Everything is Unreliable… Get Used to It
12/05/12 10:08 Filed in: From the Research
All of us want certainty in life, particularly in our professional life. Clear answers and reliable data allow us to make predictable decisions and minimise risk. Indeed, reducing risk is one of the prime motivators of human behaviour and drives much of our decision making. However, there is very little that is truly certain, and this includes the clinical decisions we all make every day. For this reason clinicians of all types tend to rely on 'tried and true' testing procedures to help us navigate the inherent uncertainty of dealing with individual human beings. The question is, what can we truly rely on?
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Migraine, Colic and Complexity
13/03/12 13:52 Filed in: From the Research
The results of a recent study to be presented next month at the American Academy of Neurology (AAN) 64th Annual Meeting has focused attention yet again upon the complexity of migraine. Dr Amy Gelfand will discuss the findings of an investigation into the relationship between mothers with migraine and the tendency for their children to suffer infantile colic. In summary, maternal migraine is associated with a greater-than two-fold increase in the chance of having a colicky baby. But what underlies this relationship?
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Expectation and Pain
07/12/11 11:32 Filed in: From the Research
I have written previously about the role that expectation plays in clinical practice. Indeed, mastering 'expectation management' is a core part of effective 'doctoring' and can easily make the difference between the success and failure of most forms of treatment, particularly when pain is involved. But there's more to this phenomenon than simply recognising the possibility of placebo analgesia. Recent studies have shown that a patient's expectation of treatment success influences their nociceptive system all the way from the cortex to the brainstem and spinal cord...
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Scoliosis - Mechanical or Neurological?
30/07/11 21:07 Filed in: From the Research
Scoliosis is a condition that chiropractors are often called upon to identify and then manage. While there is significant awareness of scoliosis in the general population, it is not accompanied by much understanding of the underlying mechanisms that bring about spinal curvature. As such, there has been considerable room for unproven, or even disproven, treatment strategies - as well as theories of aetiology that just don't make sense. Is scoliosis a mechanical condition? Or is there something else at play?
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What Does an Adjustment Do?
05/05/11 12:03 Filed in: From the Research
One of the most common questions that we are asked is, "What does an adjustment actually do?"
Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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