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At least 217 records · Page 12Linked to original sources
PubMed2006

Complementary and alternative medicine for upper-respiratory-tract infection in children.

PURPOSE: Evidence on the efficacy and safety of complementary and alternative medicine (CAM) for the prevention and treatment of upper-respiratory-tract infection (URTI) in children is reviewed. SUMMARY: A search of the literature to June 2005 identified six clinical trials examining the use of herbal medicines and nine trials of other CAM therapies. All articles were critically evaluated for adherence to standards of efficacy and safety research. Echinacea did not reduce the duration and severity of URTI. Andrographis paniculata or echinacea decreased nasal secretions (p < 0.01) but not URTI symptoms. A combination of echinacea, propolis, and ascorbic acid decreased the number of URTI episodes, the duration of symptoms, and the number of days of illness (p < 0.001). Echinacea was associated with a higher frequency of rash compared with placebo (p = 0.008). Neither ascorbic acid nor homeopathy was effective. The efficacy of zinc was not clear, and zinc may be associated with adverse effects in children. Osteopathic manipulation decreased episodes of acute otitis media (p = 0.04) and the need for tympanostomy tube insertion (p = 0.03) in children with recurrent acute otitis media. Stress-management therapy reduced the duration of URTI compared with relaxation therapy with guided imagery or standard care (p < 0.05). CONCLUSION: Current data are generally inadequate to support CAM for the prevention or treatment of URTI in children.

Child↗
PubMed1997

Chest pain and the role of somatic dysfunction.

The symptom of chest pain may be a result or manifestation of somatic dysfunction of the musculoskeletal system. Chest pain is a common chief complaint among patients in a family practice office or in the emergency room. Various intrathoracic and extrathoracic factors may be responsible. The authors describe their experience with one patient in whom osteopathic manipulative treatment was used along with accepted medical tests and therapy to diagnose and treat this patient. If chest pain is effectively diagnosed and promptly treated, OMT can provide the most thorough, cost-effective, and satisfying care available.

Chest Pain↗
PubMed2000

Management of osteoporosis in the new millennium.

Key to effect management of osteoporosis is early diagnosis. Careful assessment of risk and determination of bone mineral density can enable the clinician to recognize this disease before it manifests with fractures. Treatment strategies have been shown to reduce fracture rates and potentially improve bone mineral content. Effective nonpharmacologic treatment includes nutritional considerations, exercise, prevention of falls, behavioral alterations, and osteopathic manipulative treatment. Approved pharmacologic strategies include estrogen replacement therapy, alendronate, and calcitonin. Because of the multiple health benefits of estrogen replacement therapy, unless contraindicated, it should be used whenever possible. The effectiveness of combination therapy is yet to be determined. Serial determinations of bone mineral density and the use of urinary biomarkers are effective to monitor therapy. A "four-step approach" to management is proposed. The primary physician can play a key role in the early recognition and treatment of this potentially devastating disorder.

Aged↗
PubMed2000

Refractory torticollis after a fall.

Though multiple medical and psychiatric causes of torticollis have been described, cervical dystonias resulting from distant somatic dysfunctions have not. This article describes the treatment of a 62-year-old woman in whom refractory retrotorticollis of surmised pelvic etiology developed after a fall. Structurally, cervical dystonias have been addressed as problems that originate in the head and neck, but this limited view of the musculoskeletal component of torticollis may prevent physicians from directing osteopathic manipulative treatment to the underlying problem.

Accidental Falls↗
PubMed2000

Cervicogenic headache: mechanisms, evaluation, and treatment strategies.

