Journal of chiropractic medicine最新文献

{"title":"Immediate Effects of Cervical Spine Manipulation Compared With Muscle Energy Technique on Neck Muscle Activity and Range of Motion in Asymptomatic Participants: A Randomized Study","authors":"Sasha Lee King MTech(Chiro),&nbsp;Aadil Docrat MTech(Chiro), MMedSci,&nbsp;Ashura Abdul-Rasheed PhD, MTech(Chiro)","doi":"10.1016/j.jcm.2022.04.001","DOIUrl":"10.1016/j.jcm.2022.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to investigate the immediate effects of cervical spine manipulation (SM) compared with muscle energy technique (MET) on neck muscle activity and range of motion in asymptomatic people.</p></div><div><h3>Methods</h3><p>A randomized parallel-group study was conducted at a chiropractic<span> teaching clinic in Durban, South Africa. Fifty asymptomatic participants between 18 and 35 years of age were randomly assigned into group 1 or group 2. Group 1 received cervical SM, and group 2 received MET. Participants were blinded to group allocation only. Baseline and post-test measurements consisted of resting upper trapezius and posterior cervical muscle activity and cervical spine range of motion (ROM) in lateral flexion and extension.</span></p></div><div><h3>Results</h3><p>A significant difference was found in cervical ROM within groups (<em>P</em> &lt; .001), with no significant difference observed between the 2 groups. The right posterior cervical muscles showed a significant difference in group 1 only (<em>P</em> = .012). No significant muscle activity changes occurred in group 2. Resting muscle activity measures showed no statistically significant changes between groups.</p></div><div><h3>Conclusion</h3><p>A single application of SM and MET to the cervical spine immediately increased cervical ROM. Neither cervical SM nor MET changed resting posterior cervical and upper trapezius muscle activity.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manipulation Under Anesthesia and Prolotherapy for Adhesive Capsulitis and Rotator Cuff Tear: A Case Report With 7-Year Follow-Up","authors":"Mark W. Morningstar DC, PhD,&nbsp;Megan N. Strauchman DO, MBA","doi":"10.1016/j.jcm.2022.04.005","DOIUrl":"10.1016/j.jcm.2022.04.005","url":null,"abstract":"<div><h3>Objective</h3><p><span>The objective of this case study is to describe the history, presentation, treatment, and outcome of a patient receiving </span>manipulation under anesthesia<span><span> (MUA) followed by prolotherapy for adhesive capsulitis and </span>rotator cuff tear.</span></p></div><div><h3>Clinical Features</h3><p><span>A 50-year-old male patient had a 6-month history of chronic shoulder pain. His range of motion was markedly reduced in all planes. His intractable shoulder pain and dysfunction were refractory to chiropractic manipulation, physical therapy, and steroid injections. At presentation, he was taking </span>hydrocodone<span> 5/325 every 8 hours for pain without pain relief. Pain was preventing the patient from sleeping through the night. Magnetic resonance imaging showed adhesive capsulitis and distal infraspinatus partial-thickness tendon tear.</span></p></div><div><h3>Intervention and Outcome</h3><p>After completing medical clearance, the patient received a 3-day serial MUA. He participated in a course of post-MUA therapy for 4 weeks and thereafter received 6 total dextrose-based prolotherapy injections of the infraspinatus tendon over the subsequent 8 weeks. His self-rated pain rating scale improved from a 77 out of 100 to 11 out of 100. His range of motion returned to within normal limits in all planes and was bilaterally equal.</p></div><div><h3>Conclusion</h3><p>This patient with adhesive capsulitis and rotator cuff tear responded favorably to MUA and dextrose-based prolotherapy. Results were maintained 7 years after treatment.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of Spinal Manipulative Therapy on the Performance of Elite Brazilian Soccer Players: A Pilot Randomized Controlled Trial With an Internally Validated Sham Treatment","authors":"Marcelo B. Botelho DC, MD, PhD ,&nbsp;Marcio A. Barbosa BPhEd, PhD ,&nbsp;Celso S. Junior BPhEd, MSc ,&nbsp;Jerusa P.R. Lara BPhEd, PhD ,&nbsp;Alexandre Moreira BPhEd, PhD ,&nbsp;Abrahão F. Baptista PT, PhD","doi":"10.1016/j.jcm.2022.02.021","DOIUrl":"10.1016/j.jcm.2022.02.021","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess the feasibility of the procedures’ routine, the recruiting rate, the presence of any significant detrimental impact on the players’ training routine, and the sham efficacy in achieving blinding.