Author: Gregory Markley, DC, DACO

Cervical Artery Dissection

In this meta-analysis, the authors (who are neurosurgeons) attempt to determine if there is a causal relationship between chiropractic care (manipulation) and cervical artery dissection (CAD). Carotid artery dissection has an estimate of 2.5-3 per 100,000 and vertebral artery dissection is estimated to occur at 1-1.5 per 100,000. As you know, CAD is rare, but there have been numerous articles that have created the impression of an association between spinal manipulation and CAD.

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Shoulder Disorders and Spinal Adjustments

One of the most valuable clinical insights that I have received since starting practice is to evaluate the cervical and thoracic spine with patients who have shoulder pain. Dependent upon my evaluation, I will decide to incorporate or not incorporate the spine in the treatment of shoulder disorders. In the literature, you will find articles (like one of the ones below) that attempt to quantify the biomechanical and neurophysiologic mechanisms of the shoulder after thoracic spinal manipulation.

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Diagnosis of Sacroiliac Joint (SIJ) Pain

Chiropractic Physicians are the answer to the rising cost in back pain care. In the past several issues, I have attempted to present data that helps confirm this proposition. One of the many reasons we are the answer is our ability to use our diagnostic skills and perform a thorough examination to make an accurate diagnosis based on the information obtained. If we need advanced imaging, we can order it, but the vast majority of the time we can accurately diagnose without the need for costly tests by using clinical guidelines.

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