Joint Mobilization : A Common Condition, Ranking As The Third Most Burdensome Disease Worldwide

It was noted that the patient has neck pain, facet arthropathy and spondylosis, suggestive of facer joint origin, 80% relief from previous facet nerve injection/block, prior rhizotomy more than 6 months and cervical/thoracic facet medial branch nerve block which has been helpful, failed conservative treatments with nonsteroidal anti-inflammatory medications (NSAIDS), PT, chiropractic care and home exercises.

One of the best and safest drug free and non-invasive treatments is the chiropractic treatments. Although the treatment is a very safe option, it shows minor side effects. There have been complaints that the patients may feel a mild stiffness, aching, discomfort or soreness but this goes away within a day. Cervical manipulation which is often called a neck adjustment is used to treat some kinds of headaches and neck pain thereby improving the neck movement and zeroing the muscle pain. Chiropractors who are well qualified and experienced provide patients with safe and effective care.

1. Cervical adjustment: It is the manual treatment for the people suffering from neck and shoulder pain. The practitioner stimulate the joints position to improve the functioning of the nervous system.

Citation: Young IA, Michener LA, Cleland JA, Aguilera AJ, Snyder AR. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Phys Ther. 2009;89(7):632-42.

DOI: 07/16/2002. This is a 71-year-old male superintendent who sustained an injury when he hit his head on generator and hurt his neck. Patient is diagnosed with cervical strain, cervical degenerative disc disease, cervical facet arthropathy, cervicalgia, lumbago, lumbar degenerative disc disease, lumbar facet arthropathy, and sciatica. As per office visit note dated 5/18/2016, patient complains of flare-up of his muscle spasms. He requested for more chiropractic therapy, which he is currently receiving for his chronic pain. It allows him to have better range of motion of his neck, back, and bilateral upper extremities. He has been able to walk 1 mile every 2 to 3 days for exercise as well as perform at-home physical therapy. Prior to chiropractic

1590). A growing body of evidence suggests hypersensitivity of the nervous system and peripheral fibers as a possible cause. Learning efficient ways to help patients desensitize to central pain stimuli may help provide relief. In the Steiner, Bigatti, and Ang (2015) study, moderate levels of physical activity show improvements physical symptoms and physical function, and decrease the intensity of pain in groups with baseline relative inactivity. It will be important to discuss a physical activity strategy for the patient that stresses the amount of time the patient spends up and moving as compared to sedentary time. As shown in the study, pain reduction is considerably larger than those reductions from psychological and pharmaceutical intervention alone.

The patient, Miss Tedo, is a 69-year-old female with a diagnosis of cervical degenerative joint disease, also known as cervical osteoarthritis or neck arthritis. Miss Tedo complains that she has neck stiffness and pain rated as 6/10. Miss Tedo also reported that she has tingling and pain rated as 5/10 that radiates down the right arm to the little finger. Upon her visit to the clinic, Miss Tedo presented with limited cervical range of motion, 30o of rotation bilaterally and 10o of lateral flexion bilaterally. She exhibits moderate cervical paravertebral muscle hypertonus with a forward flexed posture and poor postural awareness.

Spinal stenosis of the lumbar vertebral column is commonly found in patients with chronic lower back, in combination with lower extremity pain. Methods of treatment for the condition include: Interlaminar Epidural Injection, Transforaminal Epidural Injection and Caudal Epidural Injection. Although there is a lot of literature to be found on Caudal Epidural Injections for pain relief related to Lumbar Spinal Stenosis, Interlaminar Epidural Injections are fairly new to the world of research. Manchikanti et al., of the Pain Management Center of Paducah located in Paducah, Kentucky, tested whether or not long-lasting pain relief could be accomplished with Interlaminar Epidural Injections, and if there was a significant difference in pain relief when injections were given with lidocaine, a local anesthetic, alone versus injections given with lidocaine and steroid.

