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RE: Low back pain treatment
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RE: Low back pain treatment - June 17, 2008 12:08:20 PM
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proud
Posts: 941
Joined: March 22, 2006
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quote:
ORIGINAL: Sebastian Asselbergs
And because they have tests that can demonstrate its presence. Objectively - like with imaging.
So if an MDT person calls it a derangement - they have established the existence, confirmed it with reliable and accurate testing or imaging? If not, it just becomes an empty word, meaning: "there is something painful going on around this joint area" - nothing more. Guess work. This is a whole lot different from what a orthopod (not my favourite medical professional always) means when s/he uses that term.
Yes. And that is what mcKenzie intened it to mean
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RE: Low back pain treatment - June 17, 2008 1:52:10 PM
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ptim
Posts: 68
Joined: September 26, 2006
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Sebastian
Why bother with a mechanical exam, if it can only be objectively determined by imaging! as we all know imaging is the gold standard of diagnosis!!!
The derangement is a sub-classification of mechanical joint pain, recognised by a symptom and mechanical response to loading. It has been shown to be reliable and accurate in the spine using discography (Donelson, Medcalf and April '1997' I think!), and Susan Mercer out of Australia is studying the extremities, nothing published yet though.
FYI, its not 'around the joint', its intraarticular.
In your previous posting 6/14 you stated the wry neck had no joint pathology, are you assuming this? or has the patient had reliable and accurate testing/imaging to rule out the presence of joint pathology?
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RE: Low back pain treatment - June 17, 2008 3:28:29 PM
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Sebastian Asselbergs
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Joined: September 29, 1999
From: Barrie, Canada
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Ptim - sorry but you are obviously not getting my point.
Where in the world did you see me say that imaging is the gold standard? I said ``like` imaging .
I am not arguing the reliability or validity of your exam. I am having trouble with terminology - I am not shooting at your religion here. I contend that the term derangement is used poorly in the context you present it. The derangement as you call it, is nothing precise: a symptom and mechanical response to loading. If you can`t see the difference between the vagueness of your `conclusion`after testing and the more ortho - well I guess we`re done.
Proud, I understand that now. I don`t know if that is also what MDT PTs mean....
< Message edited by Sebastian Asselbergs -- June 17, 2008 3:34:50 PM >
_____________________________
Mundi vult decipi
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RE: Low back pain treatment - June 17, 2008 5:56:29 PM
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ptim
Posts: 68
Joined: September 26, 2006
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I was joking about the imaging! I guess its difficult to detect sarcasm in the posting.
If you're having trouble with the Mckenzie terminology, they are very thorough on part A of the McKenzie program.
As for the term derangement, I don't think it was poorly used, i use it the same in any context!
My understanding and the ortho understanding of a derangement remains the same (definition unchanged), we just manage it differently, he wants to cut it out, I want to move them.
So as to the 'difference between the vagueness of my conclusion', I don't see it! so I guess we are done!
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