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Chiropractic Management of a Patient With Neck-Tongue Syndrome

By |June 13, 2017|Chiropractic Care, Neck Pain, Neck-Tongue Syndrome|

Chiropractic Management of a Patient With
Neck-Tongue Syndrome: A Case Report

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2016 (Dec);   15 (4):   321–324

Craig S. Roberts, DC

Private Practice,
Nevada City, CA


OBJECTIVE:   The purpose of this case report was to describe the chiropractic management of a patient with neck-tongue syndrome (NTS).

CLINICAL FEATURES:   A 34-year-old female patient sought treatment at a chiropractic clinic for symptoms involving neck pain associated with left-sided paresthesia of the tongue that had persisted for >2 years. A diagnosis of NTS was made.

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Neck Pain In Children

By |September 17, 2016|Neck Pain, Pediatrics|

Neck Pain In Children: A Retrospective Case Series

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SOURCE:   J Can Chiropr Assoc. 2016 (Sep); 60 (3): 212–219

Jocelyn Cox, BPhEd, DC,
Christine Davidian, DC, MSc,
Silvano Mior, DC, FCCS, PhD

Graduate Education and Research Department
of Canadian Memorial Chiropractic College


Introduction:   Spinal pain in the pediatric population is a significant health issue, with an increasing prevalence as they age. Pediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning.

Methods:   A retrospective chart review was used to describe chiropractic management of pediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed.

Results:   Fifty pediatric neck pain patient files were analysed. Patients’ age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented.

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Management of Neck Pain and Associated Disorders

By |March 23, 2016|Guidelines, Neck Pain, Whiplash|

Management of Neck Pain and Associated Disorders: A Clinical Practice Guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

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SOURCE:   Eur Spine J. 2016 (Mar 16) [Epub]

Côté P, Wong JJ, Sutton D, Shearer HM, Mior S et. al.

Canada Research Chair in
Disability Prevention and Rehabilitation,
University of Ontario Institute of Technology (UOIT),
2000 Simcoe Street North,
Oshawa, ON, L1H 7L7, Canada.


PURPOSE:   To develop an evidence-based guideline for the management of grades I-III neck pain and associated disorders (NAD).

METHODS:   This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD <6 months duration.

RECOMMENDATION 1:   Clinicians should rule out major structural or other pathologies as the cause of NAD. Once major pathology has been ruled out, clinicians should classify NAD as grade I, II, or III.

RECOMMENDATION 2:   Clinicians should assess prognostic factors for delayed recovery from NAD.

RECOMMENDATION 3:   Clinicians should educate and reassure patients about the benign and self-limited nature of the typical course of NAD grades I-III and the importance of maintaining activity and movement. Patients with worsening symptoms and those who develop new physical or psychological symptoms should be referred to a physician for further evaluation at any time during their care.

RECOMMENDATION 4:   For NAD grades I-II ≤3 months duration, clinicians may consider structured patient education in combination with: range of motion exercise, multimodal care (range of motion exercise with manipulation or mobilization), or muscle relaxants. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, strain-counterstrain therapy, relaxation massage, cervical collar, electroacupuncture, electrotherapy, or clinic-based heat.

RECOMMENDATION 5:   For NAD grades I-II >3 months duration, clinicians may consider structured patient education in combination with: range of motion and strengthening exercises, qigong, yoga, multimodal care (exercise with manipulation or mobilization), clinical massage, low-level laser therapy, or non-steroidal anti-inflammatory drugs. In view of evidence of no effectiveness, clinicians should not offer strengthening exercises alone, strain-counterstrain therapy, relaxation massage, relaxation therapy for pain or disability, electrotherapy, shortwave diathermy, clinic-based heat, electroacupuncture, or botulinum toxin injections.

RECOMMENDATION 6:   For NAD grade III ≤3 months duration, clinicians may consider supervised strengthening exercises in addition to structured patient education. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, cervical collar, low-level laser therapy, or traction.

RECOMMENDATION 7:   For NAD grade III >3 months duration, clinicians should not offer a cervical collar. Patients who continue to experience neurological signs and disability more than 3 months after injury should be referred to a physician for investigation and management.

RECOMMENDATION 8:   Clinicians should reassess the patient at every visit to determine if additional care is necessary, the condition is worsening, or the patient has recovered. Patients reporting significant recovery should be discharged.

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Where the United States Spends its Spine Dollars

By |November 5, 2015|Low Back Pain, Neck Pain|

Where the United States Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

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SOURCE:   Spine 2012 (Sep 1); 37 (19): 1693–1701 ~ FULL TEXT

Matthew A. Davis, DC, MPH

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA.
matthew.a.davis@dartmouth.edu


STUDY DESIGN:   Serial, cross-sectional, nationally representative surveys of noninstitutionalized US adults.

OBJECTIVE:   To examine expenditures on common ambulatory health services for the management of back and neck conditions.

SUMMARY OF BACKGROUND DATA:   Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

METHODS:   We used the Medical Expenditure Panel Survey to examine adult (aged 18 yr or older) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

RESULTS:   Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008). Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. During the study period, the mean inflation-adjusted annual expenditures on chiropractic care were relatively stable; although physical therapy was the most costly service overall, in recent years those costs have contracted.

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Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

By |September 28, 2015|Chronic Pain, Neck Pain|

Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

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SOURCE:   J Manipulative Physiol Ther. 2015 (Sep 15 ~ FULL TEXT

Anke Langenfeld, MS, B. Kim Humphreys, DC, PhD,
Jaap Swanenburg, PhD, Cynthia K. Peterson, RN, DC, MMedEd, PhD

PhD Student,
CAPHRI School of Public Health and Primary Care,
Department of Epidemiology,
Maastricht University,
Maastricht, The Netherlands


OBJECTIVE:   Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode.

METHODS:   Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere.

RESULTS:   Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as “recurrent.” Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age.

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Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

By |March 6, 2015|Chiropractic Care, Chronic Pain, Neck Pain|

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

The Chiro.Org Blog


SOURCE:   Spine J. 2014 (Sep 1);   14 (9):   1879–1889

Michele Maiers, DC, MPH, Gert Bronfort, DC, PhD,
Roni Evans, DC, MS, Jan Hartvigsen, DC, PhD,
Kenneth Svendsen, MS, Yiscah Bracha, MS,
Craig Schulz, DC, MS, Karen Schulz, DC,
Richard Grimm, MD, PhD

Northwestern Health Sciences University,
Wolfe-Harris Center for Clinical Studies,
2501 W. 84th St, Bloomington, MN 55431, USA
mmaiers@nwhealth.edu


BACKGROUND CONTEXT:   Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors.

PURPOSE:   To assess the relative effectiveness of SMT and supervised rehabilitative exercise, both in combination with and compared to home exercise (HE) alone for neck pain in individuals ages 65 years or older.

STUDY DESIGN/SETTING:   Randomized clinical trial.

PATIENT SAMPLE:   Individuals 65 years of age or older with a primary complaint of mechanical neck pain, rated =3 (0-10) for 12 weeks or longer in duration.

OUTCOME MEASURES:   Patient self-report outcomes were collected at baseline and 4, 12, 26, and 52 weeks after randomization. The primary outcome was pain, measured by an 11-box numerical rating scale. Secondary outcomes included disability (Neck Disability Index), general health status (Medical Outcomes Study Short Form-36), satisfaction (7-point scale), improvement (9-point scale), and medication use (days per week).

METHODS:   This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration. Linear mixed model analyses were used for comparisons at individual time points and for short- and long-term analyses. Blinded evaluations of objective outcomes were performed at baseline and 12 weeks. Adverse event data were collected at each treatment visit.

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