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1, Number 1 Lamb, Karl L, Sacroiliac joint dysfunction with associated piriformis syndrome mimicking intervertebral disc syndrome resulting in failed low back surgery. Journal of Chiropractic Technique, August 1997, Vol. 9, No. 3: pp. 128-32. This is a discussion of a case history of a patient who suffered from sacroiliac joint dysfunction and myofascial pain syndrome that mimicked intervertebral disc prolapse. The patient was treated with a combination of trigger point deactivation, ultrasound, nutritional supplementation, exercise, and manipulation to the left sacroiliac joint. Within 10 visits, she was completely pain free. A combination of problems as occurred here, may mimic a disc syndrome. A triage system for mechanical back pain may result in a more efficient and cost-effective approach to the chiropractic treatment of low back pain. This proactive approach may also result in fewer cases of chronic low back pain and reduced disability. Wirth-Pattullo, Virginia, Hayes, Karen W., Interrater reliability of craniosacral rate measurement and their relationship with subject' and examiners' heart and respiratory rate measurements. Physical Therapy, October 1994, Vol. 74, No. 10: pp. 908-20. This study examined the interexaminer reliability of craniosacral rate and the relationships among craniosacral rate and subjects' and examiners' heart and respiratory rates. The examiners were three physical therapists, experienced with craniosacral therapy. Examiner A had taken 7 courses in craniosacral therapy and had used craniosacral examination and treatment on more than half of her patients for 4 years. Examiner B had taken 4 courses and had also used craniosacral therapy in the treatment of more that half of her patients for 4 years. Examiner C had taken 2 courses, had participated in a 9 month internship with an osteopath who was trained in craniosacral therapy, and had subsequently worked closely with him for 2 years. All three examiners routinely assessed craniosacral motion when treating their patients. The authors concluded that measurements of craniosacral motion did not appear to be related to measurements of heart and respiratory rates and therapists were not able to measure it reliably. Measurement error may be sufficiently large to render many clinical decisions potentially erroneous. Further studies are needed to verify whether craniosacral motion exists, examine the interpretations of craniosacral assessment, determine the reliability of all aspects of the assessment, and examine whether craniosacral therapy is an effective treatment. Greenman, P.E., McPartland, J.M., Cranial findings and iatrogenesis from craniosacral manipulation in patients with traumatic brain syndrome. Journal of the American Osteopathic Association, March 1995, Vol. 95, No. 3: pp. 182-8;191-2. In a study performed at the Michigan State University College of Osteopathic Medicine, East Lansing, craniosacral findings were recorded for all patient with traumatic brain injury entering an outpatient rehabilitation program between 1978 and 1992. The average cranial rhythmic impulse was low in all 55 patients (average, 7.2 c/min.). At least one cranial strain pattern was exhibited by 95%, and 87% had one or more bony motion restrictions. Sacral findings were similar to those in patients with low back pain. Although craniosacral manipulation has been found empirically useful in patients with traumatic brain injury, three cases of iatrogenesis occurred. The incidence rate is low (5%), but the practitioner must be prepared to deal with the possibility of adverse reactions. Pick, Marc G., A preliminary single case magnetic resonance imaging investigation into maxillary frontal-parietal manipulation and its short-term effect upon the intercranial structures of an adult human brain., Journal of Manipulative Physiological Therapeutics, March - April 1994; Vol. 17, No. 3: pp. 168-73. The objective of this study was to investigate the hypothesis that external cranial manipulation can cause a change within the structures of the human brain. Two MRI scans were administered. One with investigator's contact to subject's maxillary palate and the other contact to the frontal/parietal region surrounding the bregma. The second MRI was administered with contacts in position but with application of external cranial pressure. The second MRI (when pressure was applied) demonstrated elimination of a 5-mm peak along the superior border of the corpus callosum and a 4-mm reduction in the width of the fornix column. The exposed anterior/superior wall of the lateral ventricle posterior to the fornix column increased 51 degrees cephalad with manipulative application. The angular surface of the central lobule altered by minus 26 degrees, and the posterior surface of the inferior colliculi varied by minus 7 degrees. The subject experienced no change in his asymptomatic condition as a result of this study. The author concluded that the present study supports the theory that external cranial manipulation affects the structure of the brain. It also suggests support for theories regarding suture mobility. Gregory, Thomas M., Temporomandibular disorder associated with sacroiliac sprain., Journal of Manipulative and Physiological Therapeutics, May 1993; Vol. 16, No. 4: pp. 256-65. This article presents a case of the external derangement-type temporomandibular disorder (TMD), temporarily relieved following chiropractic sacro-occipital technique (SOT) treatment, including SOT category II blocking to reduce sacroiliac sprain. There was symptom exacerbation midway through the course of treatment which followed additional dental work; symptom remission then followed additional SOT treatment. Freedom from symptoms was maintained with a 3-week treatment interval. There appears to be a cause-effect relationship between external derangement-type TMD and sacroiliac sprain. Concurrent, coordinated chiropractic and dental treatments may improve the success rate of TMD resolution. Chinappi, Albert S., Getzoff, Harvey, The dental-chiropractic cotreatment of structural disorders of the jaw and temporomandibular joint dysfunction., Journal of Manipulative and Physiological Therapeutics, September 1995; Vol. 18, No. 7: pp 476-81. This article presents a case demonstrating the concept of integrated dental-orthopedic and craniochiropractic care for treating structural disorders of the jaw, neck and spine. While receiving orthodontic therapy for significant dental and temporomandibular joint dysfunction, the patient sought chiropractic care when she had increased temporomandibular joint and neck/lower back pain. Initial chiropractic sacro-occipital technique (SOT) evaluation found Category II weight-bearing instability of the sacroiliac joint, specific thoracic and cervical vertebral subluxations, cranial sutural restrictions and temporomandibular dysfunction. The cotreatment approach eliminated pain while improving head, jaw, and tooth position. The authors concluded that the position of the jaw and head and neck are intricately linked. The acute symptoms experienced during the initial dental treatment phase were caused by the inability of the head and neck to adapt to maxillary and mandibular changes. Chiropractic treatments enabled the body to respond positively to the dental changes. As the mandibular position improved, further improvements were indicated by physical testing and x-rays. Dural Connection Internet Edition Index |