Chiropractors primarily use the manipulation ("adjustment") of the spine as a treatment. Such treatments trace back to ancient China, Greece and Egypt. It gained popularity in the late 19th century, with the development of osteopathic drugs and chiropractic in North America.
Spinal manipulation ( SMT ) became more popular in the 1980s. These include manipulation and massage to "adjust" the spine and related tissues, and are the main basis of chiropractic. A systematic review has not found evidence that chiropractic manipulation is effective for any medical condition, with the possible exception of treatment for low back pain. The safety of manipulation, especially on the cervical spine has been debated. Adverse outcomes, including death, are rare. Chiropractors can use exercise and care and other suggestions.
Video Chiropractic treatment techniques
Interventions
Skilled specialized hand techniques, including manipulation and mobilization, are used to diagnose and treat soft tissues and joint structures, to reduce pain and to increase range of motion and general health.
This approach is usually conservative, and treatments may include:
- manual procedures, including spinal or joint manipulation or mobilization, soft tissue technique and reflexes;
- sports, and other active treatments;
- the psychosocial aspects of patient management;
- patient education on spine health, posture, nutrition and lifestyle modification;
- emergency care and acute pain management;
- other supporting actions, including use of back support and orthotics;
- recognize the limitations of chiropractic care, and the need for referral to other health professionals.
Chiropractors can also use exercise and care and other conservative advice.
Manual and manipulative therapy
The Chinese used such techniques more than 3,000 years ago. Hippocrates also used techniques like those of the ancient Egyptians and other cultures.
In the late 19th century in North America, therapies including osteopathy and chiropractic became popular. Spinal manipulation gained mainstream recognition during the 1980s.
In this system, the hand is used to manipulate, massage or affect the spine and related tissues. This is the most common and major intervention used in chiropractic care.
Maps Chiropractic treatment techniques
Effectiveness
Neuromusculoskeletal disorders
Treatment is usually for neck or lower back pain and related disorders.
For acute lower back pain, low quality evidence indicates no difference between spinal and spurious manipulation, and moderate quality evidence shows no difference between spinal manipulation and other commonly used treatments, such as treatment and physical therapy.
National guidelines vary; some recommend therapy for those who do not improve with other treatments. This may be effective for lumbar herniation with radiculopathy, as effective as mobilization for neck pain, some form of headache, and some joint conditions of the extremities. The 2011 Cochrane Review found strong evidence that there was no clinically significant difference between spinal manipulation therapy and other treatments to reduce pain and improve function for chronic low back pain. A 2008 review found that with the possible exception of low back pain, chiropractic manipulation has not been proven effective for any medical condition.
Non-musculoskeletal disorders
The use of spinal manipulation for controversial non-musculoskeletal. It has not been proven effective for asthma, headache, hypertension, or dysmenorrhea. There is no scientific data supporting the use of SMT for idiopathic adolescent scoliosis.
Cost effectiveness
Spinal manipulation is generally regarded as a cost-effective treatment of musculoskeletal conditions when used alone or in combination with other treatment approaches. Evidence supports the cost-effectiveness of using spinal manipulation for the treatment of acute or chronic lower back pain whereas the results for acute lower back pain are inconsistent.
Security
All treatments require a comprehensive medical history, diagnosis, and management plan. Chiropractors, should rule out contraindications for each treatment, including side effects.
Relative contraindications, such as osteoporosis, are conditions where increased risks are acceptable in some situations and where mobilization and soft tissue techniques may be the treatment option. Most of the contraindications apply to the manipulation of the affected area.
Although security has been debated, and serious injuries and deaths can occur and may be less reported, these are generally rare and spinal manipulation is relatively safe when used with skill and precision.
Side effects are believed to be less reported and appear to be more common after high/low amplitudo manipulation than mobilization. Mild, frequent, and temporary side effects occur in TPS that include temporary increases in pain, tenderness and stiffness. This effect is generally reduced in 24-48 hours. Serious injuries and fatal consequences, especially for SM in the upper cervical area, may occur. but is considered rare when spinal manipulation is used skillfully and appropriately.
Relationship with stroke has been disputed. Stroke is statistically related to both general practitioners and chiropractic services in people under 45 years of age, and this association may be associated with pre-existing conditions. The evidence is weak and strong enough to support the cause (as compared to statistical relationship) between cervical manipulative therapy and vertebrobasilar artery stroke. The 2012 review found that there was not enough evidence to support a strong relationship or no relationship between cervical manipulation and stroke. A 2008 review found that chiropractic is more often associated with seriously related adverse effects than other professionals after manipulation and concluded that the risk of death from manipulation to the neck outweighs its benefits.
Technique
According to the American Chiropractic Association the techniques most often used by chiropractors are the 95.9% Diversified technique, Extremity manipulates 95.5%, 62.8% Drive Method, 58.5% Gonstead technique, Cox Flexion/Distraction 58.0%, Thompson 55.9%, Sacro Occipital Technique [ SOT] 41.3%, Applied Kinesiology 43.2%, NIMMO/Receptor Tonus 40.0%, Cranial 37.3%, Manipulative/Instrument Adjustment 34.5%, Palmer cervix over [HIO] 28.8%, Logan Basic 28.7%, Meric 19.9%, and Pierce- Stillwagon 17.1%. The Koren Special Technique (KST) is a chiropractic technique made around 2004. There are about 200 chiropractic techniques, but there is a large amount of overlap between them, and many techniques involve few other technical changes.
