Archived Comments for:
Spinal manipulative therapy versus Graston Technique in the treatment of non-specific thoracic spine pain: Design of a randomised controlled trial
Charles Blum, Sacro Occipital Technique Organization - USA
15 December 2008
I have a difficult time with the concept of having students delivering a thoracic spinal adjustment and that being equated to a practitioner in practice over 5 years or more. If I was attempting to devalue SMT for the thoracic spine one way would be to have students do the adjustment, under the guidance of a registered doctor or not.
The use of static or motion palpation of the thoracic spine as a rational to deliver a thrust is also might devalue the SMT since the assumption is that that joint is fixated and a thrust will reduce the fixation. In a subset of patients with this condition it may well lead to a positive outcome.
Other methods of diagnosis such as determining if the vertebra or costovertebral region has a directional preference based on pain or even adjacent muscle strength weakness or improvement with pressure to the joint could lend itself to better outcomes to SMT.
This could be a valuable time, for instance, to investigate sacro occipital technique's trapezius fibre analysis which relates to the thoracic spine and could help locate a segment warranting focused attention. Following the SMT thrust the trapezius fibre’s sensitivity would purportedly subside, offering a valuable pre and post assessment tool.
All in all I applaud the investigation of chiropractic techniques and think this study takes a good step in attempting to look at methods of treating non-specific thoracic spine pain.
Thank you,
Charles Blum, DC
Competing interests
I don't think I have any competing interest, but if I am biased I might not be aware that I do.
Chiropractic & Manual Therapies
SMT to Thoracic Spine
15 December 2008
I have a difficult time with the concept of having students delivering a thoracic spinal adjustment and that being equated to a practitioner in practice over 5 years or more. If I was attempting to devalue SMT for the thoracic spine one way would be to have students do the adjustment, under the guidance of a registered doctor or not.
The use of static or motion palpation of the thoracic spine as a rational to deliver a thrust is also might devalue the SMT since the assumption is that that joint is fixated and a thrust will reduce the fixation. In a subset of patients with this condition it may well lead to a positive outcome.
Other methods of diagnosis such as determining if the vertebra or costovertebral region has a directional preference based on pain or even adjacent muscle strength weakness or improvement with pressure to the joint could lend itself to better outcomes to SMT.
This could be a valuable time, for instance, to investigate sacro occipital technique's trapezius fibre analysis which relates to the thoracic spine and could help locate a segment warranting focused attention. Following the SMT thrust the trapezius fibre’s sensitivity would purportedly subside, offering a valuable pre and post assessment tool.
All in all I applaud the investigation of chiropractic techniques and think this study takes a good step in attempting to look at methods of treating non-specific thoracic spine pain.
Thank you,
Charles Blum, DC
Competing interests
I don't think I have any competing interest, but if I am biased I might not be aware that I do.