chiropractic efficacy for the treament of headache 1233808203798876 1
Post on 30-May-2018
215 Views
Preview:
TRANSCRIPT
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
1/40
CHIROPRACTICEFFICACY
Spinal Manipulation in theTreatment of Migraine and
Tension Type Headaches
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
2/40
HERE IS A SECRET FOR YOUOver 70% of patients
who use alternativetherapies never informedtheir medical providersthat they used suchtherapies
Eisenberg DM. Ann Intern Med. 1997; 127:61-69
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
3/40
RECENT SURVEY
A recent survey of medical doctors asked:
If you knew a Chiropractor you could trust, would you refer to them?
OVER 70%SAID YES
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
4/40
RECENT SURVEY
When asked:Do you know a Chiropractor you can trust?
OVER 80% SAIDNO
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
5/40
TODAYS AGENDA
A Review of the Literature.The Theory of Cervicogenic HeadacheSelecting a Patients for SpinalManipulationIs Spinal Manipulation Safe?
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
6/40
THE EFFICACY OF SPINAL
MANIPULATION IN THETREATMENT OF
MIGRAINE HEADACHES
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
7/40
THE EFFICACY OF SPINALMANIPULATION FOR MIGRAINE
22% of the participants reported more than a90% reduction of their migraines
50% more participants reported significantimprovement in the intensity of the migraines
Tuchin PJ. A randomized control trial of chiropracticmanipulative therapy for migraine. J ManipulativePhysiol Ther 2000;23:91-95
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
8/40
THE EFFICACY OF SPINALMANIPULATION FOR MIGRAINE
After one week of treatment they reportedcomplete relief of headache in 75% of their
subjects.They also noted a significant increase in cervicalROM and a reduction in dizziness
Stodolny J. Manual Therapy in the treatment of patients with cervical manipulation for migraine. AustNZ J Med 1989;4:49-51
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
9/40
THE EFFICACY OF SPINALMANIPULATION FOR MIGRAINE
Spinal manipulation was as effective as awell established and efficacious treatment
(amitriptyline), and on the basis of abenign side effects profile, it should beconsidered a treatment option for patientswith frequent migraine headaches
Nelson CF. J Manipulative Physiol Ther.1998;21(8):511-9
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
10/40
THE EFFICACY OF SPINALMANIPULATION IN THETREATMENT OF
TENSION TYPE HEADACHES
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
11/40
THE EFFICACY OF SMT FOR TENSIONTYPE HEADACHES
Spinal manipulation is an effectivetreatment for Tension Headaches
Amitriptyline was slightly more effective inreducing pain at the end of the treatmentperiod but was associated with more side
effects.In addition
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
12/40
THE EFFICACY OF SMT FOR TENSIONTYPE HEADACHES
Four weeks after the cessation of treatment, the patients who received SMT
experienced a sustained therapeuticbenefit in all major outcomes in contrast topatients that received amitriptyline, who
reverted to baseline values.And.
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
13/40
THE EFFICACY OF SMT FOR TENSIONTYPE HEADACHES
The sustained therapeutic benefitassociated with SMT seemed to result in a
decreased need for over the counter medication.
Boline PD. Spinal manipulation vs.amitriptyline for the treatment of chronictension type headaches. J ManipulativePhysiol Ther. 1995 18(3):148-54
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
14/40
THE EFFICACY OF SMT FOR TENSIONTYPE HEADACHES
Almost without exception, chiropracticmanipulation of the neck was found to be
superior in terms of reducing tensionheadache frequency, intensity, andimproving functional status of patients
when compared to other standard medicaltreatments.Hurwitz. Spine 1996;21:1746-1760
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
15/40
CERVICOGENIC HEADACHE
Although migraine, and tension type headachesare generally considered to be separateconditions, there is support in the literature thatthey represent a continuum with severalcommon underlying mechanisms includingcervical spine dysfunction
Featherstone HJ. Headache 1985;25:194-8
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
16/40
Which Patients Should beConsidered for SpinalManipulation
The International HeadacheSociety Diagnostic Criteria for
Cervicogenic Headaches
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
17/40
CERVICOGENIC HEADACHEDiagnostic Criteria
HEADACHE ACCOMPANIED BY ONE OR MOREOF THE FOLLOWING:
Pain precipitated by neck movement or sustained neckpostureNeck muscle tendernessAbnormal postureDecreased neck range of motion
International Headache Society
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
18/40
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
19/40
The question stillremains:
HOW CAN CERVICALDYSFUNCTION CAUSE A
HEADACHE?