Diversification Techniques
The diversification technique is a non-exclusive and eclectic approach to spinal manipulation commonly used by chiropractors. Techniques, as applied today, are mostly associated with Joe Janse's work, D.C. Diversification is the most common spinal manipulation technique used by chiropractors, with about 96% of chiropractors using it for about 70% of their patients. Diversification is also the most preferred technique to be used during future practice by chiropractic students. Diversification is the only spinal manipulation technique taught in Canadian chiropractic programs. Like many chiropractic and osteopathic manipulation techniques, Diversification is characterized by a low-velocity boost, low amplitude. This is considered the most generic manipulation technique and is distinguished from other techniques whose goal is to restore proper movement and alignment of the spine and joint dysfunction.
Orthogonal Atlas Technique
The Atlas Orthogonal Technique is a top cervical chiropractic technique made by Frederick M. Vogel and Roy W. Sweat in 1979. This technique uses percussive instruments in an attempt to adjust what is measured from specific X-rays and is found to be the subluxation of the atlas vertebra, upper vertebrae in the cervical spine. This is based on the teachings of B. J. Palmer, who advocated the Hole-In-One spinal adjustment version. It's mainly used by a direct chiropractor. Referring to the origins of the top cervical technique, Dan Murphy, DC, DABCO, writes: "Over the past 100 years, chiropractic practice has branched into dozens of specialized techniques, but historically, for a third of this time, from the 1930s to 1960s -an, the main practice of chiropractic involved especially the upper neck of the spine. "
Limb manipulation
Driving method
Chiropractic Technique Activator Method (AMCT) is a method of chiropractic care and a device created by Arlan Fuhr as an alternative to manual manipulation of the spine or the extremities of the joint. This device is categorized as a manual mechanical aid instrument (MFMA) which is generally regarded as a softer chiropractic treatment technique.
The activator is a small handheld spring instrument that provides small impulses to the spine. Found release no more than 0.3 J kinetic energy in 3-millisecond pulse. The goal is to generate enough power to move the vertebrae but not enough to cause injury.
AMCT involves the patient lying in a prone position and comparing the functional foot length. Often one foot will appear shorter than the other. The chancor then performs a series of muscle tests such as having the patient move their hands in a certain position to activate the muscles attached to a particular vertebra. If the length of the foot is not the same, it is taken as a sign that the problem lies in the spine. Chiropractors treat the problems found in this way moving progressively along the spine towards the direction of the foot toward the head.
Although vulnerable to "functional leg length" is a widely used chiropractic tool, it is not an acknowledged anthropometric technique, since the legs are often not the same length, and the measurement in the prone position is not entirely a valid estimate of the standing X-ray differences. The measurement in standing position is much more reliable. Another confounding factor is simply moving the two united legs and propping them to one side or the other producing different results. Fuhr claims that well-trained doctors show good interexaminer reliability.
In 2003, the National Chiropractic Testing Board found that 69.9% of chiropractors used this technique, and 23.9% of patients received it. The majority of US chiropractic schools and some schools in other countries teach the method of AMCT, and about 45,000 chiropractors worldwide use AMCT or some part of this technique.
There are a number of studies on AMCT, including case reports, clinical studies and controlled trials, but there are still unanswered questions. Some low-quality studies suggest that the activator may be as effective as manual adjustment in the treatment of back pain. A high-quality study showed that manipulation-assisted activators directed by leg length testing were significantly lower than manual manipulation of the spine guided by palpation and more similar to the use of paracetamol for the treatment of low back pain.
Graston Techniques
Graston Technique (GT) is a trademark therapeutic method to diagnose and treat skeletal muscle disorders and related connective tissue. This method was started by David Graston and used a collection of six stainless steel instruments of a certain shape and size, used by practitioners to rub the patient's muscles to detect and resolve adhesions in muscles and tendons. The practitioner must obtain a license from the parent company (Graston Technique, LLC.) To use the Graston Engineering trademark or patented instrument.
Some examples of Graston treatment have been used in contact sports where scars and contusions are common. However, the Graston Technique has not been scientifically tested strictly and its evidence base and assumptions are considered the most questionable. No high-quality clinical trials validate the efficacy of the Graston Technique.
Custom Techniques of Koren
Koren specific technique (KST) is a technique developed by Tedd Koren. While this technique is related to chiropractic techniques, Koren has described it as an "analytical protocol" or "health care protocol". KST can use their hands, or they can use an electrical device known as "ArthroStim" for assessment and adjustment. KST can use different postures. Insurance companies Aetna, NHS Leeds West CCG, North Dakota Department of Human Services, and The Ohio State University include other chiropractic techniques but exclude KST from coverage as they consider it to be "experimental and investigative." Aetna's policy states there is a lack of efficacy regarding this method.
Cox Flexion/Distraction
Thompson Techniques
Gonstead Techniques
The Gonstead technique is a chiropractic method developed by Clarence Gonstead since 1923. This technique focuses on direct adjustments and is claimed to extend "standard diversification techniques" by applying additional instrumentation including X-rays, Gonstead Radiographic Parallel, gauges, and the development of Nervo-Scope, a tool said to detect levels of neurophysiological activity due to vertebral subluxation based on changes in skin temperature. The heat detector device is unreliable and has no scientific evidence. This technique gained popularity in the 1960s. Approximately 28.9% of patients have been treated with the Gonstead technique.
Technique Trigenika
Trigenika is a manual-based assessment and care system supported by neurology and developed and patented by Allan Oolo Austin, DC, DO, CCSP, CCRD. The technique originally started as a chiropractic technique, but is now practiced by osteopaths, physiotherapists and massage therapists. This technique is relatively rarely used by chiropractors compared to other chiropractic techniques such as Diversified, Trigger point therapy and Activator.
References
Source of the article : Wikipedia
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