</p></div><div><h3>Methods</h3><p>A parallel randomized controlled clinical trial<span> was performed with 20 elite soccer players who were randomly assigned to 1 of 2 groups: spinal manipulative therapy (SMT) and sham SMT. All players were from the same team, were injury free, and were naive to SMT. Measured outcome tests (30-m sprint run with a 10-m split and change of direction [COD] test) were performed at the same time by all participants immediately before and after interventions. Photocell devices were used for data acquisition.</span></p></div><div><h3>Results</h3><p>Twenty participants were analyzed (10 in each group). There were no changes to the sprint (10 m and 30 m) and COD test results immediately after either of the interventions. All participants in both groups (SMT and sham SMT) answered “yes” to a question after the intervention asking if they were treated by SMT. No adverse effects or training routine impairment were reported.</p></div><div><h3>Conclusion</h3><p>This pilot study protocol showed it was an appropriate design for a confirmatory clinical trial. The study had minimal effect on the team training routine, and the recruitment rate was excellent. The proposed sham SMT strategy was successful in blinding the players. In this sample, SMT did not have any immediate effect on the performance of these elite soccer players, as measured by 10- and 30-m sprint times and COD sprint times.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinimetric Properties of the Applied Kinesiology Manual Muscle Test in Adults With and Without Pain: A Methodological Study","authors":"Décio G. Oliveira MS ,&nbsp;Gabriel M. Oliveira BPT ,&nbsp;Renata N. Kirkwood PhD","doi":"10.1016/j.jcm.2022.03.003","DOIUrl":"10.1016/j.jcm.2022.03.003","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to determine the intra- and interexaminer reliability<span>, concurrent validity, and responsiveness of the applied kinesiology manual muscle test (AK-MMT) to discriminate </span></span>gluteus medius muscle strength and latency.</p></div><div><h3>Methods</h3><p>A cross-sectional and methodological study was conducted in 38 participants using electromyography<span>, electrogoniometry, and hand-held dynamometry<span> to measure latency, angular displacement, and muscle force during the assessment of the gluteus medius by AK-MMT. Inter- and intrarater reliability of 2 examiners with different levels of experience were obtained using the intraclass correlation coefficient. Muscle force, latency, and joint angular displacement were compared between groups (facilitated vs inhibited). Latency and angular displacement also were compared within groups by using the Wilcoxon paired test. For the concurrent validity of the AK-MMT in classifying an inhibited muscle as weak, the receiver operating characteristic curve was conducted.</span></span></p></div><div><h3>Results</h3><p><span>Intra- and interexaminer reliability for the facilitated vs inhibited classifications based on AK-MMT presented good results, with intraclass correlation coefficient &gt; 0.86. For the inhibited group, force and peak force were significantly lower and joint displacement significantly greater. The receiver operating characteristic curve showed an area under the curve of 0.743, demonstrating that the test has concurrent validity </span><em>(P =</em> .001) to discriminate muscle force. The Wilcoxon paired test showed a significant delay in latency of the inhibited gluteus medius group (0.10 s vs 0.18 s, <em>P</em> = .007) when compared with the facilitated one.</p></div><div><h3>Conclusion</h3><p>In this study, we found good intra- and interexaminer reliability and concurrent validity for the AK-MMT to determine differences in gluteus medius muscle force. Although the paired data showed a different latency time between groups, the hypothesis of prolonged latency in muscles classified as inhibited by AK-MMT still needs further investigation.