VADs are spontaneous and can be normally present at the initial onset of headaches or neck pain. This represents the conclusion that the VAD was present before the technique is performed on a patient complaining of neck pain. The debate over the truth is still being waged. Even authors have joined the debate but they are touted as biased and do not support the evidenced based in research (User's Guide 2008).
Other debates rage as well. The risks of the manipulative thrusts therapies are actually no worse the risks from NSAIDs and cervical spine surgery. The primary risk involved in lumbopelvic region has been deemed as cauda equine syndrome and the adverse effects fro m the thrust therapy is roughly 1 in 6 million (Cleland 2007). It has been documented that certain people with low back pain respond immediately and dramatically with the manipulation and established patients that do not receive the therapy often have their conditions deteriorate and worsen as time goes on.
Physiology and physical therapy derived from traditional medical treatments is a way for physical interactions including physical therapy to be used in the alleviating of pain and more importantly the cause of the pain. Advanced manipulative therapy involves the use of soft tissue and joint mobilization in the treatment of musculoskeletal, sports and occupation injuries.
The terminology of spinal manipulative therapy (SMT) is most widely known as the manual treatments associated with soft tissue techniques, low velocity high amplitude mobilization, and high velocity low amplitude manipulative thrust (Maigne & Vautravers, 2002). SMT is accomplished by acting on the structure of the vertebral movement segments. The technique operates by the quick separation of the facet joint until a slight crackling sound is heard. The disk pressure has been noticed to decrease and the stretching of the spinal muscles occurs; thus causing relaxation and induces mechanisms of relief that are not yet clearly defined. These techniques give a temporary relief but must be repeated in continuous sessions to gain the full effects of the treatment.
The thrusts works by their application on the patient's body to simulate the movement as a lever or by a direct process involving the spinal processes (Maigne & Vautravers, 2002). Most of the spinal manipulative thrust motion is directly absorbed by the spinal region while a small portion is absorbed by the spinal soft tissues. Several levels of vertebral column can be affected by the leverage effect of the spinal column depending on manipulation applied and the extent of the manipulation.
Cavitation is described as the formation and collapse of low pressure bubbles in liquids or the formation of cavities in the body. The cracking sound heard during the SMT is a direct result of the cavitation of the spinal joints and studies have been conducted on its effects in the metacarpophalangeal joints. Traction does not relieve the pressure very quickly in these joints; but the cracking of these joints causes the cohesive forces to release allowing the pressure to be relieved. SMT allows the thrust to be exerted at a level that causes the immediate release of the gas and vapor at very high speed.
The results conclude form this study indicates that SMT can reduce the pain of some patients with back pain caused by disk related issues (Maigne & Vautravers, 2002). The cause of some lower back pain may be the result of a nucleus fragment trapped in the radial crack of the annulus (Maigne & Vautravers, 2002). Returning the fragment to its central location by the use of SMT may be achieved by endplate separation, the stretching of the posterior longitudinal ligament, and the relieving of the internal disk pressure (Maigne & Vautravers, 2002). Further testing...
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