Archives: Issues

We are excited to present this issue of D.C. Tracts highlighting the increasingly important subject of chiropractic care of older adults. According to published best practices for the chiropractic profession, older adults often seek chiropractic care for the management of musculoskeletal pain, either as a sole primary care provider and/or as a co-provider. In addition, best practices indicate that chiropractic care appears safe and effective, with associated high levels of patient satisfaction.

Our contributors for this issue detail the evidence-informed management of caring for our growing number of older patients. Dr. John Srbely’s feature article outlines the fundamental role of chiropractic care for managing chronic musculoskeletal pain in older adults, while audio lectures by Drs. Lisa Killinger and Brian Gleberzon discuss the role of chiropractic care in health promotion and balance disorders. In addition, Dr. Gleberzon offers a discussion of an extremely important contemporary topic in his Juris-Proofing series – COVID-19 preparedness for chiropractors. Finally, we welcome Dr. Brad Muir as he joins the D.C. Tracts team as Abstracts and Commentaries Editor! In his first issue, Dr. Muir summarizes scientific literature investigating chiropractic care for older populations, including case presentations to encapsulate key clinical applications.

I trust that as the reader, you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, DC, MS, PhD
Editor-in-Chief

For this volume of D.C. Tracts, our contributors outline the evidence-informed chiropractic management of pediatric patients. In recent years, factions from within and outside the chiropractic profession have much debated the appropriate management of pediatric patients. However, according to the National Board of Chiropractic Examiners (NBCE), approximately 40% of chiropractors deliver pediatric care. Scientific literature investigating the effects of chiropractic care for pediatric patients include conditions such as colic, otitis media, autism, ADHD and suboptimal breastfeeding. Yet, the systematic research supporting the efficacy of chiropractic care for treating these pediatric conditions is limited, thereby leaving clinicians with equivocal scientific evidence.

Dr. Brian Gleberzon’s Feature Article examines the clinical effectiveness and technique modifications for chiropractors treating pediatric conditions. Audio Lectures by Drs. Crystal Draper, Carol-Ann Weis and Stephanie O’Neill Bhogul highlight the importance of chiropractic care for pregnancy and colic. Dr. Gleberzon continues his Juris-Proofing series by discussing risk management strategies for chiropractors treating pregnant patients. Lastly, Dr. Yasmeen Khan appraises recent select scientific literature examining the efficacy and safety of chiropractic care for pediatric populations.

I trust that as the reader, you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, DC, MS, PhD
Editor-in-Chief

In this issue, our contributors review several interesting topics including multisensory myelopathy and central sensitization.

Dr. Brett Winchester’s Feature Article highlights how information from different sensory modalities may be integrated by the nervous system, and the considerable role of spinal manipulation, soft-tissue massage and rehabilitation in modulating dysfunctional afferent feedback.

Dr. Donald Murphy outlines the clinical relevance of cervical spine myelopathy, a common but at times overlooked source of neurological pain. He delivers an evidence-informed approach for managing myelopathy highlighting the importance of a thorough consultation and examination, along with a discussion of its appropriate management and careful monitoring.

In his Audio Lecture, Dr. Jeffrey Remsburg describes the pathophysiology behind nociception, including centrally-mediated pain or central sensitization. In addition, he provides clinical insights for managing chronic pain such as patient education, exercise and lifestyle changes.

Dr. Brian Gleberzon continues his Juris-Proofing series by exploring what constitutes “informed consent,” and Dr. Yasmeen Khan reviews the literature examining the effects of manual therapy on functional neurology.

I trust that you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, DC, MS, PhD
Editor-in-Chief

Welcome to the Summer 2019 issue of D.C. Tracts! In this issue, our contributors review the clinical consequences of thoracic spine pain. Although thoracic spine pain is a common clinical presentation, much of the scientific literature examining spinal conditions is focused on neck and low back pain, while the impact of thoracic spine pain on health and well-being seems generally overlooked.

This issue’s Feature Article provides an overview of thoracic spine pain, including the incidence/prevalence rates along with its health-burden and risk factors for thoracic impairments. In addition, it details the clinical significance of “red flags” and differential diagnoses for thoracic spinal conditions.

In his audio lecture, Dr. Patrick Battaglia delivers an in-depth analysis of the assessment of thoracic spine pain, including differentiating between specific and nonspecific causes of mid-back pain. He begins his lecture with a provocative quote from Dr. Nikolai Bogduk that explains that the understanding of thoracic spine pain, including its assessment and effective management, has scarcely advanced within the last century.

Dr. Adam Yoder’s lecture emphasizes evidence-informed management of thoracic spine pain, highlighting the role of exercise and manual therapy for managing thoracic conditions. More specifically, Dr. Yoder discusses the effectiveness of mobilization and manipulation as well as stabilization and strengthening exercises, along with the role of postural considerations.

