Chiropractic Clinical Reviews

Prevention Diagnosis Therapy
The following is a list of chiropractic clinical reviews published at ChiroACCESS. Please use the tabs to view clinical reviews on 'Prevention', 'Diagnosis' or 'Therapy'.

Acute Juvenile Cervical Torticollis: Prevention

A common presentation of acute juvenile cervical torticollis (AJCT) in the chiropractor’s office is a young patient experiencing a painful sternocleidomastoid (SCM) spasm of short duration which usually resolves rapidly after initiation of treatment. Cause of the spasm can be due to an atlantoaxial rotatory fixation (AARF), a potentially serious condition, or muscular and/or ligamentous etiology.

Parker College of Chiropractic Research Institute

| 4/15/2009

Acute Whiplash Injuries: Prevention

The obvious prevention strategy in acute whiplash injury (AWI) is to avoid being involved in an accident which would lead to AWI. In real world situations, to best serve the patient, the physician is obligated to identify risk factors which may lead to chronicity and attempt to address them early in treatment. One recent study found 50% of AWI patients were still symptomatic at 3 months. Another followed 42 patients for 7.5 years and found 61% had no improvement or worsening of symptoms between the two year and the 7.5 year follow-up. Other studies have found 36% to 78% of AWI patients had residual symptoms at the 1 year follow-up. Regardless of the study referenced, the need to reduce chronicity in this patient population is obvious and essential.

Parker College of Chiropractic Research Institute

| 5/1/2007

Adolescent Idiopathic Scoliosis: Prevention

The descriptor "idiopathic" provides ample evidence that risk factors or prevention strategies for developing adolescent idiopathic scoliosis (AIS) are limited. There are many causes for scoliosis but fully 80% are classified as idiopathic. Investigation in this area is developing and several possible causative factors are currently being discussed in the literature. Among these, to name a few, are genetic influences, hormonal changes, age of mother at birth, platelets, connective tissue disorders, musculature disorders and dysfunction of the posture controlling system.

Parker College of Chiropractic Research Institute

| 1/14/2008

Asthma: Prevention

Unlike many conditions there is a wealth of information relating to risk factors and prevention strategies for asthma. The difficulty is in choosing an appropriate strategy for your unique patient. Asthma is a multifactorial disease that is not well understood and can have a variety of risk factors. In the United States it affects over 22 million people, results in 4000 deaths annually (1) and is responsible for 200,000 hospitalizations annually (2). Of additional concern is the observation that the number of asthma cases has doubled in the United States since 1980 (3). Considering the fact that standard asthma treatment protocols only address symptom reduction and do not resolve the condition, prevention is the most viable treatment option.

Parker College of Chiropractic Research Institute

| 12/10/2008

Attention Deficit Hyperactivity Disorder: Prevention

Risk factors for attention deficit-hyperactivity disorder (ADHD) are difficult to firmly establish due to the uncertain nature of the condition. A great deal of controversy exists related to its biological cause and diagnosis. Without the knowledge of its etiology or objective tests for diagnosis, it is difficult to properly design a study to determine risk factors. Consequently all evidence relating to risk factors are primarily observational in nature and must be evaluated on that basis.

Parker College of Chiropractic Research Institute

| 10/1/2009

Biomechanical Sacroiliac Joint Pain: Prevention

Rather lengthy searches for information relating to risk factors and prevention strategies for biomechanical sacroiliac joint pain (BSJP) has produced very limited results. Almost all risk factors identified are as a result of expert opinion or limited scientific study.

Parker College of Chiropractic Research Institute

| 6/25/2007

Carpal Tunnel Syndrome: Prevention

Prevention strategies for heart disease, lung disease and diabetes to name just a few are obvious and often incorporated into a physician’s practice. It is well recognized in the search for effective treatment the best intervention is usually prevention. Yet prevention strategies for more mundane, less life threatening conditions are commonly overlooked although many of these conditions can result in significant morbidity and impact on quality of life. A recent Canadian study found in workers four years after carpal tunnel surgery that 46% still had moderate to severe pain, 40% had difficulty grasping small objects and only 14% were pain free. Interestingly 36% were unable to return to their previous job, whether modifications had been made or not. A separate study found 26% of workers that had surgery had to move from heavy to lighter work. The incidence of carpal tunnel syndrome (CTS) has been estimated at 2.7% to 3.5%. In certain professions, such as factory workers, the incidence has been estimated to be as high as 11.7 %. Although better reporting, more sensitive testing or litigation rewards may be responsible, a 350% increase in the prevalence of carpal tunnel syndrome has occurred in the past 20 years.