Cervicogenic headache is a chronic, hemicranial pain syndrome in which the sensation of pain originates in the cervical spine or soft tissues of the neck and is referred to the head. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibers in the descending tract of the trigeminal nerve converge with sensory fibers from the upper cervical roots. This convergence of nociceptive pathways allows for the referral of pain signals from the neck to the trigeminal sensory receptive fields of the face and head as well as activation of the trigeminovascular neuroinflammatory cascade, which is generally believed to be one of the important pathophysiologic mechanisms of migraine. Also relevant to this condition is the convergence of sensorimotor fibers of the spinal accessory nerve (CN XI) and upper cervical nerve roots, which ultimately converge with the descending tract of the trigeminal nerve. These connections may be the basis for the well-recognized patterns of referred pain from the trapezius and sternocleidomastoid muscles to the face and head. Diagnostic criteria have been established for cervicogenic headache, but presenting characteristics of this headache type may be difficult to distinguish from migraine, tension-type headache, or paroxysmal hemicrania. This article reviews the clinical presentation of cervicogenic headache, its proposed diagnostic criteria, pathophysiologic mechanisms, and methods of diagnostic evaluation. Guidelines for developing a successful multidisciplinary pain management program using medication, osteopathic manipulative treatment, other nonpharmacologic modes of treatment, and anesthetic interventions are presented.

Headache↗
PubMed2001

Osteopathic treatment considerations for rheumatic diseases.

Patients who receive medical care for musculoskeletal pain of rheumatic diseases often benefit from additional osteopathic manipulative treatment. This article offers a brief description of commonly used treatment modalities. It also includes discussion of indications as well as contraindications of operator-director versus operator-monitored techniques.

Female↗
PubMed2001

A nonsurgical approach to low back pain.

Low back pain, a leading cause of disability in the United States, has a significant economic impact not only on lost productivity but also on healthcare expenditures. Approximately a fifth of patients will see multiple physicians in their quest for relief of low back pain. Primary care physicians therefore play a crucial role in the initial approach to these patients. A thorough history and physical examination directed toward the neurologic, orthopedic, and osteopathic evaluation are essential. This article reviews the diagnosis and assessment of pain levels and a triad system of therapy involving cortical, spinal, and peripheral levels. Options include antidepressants, neuroleptics, neurostimulants, and osteopathic manipulative treatment (OMT) (cortical level); opiates, tramadol hydrochloride, and transcutaneous electrical nerve stimulators (spinal level); and nonsteroidal anti-inflammatory drugs, epidural injections, spinal blocks, antispasmodics, physical therapy, muscle relaxants, exercise, and OMT (peripheral level), By choosing a modality directed at each level, the clinician may provide the patient with a pain management program that will maximize the chosen mode of therapy and restore function and mobility.

Analgesics↗
PubMed2002

Pain management in the elderly.

Pain in the elderly is often unrecognized and undertreated. Ineffective pain management can have a significant impact on the quality of life of older adults, leading to depression, social isolation, and a loss of function. Proper assessment of older adults requires the physician to regularly ask about the presence of pain and be skillful in assessment strategies to evaluate the frequency and intensity of pain. Assessment of pain in older adults with dementia and communication disorders is especially challenging. Effective pain management in elderly patients should include both pharmacologic and nonpharmacologic strategies. Pharmacologic strategies call for administration of nonopioid analgesics, opioid analgesics, and adjuvant medication. Polypharmacy, drug-drug and drug-disease interactions, age-associated changes in drug metabolism, and the high frequency of adverse drug reactions need to be carefully considered in using medications in this population. Nonpharmacologic approaches such as cognitive-behavioral therapy, education, osteopathic manipulative treatment, and exercise should be applied in addition to pharmacologic therapy. Using a team approach and incorporating principles of pain management can effectively provide good analgesia for older adults.

Acetaminophen↗
PubMed2004

Treatment of patients with arthritis-related pain.

Many causes of arthritic pain are encountered in clinical practice. Osteoarthritis is the most common form of arthritis in the United States, afflicting tens of millions of people. The authors review current literature on the treatment of patients with osteoarthritis. They discuss nonpharmacologic therapy such as physical therapy, weight reduction, and osteopathic manipulative treatment. Pharmacologic treatment of patients with osteoarthritis includes acetaminophen, nonsteroidal anti-inflammatory drugs, tramadol hydrochloride, and opiate analgesics in patients who failed all other treatment modalities. Patients who failed medical management should be referred for consideration for surgery.