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
20/40
Before 1995 No New Muscles had beendiscovered since the 16 th Century
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
21/40
TMJ Research Leads to Discovery
Led by assistant professor Gary HackDDS, scientists at the University of
Maryland performed a special type of dissection on 10 cadavers.His goal was to identify another muscle
of mastication
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
22/40
TMJ Research Leads to Discovery
In addition to a new muscle of mastication, healso discovered a connective tissue bridge that
attaches the rectus capitus posterior minor muscle to the dura at the atlanto occipital junction. (it was present in all 10 cadavers)
Hack GD. Anatomic relation between the rectuscapitus posterior minor muscle and the dura matter.Spine 1995: 20:2484-2486
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
23/40
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
24/40
The Neuromuscular Connection
Dr. Hack stated:Maryland Scientists speculate thatthe newly described muscle duraconnection may transmit forcesfrom the neck muscles to the painsensitive dura.
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
25/40
Cadaver SpinalCord
Dura
TheConnection
Occiput
C 1 T.P.
C 2
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
26/40
Stained SlideDura
Occiput
RectusCapitus
Posterior Minor
TheConnection
AtlasAtlas
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
27/40
DuraDura
OcciputOcciput
CC 11 Transverse ProcessTransverse Process
Connective
Tissue
Rectus CapitusRectus CapitusPosterior Posterior (RCPM)(RCPM)MuscleMuscle
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
28/40
Chiropractic for headaches?
Spinal Manipulation as a treatment for headache is predicated upon the assumptionthat the dysfunction in the neck muscles
contributes to the head pain.
The muscle dura connection may represent at least in part the underlying anatomical
basis for the effectiveness of this treatment.
1998 Encyclopedia Britannica Medical and Health Annual
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
29/40
How would chiropractic help?Spinal manipulation, as performed by achiropractor, would decrease muscle
tension and thereby reduce or eliminatepain by reducing the potential force exertedon the dura via muscle dura connection.
1998 Encyclopedia Britannica Medical and Health Annual
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
30/40
Weve been able to put together ascientific explanation for how neck
structure causes some types of headaches
Chiropractors have been saying that for years. Unfortunately, many (medical)Doctors tend to have a jaundiced view of Chiropractors, but (Chiropractors) were
right about headaches.
Peter Rothbart, MD, FRCPC. President NorthAmerica Cervicogenic Headache Society
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
31/40
SPINAL MANIPULATION
IS IT SAFE?
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
32/40
MANIPULATIONA SAFE PROCEDURE
In 1996, Vick et al.performed a 68 year review of the medical literature from 1926-1993 for injuriesrelated to manipulation.
Of the estimated several hundred thousandmanipulative treatments performed each year,
only 185 reports of injury were found during the68 year period.
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
33/40
MANIPULATIONA SAFE PROCEDURE
Comparing these figures with theincidence of adverse effects (including
death) associated with manypharmaceutical agents, manipulationremains an extremely safe modality whenperformed by a skilled practitioner.
Vick DA. The safety of manipulative treatment.JOA 1996;96:113-115
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
34/40
MANIPULATIONA SAFE PROCEDURE
An article by Dabbs and Lauretti in 1996,compared the risks of serious
complications or death for patientsreceiving a course of manipulativetreatment or non-steroidal anti-
inflammatory drugs.
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
35/40
MANIPULATIONA SAFE PROCEDURE
Based on the available evidence, wecalculate the risk of serious complications
or death is 100 to 400 times greater for theuse of NSAIDs than for the use of cervicalmanipulation in the treatment of similar conditions.
Dabbs V, Lauretti WJ. J Manip Physiol Ther 1995;18:530-536
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
36/40
MANIPULATIONA SAFE PROCEDURE
In addition, an article published in themedical journal, Spine compared the risks
for :Cervical Spine ManipulationNSAIDs
Cervical Spine Sugery
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
37/40
MANIPULATIONA SAFE PROCEDURE
In this article, Hurwitz reports:Risk of vertebrobasilar accident as 7.5 per
10,000,000 manipulationsRisk of severe gastrointestinal bleedingresulting in hospitalization or death from theuse of NSAIDs as 1 in 1000 subjectsAnd.
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
38/40
MANIPULATIONA SAFE PROCEDURE
They report an average incidence rate of neurological complication or death fromcervical spine surgeries as 11.25 per 1000
Hurwitz EL. Manipulation and mobilization of the cervical spine: A systematic review of theliterature. Spine 1996;21:1746-1760
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
39/40
IS CHIROPRACTICMANIPULATION
A SAFE PROCEDURE
The most logical source for assessing therisk of any profession can be found by
examining the malpractice insurancepremiums for that profession
-
8/14/2019 Chiropractic Efficacy for the Treament of Headache 1233808203798876 1
40/40
Precision Pain Relief Center: 6316 Spalding
Drive, Norcross, GA30092
top related