Archive for the 'Advanced' Category
Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.
Clinical practice guidelines define the role of specific diagnostic and treatment modalities in the diagnosis and management of patients.
Clinical practice guideline recommendations are based on evidence from rigorous systematic reviews and synthesis of [..]
And Specific Spinal Manipulation Kim was 19 years old, athletic, physically fit, and had never suffered from a neck injury or an episode of prior neck pain; her past history was completely unremarkable.While showering earlier that morning, she turned to reach for a bar of soap. She immediately experienced a sharp zap of left–sided neck [..]
All healthcare disciplines are associated with risks of injury or death. Rare but sensational occurrences are often exploited by the media, leading the public to believe that rare events are commonplace. In contrast, common occurrences are often under reported, leading the public to have higher confidence in the safety of certain healthcare disciplines and procedures. [..]
The Posterior Cervical Sympathetic SyndromeThe Syndrome of Barre-LieouThe blood flows to the brain through two arterial systems:Anterior Circulation (branches from the internal carotid arteries)Posterior Circulation (branches from the vertebral arteries)The dividing line between the Anterior and Posterior circulation of the brain is the Posterior Communicating Arteries.The diameter of the blood vessels is controlled by post-ganglionic sympathetic efferent neurons (1). As [..]
An Update on Healthcare RisksAn Update on Cervical Manipulation and Stroke Risk
The realization that trying to stay healthy can be risky became international headlines in 1994 when Harvard’s Lucian Leape, MD, indicated that medical error was responsible for 180,000 deaths per year (1, 2). Dr. Leape’s analogy was that this was “the equivalent of [..]
AND Spinal Manipulation Spinal Postural Improvement BACKGROUND CONCEPTSUpright posture is a first class lever mechanical system, such as a teeter-totter or seesaw:Fulcrum By mechanical definition, the fulcrum is where the forces are the greatest. In human spinal posture, the fulcrum is the intervertebral disc and facet joints.When the human head is bent forward, as in looking down, [..]
Terminology UpdateThe terminology pertaining to lumbar spinal disk herniations has been confusing, inconsistent, and contradictory. Consequently, in 2014, the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology convened a combined task force to agree upon the nomenclature. The results were published in the Spine Journal, and titled (1):Lumbar [..]
Why is Chronic Low Back Pain So Prevalent and Often so Treatment Resistant?
The Concept of Hyper-innervation, Neoneuralisation, Receptive Field Enlargement
Pain, like all perceptions, is a cortical event. Pain is experienced in the brain. Pain perception in the brain begins in a peripheral tissue and is transmitted to the brain via a nerve. Thus, the peripheral tissue [..]
When a force is applied to a joint, increased motion and “joint separation” occur. This can be done without causing any injury to the joint tissues (bones, cartilage, ligaments, muscles, tendons, nerves, etc.). This increased motion has a number of proposed benefits, including (1):The disruption of intra-articular and peri-articular adhesions.The remodeling of peri-articular fibrosis.Generating spinal [..]
America’s Pain Crisis
Judy Foreman was educated at Harvard, and has been a Lecturer on Medicine at Harvard’s Medical School. In 2014, she published a book titled (1):
A Nation in PainHealing Our Biggest Health Problem
Ms. Foreman notes that of the 238 million adults in America, approximately half of them have chronic daily pain. [..]