Analgesics↗
PubMed2005

Cervicogenic headache: a review of diagnostic and treatment strategies.

Cervicogenic headache is a syndrome characterized by chronic hemicranial pain that is referred to the head from either bony structures or soft tissues of the neck. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibers in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to interact with sensory fibers from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head. A functional convergence of sensorimotor fibers in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and might also be responsible for the referral of cervical pain to the head. Diagnostic criteria have been established for cervicogenic headache, but its presenting characteristics occasionally may be difficult to distinguish from primary headache disorders such as migraine, tension-type headache, or hemicrania continua. This article reviews the clinical presentation of cervicogenic headache, proposed diagnostic criteria, pathophysiologic mechanisms, and methods of diagnostic evaluation. Guidelines for developing a successful multidisciplinary pain management program using medication, physical therapy, osteopathic manipulative treatment, other nonpharmacologic modes of treatment, and anesthetic interventions are presented.

Analgesics↗
PubMed2003

Role of radiofrequency denervation in lumbar zygapophyseal joint synovitis in baseball pitchers: a clinical experience.

Lumbar zygapophyseal joints have long been considered a source of low back pain with or without leg pain. The objective of this prospective study was to investigate the therapeutic effectiveness of lumbar zygapophyseal joint radiofrequency denervation (RFD) followed by physical therapy, for the treatment of refractory lumbar zygapophyseal joint mediated low back pain secondary to lumbar zygapophyseal joint synovitis, in baseball pitchers. Participants included twelve male baseball pitchers with a diagnosis of lumbar zygapophyseal joint synovitis mediated low back pain and a subsequent difficulty in pitching. These athletes underwent a trial of treatment, including oral anti-inflammatory medication, physical therapy, osteopathic manipulations, and fluoroscopically guided intra-articular zygapophyseal joint injection utilizing steroid and local anesthetic agent. Failure to progress led to these athletes receiving percutaneous, fluoroscopically-guided, radiofrequency denervation of the bilateral L 4-L5 and L5-S1 zygapophyseal joints. A good response to a diagnostic medial branch block was a prerequisite for RFD treatment. In all cases, the medial branch above and below the involved level was treated. Post procedure, all athletes participated in a phased physical therapy program followed by a progressive return to pitching. Success was defined as the ability to return to pre-procedure level of baseball pitching combined with greater than 50% low back pain reduction. Pre- and post-RFD, Visual Analog (Numeric) Scale (VAS) and Roland-Morris (R-M) tests were administered. Ten out of 12 (83%) athletes were able to return to pitching at a level attained prior to RFD. All 12 patients, experienced statistically significant low back pain relief, with a mean pre-RFD VAS of 8.4; mean post-RFD VAS of 1.7; mean pre-RFD R-M score of 12.3; and mean post-RFD R-M score of 22.3. In conclusion, athletes, experiencing lumbar zygapophyseal joint mediated low back pain secondary to zygapophyseal joint synovitis and have failed more conservative management may benefit from radiofrequency zygapophyseal joint denervation followed by a formal rehabilitation program.

Journal Article↗
PubMed2006

Benign joint hypermobility syndrome: evaluation, diagnosis, and management.

Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder with hypermobility in which musculoskeletal symptoms occur in the absence of systemic rheumatologic disease. Although BJHS has been well recognized in the rheumatology and orthopedic literature, it has not been discussed in the family medicine literature. Because most patients with musculoskeletal complaints are first seen by family physicians, it behooves primary care physicians to be familiar with recognizing and diagnosing BJHS. When patients with this syndrome are first seen by a physician, their chief complaint is joint pain, so BJHS can be easily overlooked and not considered in the differential diagnosis. Use of the Brighton criteria facilitates the diagnosis of BJHS. Treatment modalities include patient education, activity modification, stretching and strengthening exercises for the affected joint, and osteopathic manipulative treatment.

