Orthotics - do they really help a chiropractic patient?

Article Abstract:

Orthotics are shoe inserts used to correct abnormalities in the alignment of the body, and any adverse effects attributed to these misalignments. A four-month research project was done to evaluate whether orthotics were effective. The 10 subjects wore a brand of orthotics called Spinal Pelvic Stabilizers in their shoes for four months, during which time they received no other treatment. Spine and leg-length measurements were taken before and after the study period using X-ray studies which were evaluated by two separate examiners. These measurements are used to identify weightbearing stresses on the spinal segments and functional problems of the feet, knees, pelvis and spine. Improvements were noted in every case after four months. It was established that leg length differences can be corrected with orthotics. An increase in the lumbosacral disc angle, located between the last spinal vertebra and sacrum bones, is known to be associated with a number of complications and can result from increased angling of the lower back from being overweight. A significant decrease in this angle was noted after wearing the orthotics for four months. The results of this study support the premise that the biomechanics of the feet affect the other skeletal structures. Problems in any area of the skeleton should be reviewed as part of this integral system. Improper foot mechanics should not be overlooked in evaluating neck, back, hip and knee pain. Orthotics must be put into a good shoe to be beneficial. In a good shoe, the ball of the foot will rest at the widest part of the shoe. Also, the heel counter, the part of the shoe that fits around the heel, should be very firm and ideally extend along the length of the shoe and not end at the front part of the heel. These shoes provide a better foundation for the orthotics. The orthotics must not be too big for the shoe, or too hard to be flexible, and will require a break-in period when new. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Skeleton, Orthopedic equipment and supplies, Orthopedic appliances, Orthopedic shoes

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Patellar malalignment syndrome

Article Abstract:

Knee pain is a common complaint heard by orthopedic and sports medicine specialists, including chiropractors. It is often the result of acute injuries or chronic overuse in sports or on the job. Knee pain is also called patellofemoral pain because of the two bones that make up the knee joint. Patellar malalignment syndrome is being recognized as one cause of knee pain in young females, who may be knock-kneed or bow-legged. The syndrome is usually exacerbated after the knee has been in a flexed position for a long period of time, as can occur while sitting on a plane or in a car on a long trip. Wearing high-heeled shoes can also increase the pain. Other factors that may contribute to the development of this syndrome include obesity, tight hamstring muscles, and flat feet. The abnormal workings of, and strain on, the knee joint, can result from structural malalignments which originate at any level, and a full postural analysis and orthopedic exam is important. Crepitus, or a clicking or crackling sound, will often be heard when the knee is flexed. Knee X-rays are valuable in determining bony abnormalities and patella ("knee cap") height. Treatment is often focused around strengthening the quadriceps muscles with isometric exercises to correct or compensate for structural imbalances that are causing strain to the knee joint. Improvement is usually seen within four to six weeks of daily exercises. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Knee

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Chiropractic therapy in carpal tunnel syndrome: a case study

Article Abstract:

The eight bones in the wrist are quite mobile. One of the syndromes that compromises the functioning of the wrist is carpal tunnel syndrome, characterized by pain, paralysis, and numbness in the wrist. It results from compression of the medial nerve at the base of the wrist. Compression can occur in a variety of ways, but most often it is the result of repeated movement patterns of the wrist and hand. Carpal tunnel syndrome is second only to low back pain in occupational disorders. A 44-year-old man complained of tingling and pain in the wrists and arms, particularly in the right hand. He worked as a mail sorter. For three years he had sought medical treatment with little relief of symptoms. He then sought chiropractic care, and within two months his symptoms diminished. The extremities such as the hands and arms were manipulated during treatment, the spine was manipulated, ice was applied to reduce swelling, ultrasound therapy was used, and the patient took vitamin B6 supplements. It is not clear which treatment or combination of treatments resulted in the diminished symptoms. Given the success in treating this patient and the anecdotal reports of the success of chiropractic in treating carpal tunnel syndrome in other settings, many of these patients might be spared more invasive medical procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Occupational diseases, Carpal tunnel syndrome

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