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PubMedDate not supplied

Low back pain: pathophysiology and management.

Basic research is advancing the understanding of the pathogenesis and management of low back pain at the molecular and genetic levels. Frequently, low back pain is caused by disorders of the intervertebral disk. Cytokines such as matrix metalloproteinases, phospholipase A2, nitric oxide, and tumor necrosis factor-alpha are thought to contribute to the development of low back pain. Drugs are being developed to modulate these chemical mediators. Recent research using growth factors to promote chondrocyte regeneration appears to be promising. Advances in gene therapy to both prevent disk degeneration and regenerate the disk eventually may have clinical application.

Analgesics↗
PubMed2002

Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995-2001.

OBJECTIVE: To summarise recent evidence from case reports (published January 1995-September 2001) of adverse events after cervical spine manipulation. DATA SOURCES: Five computerised literature searches (MEDLINE-Pubmed; EMBASE, the Cochrane Library, AMED [Allied and Complementary Medicine Database], and CISCOM [Centralised Information Service for Complementary Medicine] were performed. No language restrictions were applied. STUDY SELECTION: All case reports containing original data of adverse events after cervical spine manipulation were included. DATA EXTRACTION: All articles were evaluated and key data extracted according to pre-defined criteria: patient's age, sex and diagnosis; type of therapist; type of treatment; nature of adverse event; method of diagnosis; and clinical outcome. DATA SYNTHESIS: Thirty-one case reports (42 individual cases) were found. The patients were equally distributed between the sexes (21 male, 20 female, one unknown) and mostly middle-aged (range, 3 months to 87 years). Most were treated by chiropractors. Arterial dissection causing stroke was reported in at least 18 cases. CONCLUSIONS: Serious adverse events after cervical spine manipulation continue to be reported. As the incidence of these events is unknown, large and rigorous prospective studies of cervical spine manipulation are needed to accurately define the risks.

Adult↗
PubMed2002

Chiropractic.

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Back Pain↗
PubMed2002

Chiropractic.

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Back Pain↗
PubMed2002

Chiropractic.

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Back Pain↗
PubMed2006

Osteopathic manipulative treatment of a 27-year-old man after anterior cruciate ligament reconstruction.

Increasing instability of the knee developed in a 27-year-old man who had torn his anterior cruciate ligament (ACL) approximately 10 years prior to surgical intervention. After initial conservative treatment, including use of a functional brace for activity, the patient opted for surgical reconstruction with a patellar tendon graft. One of the authors conducted three preoperative examinations to assess the condition of the patient's musculoskeletal system. These manual examinations included findings of somatic dysfunction in the lumbo-pelvic region. In addition, there was extension of muscular tension from the injured left knee and ankle into the lower thorax and ribs 6 through 9. During the postoperative rehabilitation process, examination at regular intervals included documentation of somatic dysfunction and osteopathic manipulative treatment (OMT). Following ACL reconstruction and OMT, the patient showed increasingly stable mobility in the lumbopelvic region. Furthermore, episodic new dysfunctions readily resolved with OMT. The patient returned to his regular sports activities 6 months after surgery.

Adult↗