Differential Diagnosis and Management for the Chiropractor: by Thomas Souza

By Thomas Souza

The 3rd version of this top promoting reference keeps its aim of aiding the practitioner evaluation a patient's grievance within the context of a chiropractor's scope of practice.

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III Following the stretch, the skin should be brief1y rewarmed with a moist heat pack. III The muscle should then be put through a full range of motion, passively and then actively (this is an attempt to avoid posttreatment soreness). EXHIBIT 1-4 Myofascial Release Techniques (MRTs) Several techniques have been developed and popularized under different technique names. ~Most techniques involve a stripping motion of a muscle. A combination of these techniques is found with MRT (or ART) as proposed by Leahy and Mock.

TENS-1 50 150 Increase to titanic contraction 15min. 75-100 Increase to strong but comfortable contraction 20-60 min. Brief and Intense Am litude Treatment Time Galvanic: 1-5 Burst mode 50-100 of Stimulation Mode Treatment Effect Time (min) Reduce edema Continuous High 80-1 00 Sensory 20 Reduce muscle spasm Continuous High 80-120 Sensory/motor 20-30 Autonomic response Un interrupted/Pulsed High 80-100 Sensory 20-30 Neuro/hormonal Uninterrupted/Pulsed Low2- 5 Motor (twitch) 30-60 Muscle pumping Surged 13 LowJO-50 Motor 20-30 EXHIBIT 1-2 Rhythmic Stabilization A variation of hold-relax, this technique uses a reciprocal contraction of the agonist and the antagonist following the approach outlined below: • Stretch the involved muscle to patient tolerance.

The degree of sensitivity is quite low with early disease, however. Magnetic resonance imaging (MRI) is extremely valuable in evaluating soft tissue such as tendons, ligaments, and discs. In evaluating the volume of tumor or infection involvement, MRI is also valuable. Spinal cord processes such as multiple sclerosis or syringomyelia are well visualized on MRI (Table 1-6). When attempting further to clarify the degree of bony spinal stenosis, the extent of fracture, or other bony processes, computed tomography (Gn is often a sensitive tool-better than MRI in many cases.

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