Diagnosis, Differential↗
PubMed2006

Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis.

CONTEXT: Previous research indicates that osteopathic manipulative treatment based on counterstrain produces a decrease in the stretch reflex of the calf muscles in subjects with Achilles tendinitis. OBJECTIVES: To study the effects of counterstrain on stretch reflex activity and clinical outcomes in subjects with plantar fasciitis. METHODS: In a single-blind, randomized controlled trial of crossover design, the effects of counterstrain were compared with those of placebo in adult subjects (N=20) with plantar fasciitis. The subjects were led to believe that both the counterstrain and placebo were therapeutic modalities whose effects were being compared. Ten subjects (50%) were assigned to receive 3 weeks of counterstrain treatment during phase 1 of the trial, while the other 10 subjects were given placebo capsules. After a 2- to 4-week washout period, phase 2 of the trial began with the interventions reversed. Clinical outcomes were assessed with daily questionnaires. Stretch reflex and H-reflex (Hoffmann reflex) in the calf muscles were assessed twice during each laboratory visit, before and after treatment in the counterstrain phase. RESULTS: No significant changes in the electrically recorded reflexes of the calf muscles were observed in response to treatment. However, changes in the mechanical characteristics of the twitches resulting from the electrical responses were observed. Peak force and time to reach peak force both increased (P< or =.05) in the posttreatment measurements, with the increase being significantly more pronounced in the counterstrain phase (P< .05). A comparison of pretreatment and posttreatment symptom severity demonstrated significant relief of symptoms that was most pronounced immediately following treatment and lasted for 48 hours. CONCLUSIONS: Clinical improvement occurs in subjects with plantar fasciitis in response to counterstrain treatment. The clinical response is accompanied by mechanical, but not electrical, changes in the reflex responses of the calf muscles. The causative relation between the mechanical changes and the clinical responses remains to be explored.

Adult↗
PubMed1989

Chronic cervical dysfunction: correlation of myoelectric findings with clinical progress.

In this pilot study, four patients with motion impairment and chronic cervical pain after cervical spine injury received osteopathic manipulative treatment for spinal dysfunction for periods in excess of 3 months. Records were compared for changes in the patient's subjective complaints, in the physician's findings, and in the standardized measurement of electrical activity of the cervical spine musculature. All three measures demonstrated parallel improvement in the health status of these patients. Attention to functional aspects of a neuromusculoskeletal problem appears to provide reliable indicators for directing treatment of somatic dysfunction and registering both subjective and objective change.

Adult↗
PubMed1989

An integrated osteopathic treatment approach in acute otitis media.

Ear pain is a common patient complaint in the practice of the primary care physician. Acute otitis media can affect a person of any age, although it is more often seen in children than in adults. The disease is usually caused by Streptococcus pneumoniae (Diplococcus pneumoniae) or Haemophilus influenzae. The differential diagnosis and subsequent treatment of otitis media is approximately the same for children and adults. First-line therapy usually consists of an antibiotic regimen of amoxicillin in combination with autoinflation exercises. In the case presented, a pharmacologic regimen was combined with osteopathic manipulation.

Acute Disease↗
PubMed1995

Phenobarbital-induced fibromyalgia as the cause of bilateral shoulder pain.

A female swimming instructor was seen with chronic bilateral shoulder pain and loss of range of motion. Intensive physical therapy significantly improved the range of motion but did not alleviate the pain. Osteopathic manipulative treatment produced no further improvement in pain or function. Results of laboratory tests were all within normal limits. Four months after the initial consultation, the patient, who was taking medication for tonic/clonic seizures, recalled that her symptoms began after her anticonvulsant medication was switched from hydantoin sodium to phenobarbital. Therefore, phenobarbital-induced fibromyalgia was diagnosed. In 4 months, pain had completely disappeared. The authors discuss several theories regarding the cause of fibromyalgia and the mechanism of action of phenobarbital, including its relationship to sleep disturbance, a probable contributor to pain and dysfunction in the patient described.

Chronic Disease↗