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Infectious Disease Prevention and Mitigation Practices by Chiropractic Physicians and Licensed Massage Therapists in Mississippi: A Needs Assessment to Inform Health Education and Promotion","authors":"Robert A. Leach DC, MS ,&nbsp;Harrison Ndetan MPH, MD, PhD ,&nbsp;Jeffrey A. King DC, MS ,&nbsp;Marion W. Evans Jr DC, PhD","doi":"10.1016/j.jcm.2022.02.016","DOIUrl":"10.1016/j.jcm.2022.02.016","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess self-reported infection prevention processes and their effect on businesses of chiropractic doctors (DCs) and licensed massage therapists (LMTs) in Mississippi during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>We developed a survey that was electronically delivered to all licensed DCs and LMTs in Mississippi between August and September 2020. Assessments were made using Qualtrics software, with data management and subsequent analysis including Pearson's χ² test.</p></div><div><h3>Results</h3><p>Responses were based on 32 of 323 DCs and 69 of 934 LMTs that were still seeing patients through the pandemic (n = 101, response rate 8%). The DC and LMT practitioners (94%) used treatment table and/or surface sanitizing (91.8%) and hand washing and/or sanitizing (89.8%) between all patients. Female practitioners reported practicing handwashing for at least 20 seconds, whereas male practitioners reported practicing handwashing for at least 15 seconds (<em>P</em> &lt; .001). DCs were more likely to report using gloves for personal protective equipment, and LMTs were more likely to report using face masks (<em>P</em> &lt; .001). Other COVID-19 procedures included limiting practice to acute care (82.5%), checking all patient temperatures (62.9%), sign-in and wait in the car (53.2% LMT vs 6.5% DC, <em>P</em> &lt; .001), and prohibiting all nonpatient visitors (87.7% LMTs vs 9.4% DCs, <em>P</em> &lt; .001). DCs (96.9%) and LMTs (89.9%) reported making referrals for COVID-19 testing or treatment when indicated. LMTs (82.3%) reported seeing fewer patients (<em>P</em> = .03), and older practitioners reported the most economic impact (<em>P</em> = .003) by the pandemic. Patient concerns and LMTs needing more time to perform infection control (<em>P</em> = .04) were reasons cited by practitioners for the reduced number of visits seen.</p></div><div><h3>Conclusion</h3><p>Most respondents had moderate to high compliance with guidelines on recommended infection prevention processes during fall 2020 of the COVID-19 pandemic. This assessment of compliance may be used to help guide future health education and promotion research of disease prevention and mitigation as well as physical and economic burdens faced by DCs and LMTs in Mississippi during a pandemic.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40402106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial","authors":"Jeslin T. Achens MPT,&nbsp;Vijay S. Raj Victor MPT,&nbsp;Jakson K. Joseph MPT","doi":"10.1016/j.jcm.2022.05.005","DOIUrl":"10.1016/j.jcm.2022.05.005","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to explore the possible role of pressure biofeedback in the early activation of quadriceps following </span>lower limb orthopedic surgeries.</p></div><div><h3>Methods</h3><p>This was a proof of concept clinical trial<span><span>. A single-blinded randomized controlled study was conducted on 24 patients who underwent lower limb surgeries. The experimental group received standardized physiotherapy treatment<span> in addition to pressure biofeedback for quadriceps retraining. The control group received a standardized physiotherapy treatment developed for an inpatient orthopedic setting. The motor unit action potential (MUAP) duration and amplitude were measured using </span></span>electromyography on the second and sixth postoperative days.</span></p></div><div><h3>Results</h3><p>Twenty-four participants, with a mean age for the control group of 58.67 ± 17.21 and the experimental group of 40.1 ± 6.96, were enrolled. No statistical significance in MUAP amplitude for within the groups (F[5,85] = 1.735, <em>P</em> = .135) was found. However, there was a statistical significance between the control and experimental groups in amplitude measured by electromyography (F[1,17] = 49.09, <em>P</em><span> &lt; .01). There was no statistical significance in MUAP duration for within the groups (F[5,85] = 1.303, </span><em>P</em> = .270). However, there was a statistical significance in duration (F[1,17] = 71.84, <em>P</em> &lt; .01).