In our abstracts and commentaries section, Dr. Yasmeen Khan highlights the role of chiropractic technique in the manual assessment of thoracic spine dysfunction, along with a case report emphasizing the importance of identifying warning signs and mindful diagnosis.

In addition, Dr. Gleberzon continues his Juris-Proofing discussion underscoring the role of patient communication, including the importance of complete disclosure of office policies and details related to patient management.

I trust that you will find this issue of D.C. Tracts both informative and interesting, and it will enrich both your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, BSc, BS, DC, MS, PhD
Editor-in-Chief

This issue of D.C. Tracts is a thorough, insightful review of temporomandibular disorders (TMDs) related to their structural, functional, psychosocial and clinical characteristics. Considering TMD’s relatively high prevalence and significant financial burden, a comprehensive discussion of the clinical effects and conservative management is important.

In his lecture, Dr. Justin Hildebrand provides a brief overview of the anatomical and biomechanical considerations of TMD, as well as the clinical presentation and examination of the issue. He also shares some clinical insight for conservative management including modalities, soft-tissue massage and dry needling.

Dr. Christopher Kinslow lectures on the clinical relevance of TMD and the substantial cost of management. He further highlights the psychosocial factors associated with TMD such as stress, anxiety and depression, emphasizing the role of chiropractors in identifying risk factors and appropriately referring for co-management. Finally, he outlines the role of chiropractors in managing TMD through patient education, lifestyle recommendations and patient reassurance.

Dr. Bradley Muir’s feature article delivers an in-depth review of the anatomy and biomechanics of the temporomandibular joint. He outlines the functional and structural importance of the joint capsule, musculature, articular disc and ligaments, and conveys the importance of variations in normal resting jaw position.

I trust that you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best regards,

Bryan M. Bond, BSc, BS, DC, MS, PhD
Editor-in-Chief

This issue of D.C. Tracts is focused on vertigo and its different subjective manifestations along with the proper factors to consider in a differential diagnosis. Additionally, this issue covers vertigo’s anatomy, etiology and treatment. The frequency of this condition makes it a timely subject for our consideration, since many of those suffering with it will find their way into our offices.

Dr. Brynne Stainsby’s Feature Article discusses the clinical approach to benign positional proximal vertigo (BPPV). She highlights the idea that, whenever possible, the clinician’s approach to managing a patient should be evidence-based.

In his Audio Lecture, Dr. William Huber discusses the clinically-relevant factors with respect to the causes and treatment of vertigo – the cardinal symptom of vestibular dysfunction. He covers the incidence, types, anatomy and physiology and pathology of the disturbances of the vestibular mechanism, and distinguishes between static and kinetic vertigo.

Dr. Adrienne Kaminskyj’s Audio Lecture outlines trigeminal neuralgia, focusing on its epidemiology, anatomy, pathophysiology, clinical presentation, classification and diagnosis along with differential diagnoses and current treatment approaches. She also discusses a real-world example of one patient’s clinical presentation, diagnosis and treatment course.

The Abstracts and Commentaries by Dr. Yasmeen Khan provide succinct and clinically relevant views on the epidemiology, diagnosis and treatment of the various types of conditions presenting with vertigo.

Respectfully,
Vincent P. Lucido, DC, DACBO
Editor-in-Chief

Most of us do not spend much time thinking about our body parts from day to day… that is, as long as they are not demanding our attention due to pain. However, 7.5 million Americans are thinking about their shoulders, and 25% of American adults are thinking about their knees because of distracting pain and dysfunction. In this issue of D.C. Tracts, Dr. Bryan Bond discusses some of the different conditions affecting these areas, along with their prevalence, proper evaluation and treatment. Radiographic examination and specific diagnostic tests and modalities that are best suited for the different pathologies and/or injuries are delineated. The comprehensive listing of his resources will aid practitioners in broadening the scope of their knowledge of these conditions.

In Dr. Tracey Littrell’s lecture, she also addresses knee and shoulder problems, their variations, evaluations and pathologies, but she approaches them with regard to different age populations and what is common among them. This aids the practitioner in approaching patients who present these problems with a better clinical focus.

Dr. Yasmeen Khan prefaces her Abstracts and Commentaries by citing an interesting dynamic within the chiropractic profession – the conflict of ideas regarding the utilization of diagnostic X-ray in clinical practice. She presents information that can help the chiropractic physician in determining when the use of diagnostic X-ray is appropriate. The views of chiropractic radiologists in clinical practice, those who teach radiology in the colleges and doctors in the field vary, and Dr. Khan addresses the influences that guide those views.

Respectfully,

Vincent P. Lucido, DC, DACBO
Editor-in-Chief