Chiropractic treatment of extremities.
Last updated 29/06/2019 by The pain clinics - Interdisciplinary Health
Chiropractic treatment of extremities
by Chiropractor Fredrik Tidemann-Andersen, Lierbyen Chiropractor Center.
Most people who hear the word "chiropractor" will probably think of treating headaches, dizziness, neck and back pain. What many do not know is that the chiropractors also have a thorough education in the treatment of extremities.
What are the extremes you might ask then? Extremity derives from the Latin word extremitas and means the limit. On the body it means arms and legs. As we can get locking or stiffnesses In the back, neck and pelvis, this can also occur in the extremities. Attached to the tip, a lock in the ankle can lead to incorrect gait, which in turn can lead to stiff neck and on to headaches. There is little research on the use of chiropractic correction for extremity disorders, and in what is to be found from research, different treatment techniques have often been used. Because of this, the study has a low validity when evaluated together, or in a so-called "systematic review". This is another reason why the chiropractors have not become recognized as experts on extremity treatment in the Norwegian health care system. That said, a chiropractor will also sit on knowledge about muscular therapy, home exercises, as well as possibly report sickness or refer you further to imaging, physiotherapist and orthopedics.
ALSO READ: - Pain in the joints? Joint locks and stiffness.
As there is little research in this field, much of the chiropractic correction has been performed on extremities based on clinical experience. As a therapist, whether a physician, physiotherapist or chiropractor, treatment based on clinical experience is often as important as research-based treatment.
Relevant research:
A larger RCT (Bisset 2006) - also known as a randomized controlled trial - published in the British Medical Journal (BMJ), showed that physical treatment of lateral epicondylitis consisting of elbow joint manipulation and specific exercise had a significantly greater effect in terms of pain relief and functional improvement compared to waiting and looking in the short term, and also in the long term compared to cortisone injections. The same study also showed that cortisone has a short-term effect, but that, paradoxically, in the long term it increases the chance of relapse and leads to slower healing of the injury. Another study (Smidt 2002) also supports these findings.
As mentioned above, the consultation with a chiropractor will usually also consist of soft-treating and introduction to home exercises, in addition to the chiropractic correction. In total, one will then receive a treatment that is based on both research and clinical experience. This produces good results quickly. Home exercises can be to strengthen, stretch or maintain movement. In some cases, home exercises are essential to achieve long-lasting results.
Some of the extremity conditions one has good experience in treating with a chiropractor include:
Shoulder
Shoulder joint impairment due to osteoarthritis or mild-moderate "frozen shoulder," as well as impingement syndrome and collar bone pain
elbow Pain
Inflammation of the surrounding muscles (tennis and golf elbow) or radiation pain from the elbow to the fingers. Both pains may be caused by impaired movement in one or more of the 3 joints of the elbow.
Wrist
Stiffness after old fracture, carpal tunnel syndrome and ulnar tunnel syndrome. The latter two will often lead to radiation pain as well as loss of strength in the fingers.
Knees
Wear gout, damage to meniscus or ligaments
Ankle / foot
Ankle stiffness and pain in the sole of the foot /plantar facade. Morton's neuroma; is often characterized by pain under or between the toe balls.
Chiropractor Fredrik Tidemann-Andersen at Lierbyen Chiropractor Center has taken a thorough education in the treatment of extremities. If you need to contact us, there is more information here: Lierbyen Chiropractor Center
Sources:
Chiropractic treatment of lower extremity conditions: a literature review. - W. Hoskins
Chiropractic treatment of upper extremity conditions: a systematic review. - A. McHardy
Guest Writer Profile: Chiropractor Fredrik Tidemann-Andersen
Also read: What does a chiropractor do?
Could imagine trying a rigid neck chiropractor. But there is little serious evidence that chiropractic is a serious treatment method.
Hi Per,
I almost have to arrest you for a while. In recent years there have been several excellent individual and collection studies showing that chiropractic joint correction on the neck and back pain has what we call moderate-good effect. In general, we see that manual treatment has significantly better, both short-term and long-term, results compared to drug treatment.