Parker College of Chiropractic Research Institute

| 4/1/2009

Cervicogenic Headache: Prevention

The recognition of cervicogenic headache (CH) as a distinct and separate form of headache is relatively recent. First mentioned in the literature in the late 1940’s, it wasn’t until 1983 the descriptive term "cervicogenic headache" was coined by Sjaastad et al. Many conditions have existed throughout the ages, yet have only limited information as to risk factors and prevention. It should not be surprising that only one risk factor has been published in the scientific literature for CH. The only factor that has been identified is trauma, usually whiplash injury.

Parker College of Chiropractic Research Institute

| 1/2/2007

Costochondritis: Prevention

Prevention of idiopathic costochondritis (CC) is truly an elusive subject in the scientific literature. Only a handful of studies have been performed that even attempt to address risk factors or prevention. All are observational. The following are have been rated as C and have very limited evidence.

Parker College of Chiropractic Research Institute

| 12/1/2010

Dizziness of Cervical Origin: Prevention

The diagnosis of cervicogenic vertigo has not been accepted universally within the healthcare community and others feel vertigo itself has been poorly defined in the literature. Rather than argue semantics, for the purpose of this paper, the term dizziness of cervical origin (DCO) will be used to describe what is commonly referred to as cervicogenic vertigo. It has been clearly established in the scientific literature that there is significant afferent input from the mechanoreceptors in the cervical spine and surrounding soft tissue and these afferent impulses play an important role in proprioception. It has been postulated that disturbed afferent input, due to injury, reduces joint position sense, an essential component of proprioception. Clinically, dizziness and light headedness are often seen in the physician’s office as a result of whiplash injury. Additionally these symptoms are a relatively common presenting complaint in the chiropractor’s office, regardless of etiology and, based on clinical evidence, respond well to spinal manipulation. For the purpose of this paper cervicogenic vertigo and DCO will be considered interchangeable terms and a valid clinical diagnosis.

Parker College of Chiropractic Research Institute

| 8/2/2007

Episodic Tension-type Headache: Prevention

Headache may be the most common physical complaint of mankind. Of the headache types, the bulk of research has addressed migraine headache. Far less attention has been paid to episodic tension-type headache (ETTH) although its one year prevalence in the United States has been estimated at 38% compared to approximately 12% for migraine.

Parker College of Chiropractic Research Institute

| 12/1/2009

Essential Hypertension: Prevention

It is difficult to overstate the impact of hypertension (HT) has on the health and wellness of the population in the United States and throughout the world. Mortality and morbidity is doubled for every 20 mm Hg increase in systolic blood pressure (BP) above 115 mm Hg and for every 10 mm Hg in diastolic BP over 75 mm Hg. A reduction of just 10 mm Hg in systolic BP can reduce the incidence of stroke and coronary heart disease (CHD) by 56% and 37% respectively.

Parker College of Chiropractic Research Institute

| 4/12/2010

Fibromyalgia: Prevention

Fibromyalgia is a condition of unknown etiology. Several theories as to etiology of FM have been proposed but none have been validated. Two of the more accepted theories are sensitization of the central nervous system and dysfunction of the hypothalamic-pituitary-adrenal axis. Consequently rather that providing prevention strategies based on etiology one must look at demographics to identify factors that co-exist or pre-existed in individuals with diagnosed fibromyalgia that may contribute to the condition. Using this information may aid the physician in developing strategies for reducing occurrence of fibromyalgia or at least reducing symptomology in the fibromyalgia patient.

Parker College of Chiropractic Research Institute

| 10/1/2006

High Ankle Sprain: Prevention

The high ankle sprain (HAS) is also known as an ankle syndesmosis injury. Some authors consider it a relatively rare occurrence, representing only 1% or less of all ankle sprains. Others consider it a much more common injury, especially in athletes. No studies were located that discuss prevention strategies or risk factors. However the mechanism of injury may provide some insight into risk factors.

Parker College of Chiropractic Research Institute

| 5/25/2008

Lateral Ankle Sprain: Prevention

Although lateral ankle sprain (LAS) is considered one, if not the most, common sports injury, a very conflicting body of evidence exists as to risk factors. Recurring themes of many studies are statements such as “our findings disagree with previous studies”. It seemed in preparation of this review unless a risk factor had been only reported in one study; there was a different assessment in another.

Parker College of Chiropractic Research Institute

| 4/29/2008

Lumbar Facet Pain: Prevention

Although the lumbar facet is well established as a pain generator, very little meaningful research has been performed to determine risk factors. To evaluate risk factors for lumbar facet mediated pain (LFMP), one needs to locate a population with this specific diagnosis. However this has proven difficult. Clinical diagnosis is very uncertain. The gold standard of diagnosis is a series of two facet blocks which limits study populations. As a result many of the studies available are observational, performed on animals or cadavers or are speculative in nature.