Chronic neck pain is common, costly, and a leading cause of disability. Literature suggests that ascending pain pathways (i.e. pain pressure threshold or PPT) and/or descending pain pathways (i.e. CPM) may be impaired in those with chronic pain [please see Appendix for illustration of ascending and descending pain pathways]. Spinal mobilization (SM), a form of MT, is a common treatment that has been effective in relieving neck pain according to Cochrane Review (Gross et al 2015). A recent systematic review (Coronado et al 2015) concluded that although the pain relief from MT seems to improve PPT; the pain relief, however, is not associated with PPT, a measure of the ascending pain pathways. Whether the pain relief from SM is due to its effects on the descending pain pathways (e.g. CPM) is not known at this time.

Headaches are common conditions which are seen in 66% of the global population, therefore causing disturbance to both quality of life (QoL) and psychosocial state (Stovner, L., et al. 2007). Cervical Headache or more commonly known as Cervicogenic headache (CGH) is mainly characterized by unilateral headache symptoms which arise from the cervical spine radiating to the fronto-temporal and possibly to the supraorbital region (Pfaffenrath, V. and Kaube, H. 1990; Nilsson, N. 1995). There is controversial evidence on the strict definition of CGH, with some criteria’s including; unilateral headache, neck pain or neck trauma injury (whiplash), reduced cervical range of motion. Although prevalent

Chronic neck pain is the 3rd most common pain condition in the US with about 30-50% of adults being affected each year. On average, spin care costs about 9% of total health care cost each year ranging from about $3,000 to $8,000 per patient. This high cost of treatment for idiopathic neck pain raises an issue because treatment seems to be ineffective. Current research is analyzing the effectiveness of treatment consisting of joint mobilization combined with exercise. Research shows that a combination of the two techniques prove to be more effective than each alone for improving patient function. However, the sequence of the therapy as well of the number of visits is still unclear.

Rodger Evans DPT has just returned from the 2016 MDT Conference of the Americas in Miami. This consisted of a broad base look at the latest trends in treating back /neck pain. Some of the top researchers in the world presented. Rodger hopes to incorporate the knowledge learned into practice here in Big pine Key.

This trial had randomly selected 119 patients with neck pain associated with ‘active trigger points’. The patients aged between 30 and 60 years old. The results proved that myofascial release was beneficial especially when combined with heat therapy. (Hou, Tsai, Cheng, Chung & Hong, 2002). The Physiotherapy department, Health Sciences School, University of Granada, Spain (2008) conducted a randomized clinical trial which supported the effectiveness of myofascial release. The effects of this technique when applied after high-intensity exercise, were examined and recorded with 62 randomly selected people. The results concluded that the treatment was beneficial for the recovery of the heart rate variability (HRV) and diastolic blood pressure (BP) (Arroyo-Morales et al., 2008). However, it is difficult to apply these findings to clinical situations because the mean age used for this experiment was 21.1 ± 2.16 years. A larger age group is required to apply to general

This article is seen as reliable as it was written by two authors who hold educated degrees. This article provides knowledge on the challenges of neuropathic pain treat-ment and how multimodal approaches are required for managing neuropathic pain effec-tively (Williams, 2006). It is important that nurses realise that treatment of neuropathic pain is challenging and that multidisciplinary approaches are required such as drug ther-apy and other various interventional procedures such as acupuncture (Brooker & Waugh, 2013). Although evidence shows that acupuncture can be a useful alternative treatment, further research is required in order to evaluate the efficacy of acupuncture as a treat-ment for neuropathic pain conditions (Ju, Wang, Cui, Yao,

Background: Neck pain is a prevalent global malady. Physiotherapists apply joint mobilization (JM) as a routine, pragmatic procedure for neck pain. Perhaps because JM is widely known as an effective intervention as concluded by multiple systematic reviews and meta-analyses. One easy-to-perform variant of JM is unilateral anterior glide (UPA). The purported rationale of how pain modulation is attained when employing JM is expounded as a neurophysiologic mechanism. Notwithstanding, the neurophysiologic system that alters pain overlaps with blood pressure (BP) as observed in BP-related hypoalgesia. Therefore, BP is a pertinent and easily quantified variable to examine. Nonetheless, there is scant literature on the cardiovascular response to UPA.