I wanted to share this article today as it has been relevant for many of my patients over the last month.

This was published in CLINICAL REHABILITATION in Jun 2012 and shows the importance of Lumbar Extension traction in managing pain and rehabilitating patients with acute lumbosacral disc bulges.

Extension traction treatment for patients with discogenic lumbosacral radiculopathy: a randomized controlled trial (Authors: Ibrahim M Moustafa. Aliaa A Diab. Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt.

AbstractObjective: To investigate the effects of lumbar extension traction in patients with unilateral lumbosacral radiculopathy due to L5–S1 disc herniation.

Subjects: Sixty-four patients with confirmed unilateral lumbosacral radiculopathy due to L5–S1 disc herniation and a lumbar lordotic angle less than 39°, randomly assigned to traction or control group.

Interventions: The control group (n = 32) received hot packs and interferential therapy, whereas the traction group (n = 32) received lumbar extension traction in addition to hot packs and interferential therapy.

Results: There was a significant difference between the traction group and the control group adjusted to baseline values at 10 weeks post treatment with respect to: absolute rotatory angle (P < 0.001), Oswestry Disability Index (P = 0.002), back and leg pain (P= 0.009, P = 0.005), Modified Schober test (P = 0.002), latency and amplitude of H-reflex (P = 0.01, P < 0.001), intervertebral movements (P < 0.05). At six-month follow-up there were statistically significant differences between the study and control groups for all the previous variables (P < 0.05).

Conclusion: The traction group receiving lumbar extension traction in addition to hot packs and interferential therapy had better effects than the control group with regard to pain, disability, H-reflex parameters and segmental intervertebral movements.

Hi everyone,

Below is a research case study I came across published in Journal of Manipulative and Physiological Therapeutics.  Volume 27, Issue 8, October 2004.  This is a particularly interesting case with the growing number of children diagnosed with ADHD.  Please feel free to leave a comment.

Abstract Objective- To discuss the case of a patient who was diagnosed with attention-deficit/hyperactivity disorder (ADHD) by a general practitioner and was treated with chiropractic care.

Clinical Features - A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12° C2-7 kyphosis to a 32° C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis.

Conclusion - The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication. There may be a possible connection that correction of cervical kyphosis in patients with ADHD may produce a desirable clinical outcome.

I came across this study published in 2013 reporting the beneficial effects of spinal manipulative therapy on cervical disc herniations and I wanted to share it with you, particularly because the risks of this VERY SAFE PROCEDURE are so often sensationalized by the media, and the benefits are so often overlooked.

Title - Outcomes From Magnetic Resonance Imaging–Confirmed Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulative Therapy: A Prospective Cohort Study With 3-Month Follow-Up.  (JMPT - Volume 36, Issue 8, October 2013, Pages 461–467)

The purpose of this study was to investigate outcomes of patients with cervical radiculopathy (Nerve pain travelling down the arm) from cervical disk herniation (CDH) who are treated with spinal manipulative therapy.

Results -Fifty patients were included. At 2 weeks, 55.3% were “improved,” 68.9% at 1 month and 85.7% at 3 months. Statistically significant decreases in neck pain, arm pain, and NDI scores were noted at 1 and 3 months compared with baseline scores (P < .0001). Of the subacute/chronic patients, 76.2% were improved at 3 months.

Conclusions - Most patients in this study, including subacute/chronic patients, with symptomatic magnetic resonance imaging–confirmed CDH treated with spinal manipulative therapy, reported significant improvement with no adverse events.

The long term effects of infantile colic are only just being studied.  Below are the results of a study published in JMPT in 2009 which looked at behavioural issues of toddlers who were bad sufferers of colic as infants.  

Paper - Long-Term Effects of Infant Colic: A Survey Comparison of Chiropractic Treatment and Nontreatment Groups - (JMPT vol 32 issue 8 - oct 2009) - 

Results - Toddlers who were treated with chiropractic care for colic were twice as likely to not experience long-term sequelae of infant colic, such as temper tantrums (relative risk, 2.0; 95% confidence interval, 1.3-3.0) and frequent nocturnal waking (relative risk, 2.0; 95% confidence interval, 1.5-2.8) than those who were not treated with chiropractic care as colicky infants.

Conclusion - Untreated post-colicky infants demonstrated negative behavioral patterns at 2 to 3 years of age. In this study, parents of infants treated with chiropractic care for excessive crying did not report as many difficult behavioral and sleep patterns of their toddlers. These findings suggest that chiropractic care for infants with colic may have an effect on long-term sequelae.