COMMON CHIROPRACTIC CARE By: Brian Blunt. INTRODUCTION.

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


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


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


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


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


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.


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

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.


Treatment time varies from person to person, depending on the severity of the case and whether or not it is acute or subacute/ chronic.

LUMBOSACRALSTRAIN-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? Work injuries Sports injuries Car accidents Continuous use Microtrauma Leg length Muscle imbalance Excessive foot

pronation


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


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.


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


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)


Sclerosis Eburnation of the uncovertebral joints Subchondral osteoporosis IVF encroachment


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


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.

COMMON CHIROPRACTIC CARE By: Brian Blunt. INTRODUCTION.

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