Chiropractors

A First Line of Defense Against Pain

In 2017, the American College of Physicians released an update to its low back pain treatment guideline that recommends first using non-drug treatments, such as spinal manipulation, for acute and chronic low back pain.

The use of complementary and alternative medicine has increased dramatically during the past several decades. Chiropractic is the largest complementary and alternative medicine profession in the United States, with approximately 70,000 members, and chiropractic services account for the greatest number of complementary and alternative medicine visits.

A clinical comparative trial conducted  at three military medical centers found that chiropractic care combined with usual medical care for low back pain provides greater pain relief and a greater reduction in disability than medical care alone.

Chiropractic care is a complementary and alternative medicine treatment best known for manipulation of the spine and extremity joints. Chiropractors manipulate parts of the body that are in need of realignment, which helps to relieve pain and fix dysfunction. My goal is to allow the body to achieve its natural state of healing through the use of different manual therapies mentioned below.

Techniques Offered

Manipulation

The chiropractic manipulation technique typically involves a quick HVLA (high velocity, low amplitude) thrust to the joint that has become fixated, or out of alignment. Depending on the condition, the adjustment can also be modified as more of a “mobilization” to treat the joint to the same effect.

What is it?

Active Release Techniques is a soft tissue therapy developed by Michael Leahy, DC. This is a manual, hands on technique used to examine, diagnose and treat soft tissues problems involving muscles, tendons, ligaments and nerves. ART is very successful in treating adhesions and scar tissue resulting from acute and chronic injuries to the musculoskeletal system. 

Not only may the patient experience pain and tenderness due to the injury, but overall movement patterns become distorted as a result. This treatment helps to restore the body’s natural movement patterns after treating the injured tissue. 

The Mechanism

These injuries can occur over time, or as a result of a singular occurrence. The pattern usually starts with a weak or tight muscle leading to increased tension in that area of the body. This increased pressure will then result in reduced circulation to that area which leads to cellular hypoxia (lack of oxygen). The unfortunate result of this is the fibrosis and adhesions that occur in and between the tissues. If this reduced circulation occurs around the lymphatic channels, it can lead to edema.
 
The adhesions that result will tend to bind down the muscle, therefore resulting in loss of motion and pain. If the scar tissue binds down on a nerve, it can result in tingling and numbing in that area. Both of these scenarios result in not allowing the tissue to move freely, therefore causing abnormal sensations and weakness. 

    Diagnosis & Treatment

    The diagnosis portion of Active Release Technique is understanding the nature of the injury, which structures are involved and the resulting syndrome from this injury. The treatment drives oxygen back into the injured tissue by breaking apart the adhesions that have developed. This will free the structure to allow it to move freely again, and restore blood flow and normal movement patterns. 

    Conditions Treated

    • Headaches
    • Back Pain
    • Carpal Tunnel Syndrome
    • Tennis Elbow
    • Plantar Fasciitis 
    • Golfer’s Elbow
    • DeQuervains Syndrome 
    • Frozen Shoulder 
    • Dupuytren’s Contracture 
    • ITB Syndrome 
    • Sciatica 

    ART Research

    In a study published in the Journal of Physical Therapy Science, Active Release Techniques demonstrated significant positive outcomes in twenty-four individuals measured using Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT) and Range of Motion (ROM). VAS is a measurement of a patient’s perceived pain level. PPT is a measurement of the minimum force applied which induces pain. ROM is the full movement potential of a joint, usually its range of flexion and extension.

    Results:

    Visual Analogue scale (Vas)

    The ART group demonstrated significant improvements in VAS pain score, but no significant change was observed in the control group.

    pressure pain threshold (ppt)

    The PPT significantly increased in every muscle measured in the ART group. Muscle PPT demonstrated no significant change in the control group.

    range of Motion (ROM)

    After treatment, the ART group demonstrated significant increases in every neck, joint ROM parameter, while no significant changes were observed in the control group.

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