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Re: Spinal manipulation and pregnancy
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Re: Spinal manipulation and pregnancy - July 26, 2006 11:50:00 AM
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dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
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Diane,
and you would say this is (min,mod,very) effective for what % of your patients and can you classify the "type" of pt. you most typically see, (ie: post surgical, acute orthopedic, chronic orthopedic, ect.)
Why is it that those who would like to be seen as opened minded tend to have a very narrow view of the way that they think others who don't share the exact view as theirs tend to practice?
Rick
ps, I hope you are not banned, we might actually be able to learn something from each other.
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Re: Spinal manipulation and pregnancy - July 26, 2006 12:01:00 PM
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dfjpt
Posts: 238
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Rick, I'd say "very", I'd say for most, like more than 9 out of 10, typical garden variety patients most of whom are long term pain patients who've been everywhere and tried everything else already, but aren't necessarily highly sensitized. By that I mean, they are mostly functioning people who can downregulate naturally, are not necessarily (yet) candidates for a pain management center, yet are really tired of battling pain all the time. I will add, I refuse to have anything to do with insurance. I treat pain, not bits of body/not joints.
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Re: Spinal manipulation and pregnancy - July 26, 2006 12:41:00 PM
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ALICIAPT13
Posts: 95
Joined: December 12, 2005
From: North Syracuse, NY
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Rick, I enjoyed your comment about open-mindedness. How true.
Diane, I assure you I am not a chiro lover. In fact, I do everything in my power to explain to patients the differences between them and us (PTs). And the fact that we are better! These manipulations are far less powerful than those provided by chiropractors. It is merely bringing a patient to end-range and applying min-mod force at that point. Much less scary than chiros!
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Re: Spinal manipulation and pregnancy - July 26, 2006 1:06:00 PM
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nari
Posts: 1568
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From: Australia
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Alicia
It is the use of 'force' (which you mentioned in the above post) which is debatable. It is the fact that PTs have had a long, tedious reputation of being prone to using force for all manner of interventions. Take frozen shoulder - force is still used, it seems, in these people and it is the last thing any nervous system needs in order to try and resolve pain and dysfunction.
I think the differences in approaches can be summed up as this: some PTs treat a segment as if it had a life of its own and ignore the rest of the person; others treat the person as a whole, with regard to pain and not just dysfunction all by its little self. It's debatable just how much we do impact on patient care, as placebo is a very powerful aspect of any patient/therapist en counter; but the use of force for a quick fix is not the way of enhancing patient self-efficacy and long term results.
Neigh, neigh...the horse does prefer to be before the cart; things do not work as well long term if it is the other way around.
Nari
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Re: Spinal manipulation and pregnancy - July 26, 2006 2:18:00 PM
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drbuddy
Posts: 429
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From: Pennsylvania
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Hey now, I manipulate fairly gently. Maybe it's because I'm hanging around with you guys too much : )
BTW, it's just as narrow minded to stereotype professions just as it is to stereotype races and ethnic backgrounds, not to mention very unprofessional.
If you came into my practice without looking at my sign, you'd probably think I was a PT.
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Re: Spinal manipulation and pregnancy - July 26, 2006 3:09:00 PM
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nari
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From: Australia
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Buddy
I am sure I would think you were equivalent to a PT. And I have no bones about that; unless you wanted only to manip and return in a month... ;)
Any profession has its bad eggs; but like a lot of implicit memory recall, we tend to remember the bad eggs over the good eggs. Which leads to bias and unhelpful memes and so on.
I suspect most patients can pick the bad eggs by word of mouth, anyway?
Nari
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Re: Spinal manipulation and pregnancy - July 26, 2006 4:29:00 PM
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UTDC
Posts: 221
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[QUOTE]It is merely bringing a patient to end-range and applying min-mod force at that point. Much less scary than chiros! [/QUOTE]Ahh yeah. Thats totally different. LOL.
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Re: Spinal manipulation and pregnancy - July 26, 2006 6:23:00 PM
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steve
Posts: 452
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From: victoria, bc Canada
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I agree with you UTDC, lots of manip language variation between the professions and plenty of differences on why it works but its generally the same techniques. I've seen lots of gentle physios manipulate and Ive seen chiros do the exact same thing. Ive also seen other athletic therapists, physios and chiros virtually jump on people when they manipulate.
Steve
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Re: Spinal manipulation and pregnancy - July 26, 2006 6:33:00 PM
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jbird007
Posts: 297
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From: USA
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funny stuff..
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Re: Spinal manipulation and pregnancy - July 26, 2006 6:42:00 PM
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jbird007
Posts: 297
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From: USA
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I remember the days when med-heads informed patients how DC's were hurting and paralyzing people. Now I sit and read about you chumps embracing manipulation and supporting ideas that was once dismissed. Stick with re-hab and stop subjecting patients to high risk maneuvers due to your low and poor level of training. A few week-end seminars just won't get the job done.
jbird007
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Re: Spinal manipulation and pregnancy - July 27, 2006 12:14:00 AM
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Randy Dixon
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I assume jbird is a chiropractor. If you wish PT's to "stick with Re-hab" and leave manipulation to the pro's then I wonder what you are doing on a forum called Rehabedge, other than trying to stir up trouble?
