Lecture 9 Flashcards
(14 cards)
How does SMT compare to medical management?
SMT is generally safer and more cost-effective, especially compared to opioid use.
What does the evidence say about manual therapies for neck and low back pain?
SMT is supported by low-to-moderate quality evidence for improving pain and function in chronic nonspecific neck and low back pain.
What does current evidence suggest about using SMT for headaches with neck pain?
SMT should not be the sole treatment but may be used alongside exercise and education, especially for cervicogenic and tension-type headaches.
What is CMC?
A long-term management strategy using periodic care (e.g., monthly SMT, education, exercise) aimed at preventing recurrence and optimizing health.
What are the theoretical benefits of CMC?
Prevent recurrence/exacerbation
Provide palliative care
Maintain optimal function and health
Prevent development of new conditions
What does the research show about CMC’s effectiveness?
RCTs show that CMC helps maintain improvements in disability and reduce bothersome LBP days compared to symptom-guided care.
How is CMC used in chiropractic practice?
Primarily for secondary and tertiary prevention of musculoskeletal and general health conditions.
What role does evidence play in teaching manual skills to chiropractors?
Research has challenged assumptions (e.g., facet symmetry, segment specificity), influencing curriculum and emphasizing evidence-based practice.
Does SMT need to target specific spinal segments?
Some RCTs show no difference between targeted and non-targeted SMT, while others show site-specific SMT can affect neurophysiology (e.g., N30 SEP changes).
Does the ‘dose’ of SMT matter?
Yes—research shows a dose-response relationship. For example, 12–18 SMT sessions led to better outcomes for chronic LBP and cervicogenic headaches than fewer visits.
What is a clinical red flag?
A sign/symptom indicating possible serious pathology that may contraindicate chiropractic care and require urgent referral.
List some common red flags in chiropractic screening.
Acute confusion
Saddle anesthesia
New gait disturbances
Unexplained weight loss or fever
Progressive neurological deficits
Incontinence
History of malignancy
Which red flags have the highest diagnostic accuracy?
History of malignancy
Strong clinical suspicion of serious pathology
What is the clinical implication of red flags?
They are critical in deciding when to refer patients out of chiropractic care for urgent medical attention.