Parker College of Chiropractic Research Institute

| 7/16/2008

Myofascial Pain Syndromes: Prevention

During the 1930’s and 40’s three researchers, working independently in Germany, Australia, and the United States, established myofascial trigger points (MTrPs) as commonly occurring pain generators. Of these Janet Travell, M.D. emerged as the best known proponent of treating and reducing MTrPs in order to eliminate muscular pain in many patients. David Simons M.D. collaborated with Travell for well over 20 years and has now assumed the role chief proponent and investigator of myofascial pain syndrome. Although MTrPs have been identified and studied for nearly 70 years and many physicians and researchers acknowledge their role in pain, universal acceptance is still lacking. For the most part the scientific literature relating to risk factors and prevention has been limited to expert opinion, tradition and consensus. The source for most of the risk factors and prevention strategies mentioned below are from the Travell & Simons seminal text, The Trigger Point Manual and repeated by numerous other authors in the scientific literature.

Parker College of Chiropractic Research Institute

| 9/2/2007

Osteoarthritis: Prevention

Osteoarthritis (OA) is a condition that can involve any moveable joint in the body and can have profound impact on quality of life. It is commonly associated with the aging process yet early onset and accelerated progression is usually the result of poor lifestyle choices. Prevention strategies can be very effective in reducing the risk of developing early OA or slowing progression when established.

Parker College of Chiropractic Research Institute

| 2/28/2007

Otitis Media: Prevention

The American Academy of Pediatrics has expressed concern with the rising rates of antibacterial resistant pathogens and resultant use of more expensive and broader spectrum antibiotics for the treatment of otitis media (OM). As a result they have issued recommendations intended to reduce the amount of antibiotics prescribed. It appears these recommendations have had little effect on prescription patterns between 1995 and 2000. One answer to reducing antibiotic therapy would be to reduce the number of children who develop acute otitis media (AOM) through prevention strategies. Several risk factors have been identified in the literature. Although some of these prevention strategies do not have large clinical trials demonstrating effectiveness, the evidence available has been repeated in multiple studies and appears promising.

Parker College of Chiropractic Research Institute

| 4/2/2008

Patellofemoral Pain Syndrome: Prevention

The knee is the most commonly injured joint and patellofemoral pain syndrome (PFPS) accounts for 25% of sports related knee injuries. Although many biomechanical faults have been identified as risk factors in developing PFPS, few have been clearly validated in the scientific literature. Consequently most prevention strategies relating to biomechanical factors are based on limited investigation. The cause of PFPS remains multifactorial. Consequently there are no single prevention strategies available although reducing intense running activities and strengthening the lower extremities appear to be most effective.

Parker College of Chiropractic Research Institute

| 6/4/2009

Plantar Fasciitis: Prevention

Medline, CINHAL and MANTIS searches relating to prevention of plantar fasciitis (PF) returned only a handful of references. Plantar fasciitis is a common condition which is responsible for 1% of all visits to orthopedic surgeons and accounts for 15% of adult foot pain complaints. It is known for its recalcitrant nature and lengthy recovery time.

Parker College of Chiropractic Research Institute

| 3/9/2011

Shoulder Impingement Syndrome: Prevention

Very few high quality studies have been performed to determine risk factors for developing shoulder impingement syndrome (SIS). Much of what we know relating to risk actors is based on clinical common sense and lower level clinical studies.

Parker College of Chiropractic Research Institute

| 1/28/2008

Temporomandibular Joint Disorders: Prevention

Temporomandibular joint disorder (TMD) is a condition that has multiple etiologies. Pain in the temporomandibular region can arise as the result of myofascial dysfunction, arthralgia, internal derangement of the joint or as part of a larger psychosocial complex of symptoms. It should be noted that the natural course of TMD results in 31% of patients remaining symptomatic after 5 years while 33% enter remission and 36% have recurrent symptoms (1).

Parker College of Chiropractic Research Institute

| 9/13/2010

Tennis Elbow: Prevention

Few studies have examined risk factors and prevention strategies for lateral epicondylitis (LE).

Parker College of Chiropractic Research Institute

| 12/1/2006

Thoracic Outlet Syndrome: Prevention

Risk factors and prevention strategies for thoracic outlet syndrome (TOS) are very difficult to access for a number of reasons. Since its introduction as a diagnostic term in 1956 the diagnosis itself has remained controversial with some doubting the clinical entity even exists. Thoracic outlet syndrome has become an umbrella diagnosis that includes scalenus anticus syndrome, cervical rib syndrome, costo-clavicular syndrome and hyperabduction syndrome, to name just a few.

Parker College of Chiropractic Research Institute

| 7/19/2010