Citations
To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder.
A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention.
The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05).
These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.
Citations
We present a case of 5th cervical spine (C5) body fracture following cervical spine manipulation. The patient was an 18 year-old girl. She visited a non-authorized manipulation practitioner because of her shoulder pain. At that time she had no neck pain. During manipulation, the practitioner turned her neck suddenly with strong force, then she felt sudden neck pain. A fracture of the C5 body was identified in magnetic resonance images of the cervical spine.
We should be aware of the risk of serious complications associated with chiropractic manipulation.
Manual medicine is as old as the science and art of medicine itself. Spinal manipulation in manual medicine is widely used as a treatment modality for spinal disorders. But one of the problems as perceived by the medical profession is that the therapy is often treated as a business rather than a science. In addition, its reputation has been blurred by some of its advocates claiming far too much for its effectiveness and using it as a panacea. Another observation is that many patients have been subjected to a prolonged and failed trial of spinal manipulation. It was written with one purpose in mind. The purpose is to give a basic overview of the present day practice and scope of the field of manual medicine. If, in addition, the information thus provided helps reduce certain existing prejudices toward this field.
Objective: To assess the efficacy of spinal manipulation for the patients with acute low back pain.
Method: Twenty patients with acute low back pain have been received spinal manipulation 3 times per week. The 10-point scale and the distance of the fingertips from the floor on maximum forward flexion (fingertip-flexion test) were checked pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, and 2 weeks posttreatment.
Results: The results were as follows: 1) The 10-point scale at pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, and 2 weeks post-treatment were 10.0⁑0.0, 5.8⁑1.4, 2.2⁑1.0, 1.1⁑0.2, and 1.0⁑0.0, respectively (P＜0.01). 2) The fingertip-flexion test at pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, 2 weeks posttreatment were 35.4⁑8.4 cm, 22.4⁑7.0 cm, 14.1⁑4.9 cm, 7.4⁑3.6 cm, and 5.4⁑4.6 cm, respectively (P＜0.01).
Conclusion: In our study, the spinal manipulation for the patients with acute low back pain offered significant efficacy and appeared to be a reasonable therapeutic option. But the effectiveness of this method leaves a critical aspect that should be dealt with in future studies.
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