ABSTRACT
OBJECTIVE: The objective of this pilot study was to determine the number of patients required for a randomized controlled trial of spinal manipulation for neck pain and to determine if there is a relationship between pain and range of motion (ROM) in the cervical spine. DESIGN: Fifty consecutive outpatients were studied in a pretest-posttest design without long-term follow-up. SETTING: The patients were taken from a primary cae outpatient teaching clinic specializing in back pain. PATIENTS: All patients had unilateral neck pain without neurological deficit. The patients were selected as a consecutive sample. INTERVENTION: All the patients received a single cervical manipulation. MAIN OUTCOME MEASURES: Prior to and immediately after the treatment, cervical ROM was recorded on a goniometer, and pain intensity was rated on the 101-point numerical rating scale. RESULTS: The results show an increase in all planes of post-treatment ROM and a decrease in post-treatment pain scores. Partial correlations between post-treatment ROM and 101-point numerical rating scale scores reveal a significant relationship between a decrease in pain and an increase in cervical rotation (p < .005). CONCLUSIONS: Since the results of this pilot study are not controlled, they cannot be seen as proof supporting the clinical efficacy of manipulation for neck pain. However, the correlation between an increase in cervical rotation and a decrease in pain is clinically instructive. In addition, the outcome measures used in this study could prove to be useful in the design of future randomized controlled trials of cervical manipulation.
Subject(s)
Cervical Vertebrae , Manipulation, Orthopedic/methods , Pain Management , Adult , Aged , Cervical Vertebrae/physiology , Female , Humans , Male , Middle Aged , Pain Measurement , Pilot Projects , Range of Motion, Articular , Spinal Diseases/therapyABSTRACT
Subdural hematoma formation should be considered as a diagnosis in the patient who complains of headache and is on long-term anticoagulant therapy. Three such cases are described and the proper medical management is discussed.
Subject(s)
Anticoagulants/adverse effects , Headache/etiology , Hematoma, Subdural/chemically induced , Aged , Anticoagulants/therapeutic use , Female , Headache/diagnosis , Hematoma, Subdural/diagnosis , Humans , Male , Middle AgedABSTRACT
We describe the case of a patient with a lumbar disc herniation who underwent a course of side posture manipulation. Despite the appearance of an enormous central herniation on the CT scan, the patient improved considerable during only 2 wk of treatment. The disparity which so commonly exists between radiological and clinical findings is depicted in this case. Further, it is emphasized that manipulation has been shown to be an effective treatment for some patients with lumbar disc herniation. While complications of this form of treatment have been reported in the literature, such incidents are rare.