You must also remember that if you seek out a chiropractor for your neck it is not just "a crack" then you are done. The chiropractor will also assess, and possibly assist you with, muscular treatment, home exercise tips, and assess and print out sick leave or referral to a physical therapist, imaging diagnostic and medical specialist. Due to the extensive training of chiropractors, the Norwegian health care system has decided that we should be part of what we call the first-line service, or the primary health service in Norway. Therefore, you do not need a referral to seek out a chiropractor as you previously needed.
If you have other questions, you can reach us on 47 16 54 76 - or send me some lines here.
Sincerely,
Chiropractor Fredrik Tidemann-Andersen
Lierbyen Chiropractor Center
Hi Fredrik. I am a physio student in the second year. Wondering if you could elaborate a bit on those studies on chiropractic neck manipulation? 🙂 Very nice to know a little more for future 'referrals' and the like! I think interdisciplinary collaboration should get more focus in the Norwegian health care system .. What do you think?
Hi Therese,
Of course I can.
See link:
http://www.ncbi.nlm.nih.gov/pubmed/22213489
http://www.jospt.org/doi/abs/10.2519/jospt.2012.3894?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&#.VdcdefntlBd
http://www.thespinejournalonline.com/article/S1529-9430(13)01630-6/abstract
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004249.pub3/abstract
I also attach some to migraine and cervical headaches:
http://www.ncbi.nlm.nih.gov/pubmed/9798179
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381059/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819630/
I am of the opinion that nobody knows everything, and this makes it essential that physiotherapists, manual therapists, chiropractors and doctors in Norway work well together. This will undoubtedly benefit the patients and be more cost effective in the long run. Cooperation is probably significantly better now than before, but we still have a lot to go on 🙂
Have a nice day.
Sincerely,
Chiropractor Fredrik Tidemann-Andersen
Lierbyen Chiropractor Center
Thanks for the good answer, Fredrik. 🙂 I am amazed at how prejudiced some of my fellow students are…. and my GP too…. several of them are of the opinion that a chiropractic neck adjustment can be "dangerous", but that if a manual therapist or naprapath adjusts, there is no talk of side effects .. have you thought about the strange thing there ?? Why are some people so negative about chiropractic? I see it more as a collaborative resource when I enter the practical world one fine day. ^^
Therese, if your GP is so poorly updated in the world of research, I recommend you switch GPs 😉
There has been a lot of discussion around neck manipulation and strokes as individual cases of this have been reported. Since this is very rare, it is difficult to estimate the exact risk around this, but we know that such sudden deaths occur just as often in everyone in primary (physician, chiropractor and manual therapist) and secondary (physiotherapist) health service in Norway.
Chiropractic has met a lot of resistance throughout and this I believe is something that will follow the profession no matter how much documentation is presented regarding effect. But ultimately, it is the people who decide who they are looking for and what they think works best? 🙂
Frederick
Hehehe .. true enough !! he has not kept very well updated on muscle and skeleton I think .. becomes a lot of ibuprofen + 3 weeks rest there in the yard. Believe much of the skepticism is due to sheer ignorance. Good with such informative articles as you write here. Maybe such articles can help reverse skepticism (at least in the long run)?
Good luck! Maybe we cooperate a little when I eventually (hopefully) get practice in the Drammen region! 😀
friday: has hurt so badly in both arms, has been hurting for years, ready to say no things, not eda, sew, write, work with anything and this is so tiring and so boring, so want to clear things again. what can help? health Elizabeth
Hi Elisabeth,
Prolonged ailments are never fun and undoubtedly aggravate both our physical and mental health.
It is difficult to give advice without having seen you in person. Your pain may come from your back or neck or your extremists themselves. The pain can sit in both muscles and joints. Even more likely is that you experience a combination of all the above factors.
My best tip is to seek out a chiropractor who has good experience in treating extremities but also one that works with a focus on both muscles and joints to get a comprehensive evaluation.
If you are located in Eastern Norway and are close to us, you can find contact information here:
http://www.lierbyenkiropraktorsenter.no/kontakt/
MVH
Chiropractor Fredrik Tidemann-Andersen
MNKF
Lierbyen Chiropractor Center