic care there to help them, but it can
only do so much and cannot be expected to work
miracles for everyone.