Chiropractic treatment of postsurgical neck syndrome with mechanical force, manually assisted short-lever spinal adjustments.

OBJECTIVE: To describe a case of postsurgical neck pain, after multiple spinal surgeries, that was successfully treated by chiropractic intervention with instrumental adjustment of the cervical spine. CLINICAL FEATURES: A 35-year-old woman had chronic neck pain for over 5 years after two separate surgeries of the cervical spine: a diskectomy at C3/4 and a fusion at C5/6. Surgeries were performed 6 months apart in an attempt to resolve persistent neck pain and spasm of the cervical musculature. Neither surgery was effective in relieving the patient's pain. Five years after the second surgery, a third surgery was recommended by the patient's physicians to alleviate the chronic pain. The patient sought chiropractic evaluation of her condition to avoid further surgical intervention. INTERVENTION AND OUTCOME: The patient was treated with conservative instrumental chiropractic manipulation, consisting of mechanical force, manually assisted short-lever spinal adjustments rendered with an Activator Adjusting Instrument (AAI) II. She comfortably tolerated the treatment and responded favorably to this therapy. All chronic symptoms had resolved within 30 days of instituting the chiropractic instrumental adjustments with an AAI. More interestingly, longitudinal examination over the next 2 years showed that the patient experienced no residual effects or further recurrences of her previous chronic problem after her initial course of chiropractic care. CONCLUSION: Chiropractic treatment of postsurgical neck syndrome may be effectively treated, in certain cases, by mechanical force, manually assisted adjusting procedures with an AAI. The use of instrumental adjustment methodology may provide chiropractic physicians with an effective alternative to manual manipulation in those cases in which the patient's surgical history or presenting symptoms make forceful manipulation of the spine, particularly performed at end range, inappropriate. This approach may be contemplated by physicians faced with managing this type of condition. Further study should be made in this regard, in an academic research setting, to determine the safest and most effective approaches to managing postsurgical patients in a chiropractic setting.

Chiropractic treatment of coccygodynia via instrumental adjusting procedures using activator methods chiropractic technique.

OBJECTIVE: To discuss a case of coccygodynia that responded favorably to conservative chiropractic adjusting procedures with the Activator Methods Chiropractic Technique (AMCT) and the Activator II Adjusting Instrument (AAI II). CLINICAL FEATURES: A 29-year-old woman had unremitting coccygeal pain of 3 weeks' duration. The problem began after she had moved heavy boxes while at work. The pain was characterized by a continual dull ache in the coccygeal region, accompanied by intermittent sharp pain, particularly upon sitting or rising from a seated position. She had been taking self-prescribed over-the-counter analgesics (aspirin and ibuprofen) for 3 weeks without obtaining relief. INTERVENTION AND OUTCOME: Treatment consisted of mechanical force, manually assisted, short-lever (MFMA) chiropractic adjusting procedures to the coccygeal area, primarily the sacrococcygeal ligament. The AAI II was used to deliver the adjustment according to diagnostic and treatment protocol specified for AMCT. The patient experienced first treatment. CONCLUSION: Chiropractic coccygeal manipulation may be effectively delivered via instrumental adjustment in certain cases of coccygodynia. The use of an AAI II in administering the coccygeal adjustment has the benefit of being a gentle, noninvasive procedure, as well as being comfortably tolerated by the patient. This method of coccygeal adjustment may bear consideration in certain cases of coccygodynia.

Treatment of symptomatic lumbar disc herniation using activator methods chiropractic technique.

OBJECTIVE: To describe a case of symptomatic lumbar disc herniation, successfully treated via chiropractic intervention using Activator Methods Chiropractic Technique. CLINICAL FEATURES: A 26-yr-old man suffered from a chronic multisymptom complex composed of low back pain, left groin pain, left leg pain, left foot drop and associated muscle weakness with atrophy. The symptoms had persisted for more than 2 yr after an athletic injury. Magnetic resonance imaging evaluation revealed a 6-mm focal central disc protrusion with accompanying deformation of the thecal sac, consistent with the presenting symptoms. Lumbar spinal surgery had been recommended to the patient as the appropriate medical management for optimal outcome. INTERVENTION AND OUTCOME: The patient elected to pursue chiropractic treatment in an effort to resolve his condition via conservative management. Chiropractic intervention consisted of mechanical-force, manually assisted short-lever adjusting procedures, rendered via an Activator Adjusting Instrument (AAI). The patient responded favorably and his multisymptom complex resolved within 90 days of treatment. No residuals or recurrences were noted at examination over 1 yr later. CONCLUSION: This report suggests that chiropractic treatment of lumbar disc disorders may be effectively implemented, in certain cases, via mechanical-force, manually assisted adjusting procedures using an AAI. We speculate that the use of an AAI, combined with Activator methods, may provide definitive benefits over side-posture manipulation of the lumbar spine in treatment of resistive disc lesions, because of the lack of torsional stress imposed upon the disc during instrumental spinal adjustment. Further study should be made in this regard to determine the safest and most effective method to treat lumbar disc lesions in a chiropractic setting.