I see the same arguments presented again and again, manipulation is dangerous, it's coercive, and their are more effective treatments. Use science. Yet I never see it backed with evidence.
It's wrong to tell other people how to act.
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Re: Spinal manipulation and pregnancy - July 27, 2006 1:55:00 AM
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emad/emad
Posts: 42
Joined: July 4, 2006
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Alicia :
Still i have no reasonable answer ,why Manipulators prefer to manipulate only acute back pain over the chronic ??
Steve,alex, if you have studies supports the harms/complications of neural mobilization ,please attach or poast it here !
Cheers
Emad
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Re: Spinal manipulation and pregnancy - July 27, 2006 2:13:00 AM
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SJBird55
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From: Michigan
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Alicia, the reasonable answer as to why the technique of manipulation would be performed on a patient with acute back pain is simply because after all the data was collected by the physical therapists that defined the clinical prediction rule for manipulation of the lumbar spine, the onset date was one of the factors that needs to be considered before applying manipulation if the goal is a substantial reduction in disability scores.
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Re: Spinal manipulation and pregnancy - July 27, 2006 3:52:00 AM
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drbuddy
Posts: 429
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From: Pennsylvania
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Emad,
Perhaps the reason that acute LBP responds better to chronic LBP is that chronic LBP is usually more resistant to treatment.
What type of patients get better faster and more complete in your clinic? The guy that just pulled his back for the first time lifting something, or someone who has had multiple episodes of low back pain that has been in pain for many months?
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Re: Spinal manipulation and pregnancy - July 27, 2006 5:40:00 AM
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Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
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Emad,
I will post the studies as soon as you post studies supporting that lumbar manipulation causes harm and complications.
I also perform neural mobilizations to patients usually who have radiculopathy symptoms and I find them very helpful. But like with any intervention, you can't tell me that you have not flared someone up with those techniques because it is pretty easy to do with someone with acute symptoms. I would say that lumbar manipulation has the same chance of aggravating low back symptoms as your neural mobilizations.
_____________________________
Alex Brenner, PT, MPT, OCS
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Re: Spinal manipulation and pregnancy - July 27, 2006 5:48:00 AM
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Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
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Jbird,
I think the reason that Chiropractic received such backlash from the medical community is/was because of the theory behind the intervention and not so much the intervention itself. Please tell me you are not a subluxation model Chiro and that you have your patients coming in three times a week on the 6-month plan for adjustments to their spine which is in stage 3 of spinal decay. And if they don't agree to sign up for the discounted 6-month plan that you won't be responsible for their spine moving further into spinal decay and that their innate intelligence will remain impinged by their malaligned vertebral column.
Unfortunately your profession, just like mine, has some bad apples that practice unethically.
_____________________________
Alex Brenner, PT, MPT, OCS
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Re: Spinal manipulation and pregnancy - July 27, 2006 6:02:00 AM
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dfjpt
Posts: 238
Joined: April 9, 2006
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[QUOTE]I would say that lumbar manipulation has the same chance of aggravating low back symptoms as your neural mobilizations.[/QUOTE]Alex, how do you know that lumbar manipulation is doing anything different? Maybe all it's doing (the bit that produces pain relieving benefit) IS a neural mobilization.
That being the hypothetical case here, why would you want to do this fast rather than slow?
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Re: Spinal manipulation and pregnancy - July 27, 2006 6:07:00 AM
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jbird007
Posts: 297
Joined: May 2, 2006
From: USA
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I have seen and heard many patients undergo 3-4 visits per week for PT care. This goes for months sometimes years. Now some of you condemn the DC who does the same?
My post brought up the topic regarding how the medical community looked at adjusting/manipulation as evil but now everyone is trying to do some version of it. You people seem bright. Please tell me why the sudden turnaround.
btw, I run a NMS practice. Some pateints are treated once with resolution and released, others need more visits. I have no magic number and I do encourage maintainance care the same as I encourage patients to continue lifting weights, walking, jogging, getting massages and eating better.
It just amazes me reading all the PT comments who have jumped on the manipulation wagon. it wasn't long ago it was considered pure Quackery.
Thoughts?
jbird
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Re: Spinal manipulation and pregnancy - July 27, 2006 6:10:00 AM
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jbird007
Posts: 297
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From: USA
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Alex, You and other medical professionals seem to ALWAYS bring up the very small percentage of DC's who are practicing out of the norm. Why is that? I think you are intelligent enough to know the truth. Why take a "spin" on the issue?
jbird
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Re: Spinal manipulation and pregnancy - July 27, 2006 6:26:00 AM
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drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
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"That being the hypothetical case here, why would you want to do this fast rather than slow?"
I too use neural mobilizations in practice. Your assumption is that a manipulation is doing the same thing as the neural mobilization techniques. I think that is quite a stretch. If we are going to walk around in your hypothetical world, I think you need to supply some bit of evidence that these are similar. I know of studies done on the neurophysiological effects of manipulation, but none on simple contact or other neural mobilization techniques. What effects does simple contact have on h-reflexes, local muscle activity, etc.?
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