</p></div><div><h3>Conclusion</h3><p>Pressure biofeedback was more effective in the early activation of quadriceps muscle when coupled with conventional exercises compared with conventional exercises alone following lower limb orthopedic surgeries. Early activation of quadriceps could be a contributing factor to preventing arthrogenic muscle inhibition.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Telemedicine in the Diagnosis of Cervical Spondylotic Myelopathy in a US Veteran During the COVID-19 Pandemic: A Case Report","authors":"Alyssa Troutner DC, MS,&nbsp;Michael Barbato DC","doi":"10.1016/j.jcm.2022.03.004","DOIUrl":"10.1016/j.jcm.2022.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this case study was to describe the diagnosis of cervical spondylotic myelopathy through telemedicine during the COVID-19 pandemic.</p></div><div><h3>Clinical Features</h3><p>A 57-year-old male patient was evaluated at a Veterans Affairs chiropractic clinic via video telemedicine for evaluation regarding neck pain and bilateral arm paresthesia.</p></div><div><h3>Intervention and Outcome</h3><p>During the initial evaluation performed by video telemedicine, the doctor of chiropractic was concerned about the possibility of cervical spondylotic myelopathy. This prompted a face-to-face consultation with the patient for further evaluation. The face-to-face evaluation revealed correlating objective findings, including brisk reflexes and transient clonus. Noncontrast magnetic resonance imaging of the cervical spine was performed, which showed evidence of cord compression with associated myelomalacia in the cervical spine at the C4-C5 level. After a neurosurgical consultation, the patient underwent successful anterior cervical decompression and fusion at the C4-C5 level.</p></div><div><h3>Conclusion</h3><p>Chiropractic services through live video telemedicine in conjunction with face-to-face evaluation resulted in a timely neurosurgical consultation and successful decompression of the affected region. In this case, telemedicine facilitated a positive outcome for a patient with cervical spondylotic myelopathy.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479199/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Blood Pressure and Pulse Adaptations Between Younger and Older Patients During Balneotherapy With Physiotherapy","authors":"Senem Sas MD ,&nbsp;Derya Ozer Kaya PT, PhD ,&nbsp;Seyda Toprak Celenay PT, PhD","doi":"10.1016/j.jcm.2022.02.012","DOIUrl":"10.1016/j.jcm.2022.02.012","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate the blood pressure and pulse adaptation characteristics between younger and older patients with musculoskeletal disorders<span> during acute and recovery responses at the first and 10th sessions of balneotherapy added to physiotherapy.</span></p></div><div><h3>Methods</h3><p>Forty-six participants (n = 22, between 18 and 35 years of age as young adults; n = 24, more than 65 years of age as older adults) with musculoskeletal disorders admitted to physiotherapy therapy sessions with balneotherapy were enrolled. The participants’ immersion time was 20 minutes each during 10 sessions occurring over the course of 2 weeks. Blood pressure and pulse were measured at the baseline and the 5th minute as acute responses, and at the baseline and the 30th minute as recovery responses during the first and 10th sessions.</p></div><div><h3>Results</h3><p>First, the group and session effect was examined. There was no significance in this part. Then, session main effect and group main effect were examined. The group main effect was significant, that is, a difference was found between groups independent of the session in terms of only pulse values <em>(P &lt;</em> .001). There was no difference in sessions. The acute and recovery responses of the pulse at the first and 10th sessions of balneotherapy showed higher alterations in the young people compared with the older people (<em>P</em> &lt; .008).</p></div><div><h3>Conclusion</h3><p>Greater pulse alterations at the acute and recovery phases of the first and 10th sessions were observed in young adults.