Treatment of cervical disc protrusions via instrumental chiropractic adjustment.

OBJECTIVE: To discuss the case of a patient suffering from posttraumatic cervical syndrome involving multiple protrusions of cervical intervertebral discs that was treated successfully with conservative, instrumental chiropractic adjusting procedures. CLINICAL FEATURES: A 42-yr-old woman suffered from acute neck and arm pain after traumatic injury sustained in an automobile accident. Radiological examination exhibited a complete reversal of the cervical lordosis, and magnetic resonance imaging of the cervical spine revealed intervertebral disc protrusions, ranging in size from 1-4 mm, at four separate segmental levels. INTERVENTION AND OUTCOME: The patient was initially treated with high-velocity manual manipulation of the cervical spine and reported a subsequent aggravation of her symptoms. Thereafter, she was treated with short-lever, mechanical-force, manually-assisted chiropractic adjusting procedures to the cervical spine, utilizing an Activator Adjusting Instrument. She tolerated the treatment well and subsequently experienced a complete resolution of the presenting symptoms. CONCLUSION: Conservative chiropractic treatment may provide an effective therapeutic intervention in selected cases of cervical disc protrusion. Instrument-delivered adjustments may provide benefit in cases in which manual manipulation causes an exacerbation of the symptoms or is contraindicated altogether. Further study in this area should be made via large scale studies organized in an academic research setting.

Chiropractic treatment of frozen shoulder syndrome (adhesive capsulitis) utilizing mechanical force, manually assisted short lever adjusting procedures.

OBJECTIVE: To describe treatment of frozen shoulder syndrome (adhesive capsulitis) via conservative chiropractic treatment to the shoulder joint, utilizing specific contact, low force, instrumental adjusting procedures. A case report, providing an illustrative example of the same, is presented along with a review of the relevant literature. CLINICAL FEATURES: A 53-yr-old woman suffered severe shoulder pain of over 6 months' duration. The patient had been diagnosed as having adhesive capsulitis and had undergone a variety of different treatment regimens without obtaining relief, including various NSAIDs, analgesics and physical therapy. At the time of her presentation, her condition had progressed to the point of near total immobility of the shoulder joint, accompanied by severe pain with resulting marked restriction in her normal activities of daily living. INTERVENTION AND OUTCOME: The patient's shoulder was conservatively managed with chiropractic adjustments to the affected shoulder joint, as well as to the cervicothoracic spine. Treatment consisted of mechanical force, manually assisted short lever chiropractic adjustments, delivered via an Activator Adjusting Instrument. Successful resolution of the presenting symptomatology was achieved. CONCLUSION: Chiropractic care may be able to provide an effective mode of therapeutic treatment for certain types of these difficult cases. Low force instrumental adjustments, in particular, may present certain benefits in these cases that the more forceful manipulations and/or mobilizations cannot. As such, further formal investigation of this type of therapeutic intervention for treatment of frozen shoulder may be warranted on a larger scale.

Conservative treatment of torn medial meniscus via mechanical force, manually assisted short lever chiropractic adjusting procedures.

OBJECTIVE: To present the first reported case of successful chiropractic intervention in treatment of a torn medial meniscus of the knee, the meniscal tear being documented by magnetic resonance imaging (MRI). CLINICAL FEATURES: A 54-yr-old woman complaining of right knee pain of several months' duration with accompanying marked functional impairment was diagnosed as having a tear in the posterior horn of the ipsilateral medial meniscus, verified by MRI studies of the same. Independent consultation with three medical specialists resulted in the unanimous decision that surgical intervention for the purpose of meniscectomy provided the only therapeutic approach indicated for the problem. However, the patient was reticent to undergo said surgical procedure and chose, instead, to utilize chiropractic care and conservative management in an effort to resolve her condition without having to resort to surgery. INTERVENTION AND OUTCOME: The patient received chiropractic treatment to the knee via mechanical force, manually assisted short lever chiropractic adjusting procedures (MFMA) utilizing an Activator Adjusting Instrument. Auxiliary treatment included the use of homeopathic therapy as an adjunct to chiropractic care. Said treatment resulted in a complete resolution of the patient's disability, the patient recovering full function of the knee joint and achieving an asymptomatic status without having to submit to surgical intervention and its possible adverse sequelae. CONCLUSIONS: Conservative management of meniscal tears via chiropractic treatment may provide a therapeutically effective and financially cost containing alternative to routine meniscectomy in certain cases involving torn medial menisci of the knee.