Saner J et al. Manual Ther 20 (5) Sept, 2015Conclusion: There was no difference between groups after treatment, at 6 months or 12 months. Both groups were much improved after one year. There was no added benefit of specific exercise which targeted movement control impairment.Comment: It is fairly consistent that RCTs comparing specific exercise vs. […]
Kyungsoo K et al J Phys Ther Dec(6) 2014 DiscussionThe biomechanical effects of two-step traction on the lumbar spine were investigated. During global axial traction, the intradiscal pressures at all MSUs (motion units) decreased and this resulted in increased stress on the fibers of the annulus fibrosus in the posterior region. The stress on the fibers […]
This is the opening line from both Low Back Pain and Clinical anatomy of the lumbar spine circa 1979 and 1987. Grieves referred to LBP as an “epidemic” in 1983. Innumerable authors recognized it as the most common entrance complaint to family physicians (behind colds & flu) in the US (these studies being as early […]
Many patients have spondylolisthesis and it’s a concern as to when and how to best decompress them. Slippage on flexion/extension films can certainly indicate the “stability” of the segments but can be impractical and mercurial. By simply elevating the prone patients’ legs bilaterally from the ankles (creating a shear at L5) pain provocation becomes obvious. […]
If you haven’t read David Seamen’s clinical synopsis: The chemistry of discogenic and disc herniation pain, I highly recommend you do…its available on this site. As Chiropractors we are of course just itching to “lay hands on” our patients to find and “cure” them of their pains, mechanically. However a potential reality of discogenic pain, […]
“Just a few words about my experience of working with Travis.From the initial contact, he went above and beyond with answering my many questions about a chiropractic table I was considering purchasing. After the purchase, he made sure to personally deliver the table to my office in Canton, Ohio. He has always availed himself to […]
Many of us tend to associate LBP with the disc, more specifically with a ‘herniated’ disc. However research which began in the mid 1970s’ and was described in depth in the 1987 text Clinical Anatomy of the Lumbar Spine (Bogduk & Twomey) explicated the most compelling source of acute LBP: internal disc disruption promulgating annular […]
Intradiscal pressure research In 1994 a study published in the Journal of neurosurgery (Ramos & Martin) demonstrated the disc-pressure effects of prone traction. It’s important to note 3 particular findings which are relevant to our daily practice protocols. 1. There is an apparent “threshold” distraction tension at (and above) which rapid intradiscal decompression (negative IDP) […]
Sarno’s groundbreaking books beginning in the early 1980’s put a ‘non-organic/non-structural’ spin on the impending epidemic of LBP in western culture. Instead of adding more ‘mistaken structural causes’ to the fields of physical medicine (trying to “explain” why back pain disables so many) he opted to consider TMS (tension myofascial syndrome). The underlying cause is […]
Global spine J 2014 Dec;4(4):279-86. Alentado VJ et al Conclusions: There are limited studies supporting any optimal duration of conservative treatment prior to surgery for cervical and lumbar radiculopathy. Therefore, evidence-based conclusions cannot be made. Based on the available literature, we suggest that an optimal timing for surgery following cervical radiculopathy is within 8 weeks […]