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10814874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of a Sacroiliac Belt on Pain and Functional Impairment in Patients With Low Back Pain: A Randomized Trial","authors":"John S. Ward DC, MA, MS","doi":"10.1016/j.jcm.2022.06.001","DOIUrl":"10.1016/j.jcm.2022.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess the protective influence of the Serola Sacroiliac Belt on pain and functional impairment in individuals with low back pain (LBP) during 5 days of strenuous manual labor.</p></div><div><h3>Methods</h3><p>Thirty-three participants (mean ± standard deviation: age, 43.2 ± 11.4 years; height, 1.74 ± 0.11 m; body mass index<span><span>, 88.3 ± 16.7 kg) with LBP were randomized to either condition A (wearing the Serola Sacroiliac Belt during a 10-minute daily repeated strenuous lifting task) during week 1 or condition B (not wearing a Serola Sacroiliac Belt during the same lifting task) in week 2 or vice versa. All 33 participants completed 1 week under condition A and 1 week under condition B for comparison. At the beginning and end of each week, the following dependent variables were measured: lumbar spine<span> pain on a 0 to 10 Numeric Rating Scale (NRS), spine and thigh discomfort on a Nordic Musculoskeletal Questionnaire, and completion of a toe-touch </span></span>surface electromyography flexion relaxation phenomenon test.</span></p></div><div><h3>Results</h3><p>During the week that participants used the Serola Sacroiliac Belt, spine pain increased 0.2 compared with 0.9 on the NRS for those who did not use the belt. No statistically significant difference was observed for Nordic Musculoskeletal Questionnaire data or the flexion relaxation phenomenon test in this study.</p></div><div><h3>Conclusion</h3><p>The findings of this preliminary study suggest participants using the Serola Sacroiliac Belt while performing a daily repeated lifting task had less progression of their LBP. However, this protective value did not meet the recommended NRS for minimally clinically important difference, and there was no effect on functional impairment.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing Anatomic Variants of the Sciatic Nerve Using Diagnostic Ultrasound During Piriformis Muscle Injection: An Example of 4 Cases","authors":"Gamze Gül Güleç MD ,&nbsp;Kübra Neslihan Kurt Oktay MD ,&nbsp;İlknur Aktaş MD ,&nbsp;Barış Yılmaz MD","doi":"10.1016/j.jcm.2022.02.017","DOIUrl":"10.1016/j.jcm.2022.02.017","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this article is to present examples of patients in whom piriformis muscle (PM) and sciatic nerve<span> (SN) variations were detected by a diagnostic ultrasound (US)–guided examination and were successfully diagnosed and treated for piriformis syndrome (PS) by US-guided injections.</span></p></div><div><h3>Clinical Features</h3><p>This series includes 4 cases. In case 1, a 30-year-old woman with a 7 numeric rating scale (NRS) score for pain (on a 0-10 scale) was evaluated for complaints of left gluteal pain radiating to the thigh for 5 years and right gluteal pain for 2 years. Case 2 involves a 32-year-old man with a 7 NRS score presenting with left gluteal pain radiating to his leg for 1 year. The third case presents a 37-year-old man who had pain (6 NRS score), numbness, and discomfort radiating from the right hip to the leg that lasted for 7 years. Finally, in case 4, a 23-year-old male patient was examined with deep gluteal paresthesia and discomfort on the left side for 1 year.</p></div><div><h3>Intervention and Outcome</h3><p><span><span>Diagnostic US evaluation of the gluteal region for each patient revealed anatomical variations of the SN. In 3 of the cases, corresponding </span>contralateral US images demonstrated similar anatomic variations. Diagnosis of PS in each patient was made by US-guided injection. After the injection of 4 cm</span>³ of lidocaine 2% into the PM, the patients’ complaints resolved almost fully.</p></div><div><h3>Conclusion</h3><p>The anatomical variations of the SN and PM might be a facilitating factor for myofascial pain syndrome in PS. These cases demonstrate that SN variations could be visualized with the help of diagnostic US.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}