Best conservative treatments for stenosis without Myelopathy (Full Version)

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Dr. Ratcliffe -> Best conservative treatments for stenosis without Myelopathy (August 24, 2010 7:21:12 PM)

Ok. Have a patient with Cervical stenosis. Congenitally narrow and absolute. Had neuro-surg consult and as of yet no myelopathy. Occasionally has random arm paresthesia. EMG normal. At this point he does well with passive modalities (interferrential, US, etc.), Myofascial/Active Release and Graston therapy, Stretching. I have seen in the literature that spinal manip can rarely cause myelopathy if stenosis present so am reluctant to perform. Any other ideas. I am open.You can either click on <a href=http://www.novachiro.com/>Chiropractor in Northern Virginia</a> or go directly to http://www.novachiro.com.




rwillcott -> RE: Best conservative treatments for stenosis without Myelopathy (August 25, 2010 6:43:40 AM)

I would trial a treatment plan consisting of mechanical traction, thoracic manipulation and exercise program focusing on deep neck flexors and scapular stabilizers.




ragempt -> RE: Best conservative treatments for stenosis without Myelopathy (August 25, 2010 1:28:23 PM)

Let's start over. What is the chief complaint? Or did he walk in with the complaint of stenosis?




ysumpt2006 -> RE: Best conservative treatments for stenosis without Myelopathy (August 25, 2010 1:41:04 PM)

I mirror the previous question. What is the chief complaint? Is he functional? If so, why the PT at all?




fapt -> RE: Best conservative treatments for stenosis without Myelopathy (August 26, 2010 10:41:37 AM)

The data you show up indicate the dysfunction and what is the pt c/o? I can't find it?




rwillcott -> RE: Best conservative treatments for stenosis without Myelopathy (August 26, 2010 12:29:33 PM)

I noticed from your website you offer physical therapy.  However, you have no phsical therapist on staff.  Interesting.




OAK -> RE: Best conservative treatments for stenosis without Myelopathy (August 26, 2010 2:14:44 PM)

quote:

ORIGINAL: rwillcott

I noticed from your website you offer physical therapy.  However, you have no phsical therapist on staff.  Interesting.


Can you explain this Dr. Ratcliffe?




gundy0521 -> RE: Best conservative treatments for stenosis without Myelopathy (August 26, 2010 5:45:34 PM)

quote:

ORIGINAL: rwillcott

I would trial a treatment plan consisting of mechanical traction, thoracic manipulation and exercise program focusing on deep neck flexors and scapular stabilizers.


Assuming no hard neuro signs or other contraindications, definately an approach to go with.

As with previous posters, I'm interested in the following quote from your website: "He is a certified and licensed to perform physiotherapy..."

If you are not a physical therapist (physiotherapist), how do you justify this statement? In the state of Virginia, physical therapy and physiotherapy are now protected titles.

You'll likely have to change this.

http://www.vpta.org/secure/legislative/index.cfm




Tom Reeves DPT ATC -> RE: Best conservative treatments for stenosis without Myelopathy (August 27, 2010 8:33:40 AM)

don't even spell chiropractic right on the website.   dazzling




fapt -> RE: Best conservative treatments for stenosis without Myelopathy (August 30, 2010 12:06:23 PM)

NO physio there was found...




JWarePT -> RE: Best conservative treatments for stenosis without Myelopathy (August 30, 2010 1:58:50 PM)

Dr. Ratcliffe,

You know, just because you participate in a physical therapy discussion forum doesn't give you an exemption from compliance with the VA State PT Practice Act through your use of the protected term "physical therapy" on your website.

Don't bother thanking me for the savings in legal fees.




JSPT -> RE: Best conservative treatments for stenosis without Myelopathy (September 24, 2010 12:44:41 PM)

Just caught up with this discussion.  I agree to the "foul" call on "Dr." Ratcliffe.  I love 2 things about his website, however:

1. I can't resist a chiro in scrubs
2. The pic of him pointing at the diagnostic on the light box looks like he's playing a game of "Where's Waldo".  Thought bubble = "Oh yeah, you definitely has subluxation; I can tell by the picture".




ysumpt2006 -> RE: Best conservative treatments for stenosis without Myelopathy (September 30, 2010 8:36:52 AM)

Well he does have board certification in Advanced Rehabilitation (sense the sarcasm). I wonder what the backlash would be if PT's advertised that they provide chiropractic care (not that we would)? How would that go over? I bet "Dr" Ratcliffe would be just a little bit opposed to the notion.




chiroortho -> RE: Best conservative treatments for stenosis without Myelopathy (May 7, 2011 11:27:45 AM)

Good grief, I step in for a while and find this. 

Advertising, misspellings and hyperbole come as a package. 

As for the potential Board issues, if true, I think some excellent advice has been given here.  If your Board disallows it, please reconsider your assertions.  Nobody wants to see anyone get into trouble. 




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