Joint Manipulations

Question 1

Is joint manipulations affective for acute LBP

Answer 1

Yes highly effective

Question 2

Occurrence of causes equina with manip

Answer 2

<1/100

Question 3

What percent of people develop GI bleed from NSAIDS

Answer 3

1~3%

Question 4

How many deaths and hospitalizations in US from NSAIDS

Answer 4

7,600 deaths

76,000 hospitalizations

Question 5

Are L spine manips or mobs more effective

Answer 5

Manips

Question 6

Criteria of people who won’t likely benefit from manipulation

Answer 6

Longer sx duration
Sx distal to back
Absence of hypo mobility in lumbar spine
Negative SIJ provocation tests
Decreased hip IR

Question 7

Do occupation LBP patients respond well to manip

Answer 7

Yes

Question 8

Is there any correlation between stroke and manip

Answer 8

No

Question 9

When is conservative tx recommended in early stages

Answer 9

Acute onset HA “unlike any other”

Question 10

CPR for T spine manip for mechanical neck pain

Answer 10

Sx less than 30 days
No sx distal to shoulder
Looking up does not aggravate
FABQPA< 12
Decreased upper thoracic kyphosis
Cervical ext of less than 30 degrees

3/6 = 86%

Question 11

Is T spine manips helpful in UE CRPS

Answer 11

Yes

Question 12

Manip good for hip OA

Answer 12

Yes, manual tx is first choice is exercise therapy

Question 13

Targeting joints in lumbar and thoracic

Answer 13

About 1/2 time is right joint

L spine error is about 1 vertebra or 5.29cm

T spine error is 3.5cm (more accurate)

Question 14

Success of manip mainly dependent upon what

Answer 14

Identifying individuals likely to respond well

Question 15

What do manips do to muscles

Answer 15

Increases strength
Increases flexibility
Increase stabilization in L spine

Question 16

Manips and cytokines

Answer 16

Decrease in chemokine which leads to decrease in cytokine receptor sensitivity

Question 17

3 ways manips work by

Answer 17

Mechanical
Neurological
Psychological

Question 18

How do they do it mechanically

Answer 18

Release meniscoid inclusions
Restore positional faults

Question 19

How do they do it neurologically

Answer 19

Increased activity of proprioceptors
Adjust nociception receptor pattern
Decrease central sensitization
Effects autonomous nervous system

Question 20

Which manip sites immediately reduce pain and mechanosensitivity and are justifiable to use in SNS problems

Answer 20

Cervical and thoracic

Question 21

Age to manip

Answer 21

At least 12 because this is when upper cervical spine bones are fully fused

Question 22

When do uncinate processes develop

Answer 22

10