The Praeger Handbook of Chiropractic Health Care: Evidence-Based Practices by Cheryl Hawk

Author:Cheryl Hawk
Language: eng
Format: azw3
Publisher: ABC-CLIO
Published: 2017-03-31T04:00:00+00:00

One immediate goal of conservative treatment is to manage the patient’s pain. This can be done without medications by using electrical therapies such as transcutaneous electrical nerve stimulation (TENS), heat, ice, or topical creams. If the patient is comanaged with a medical physician, it may be appropriate to include nonsteroidal anti-inflammatory drugs, an epidural steroid injection, or, in carefully selected patients, short-term use of narcotics. Effective pain management is an important first step toward gaining patients’ confidence and keeping them committed to a nonsurgical approach. Some patients whose pain is not well managed come to believe that surgery will definitively “fix” their problem, but they seldom appreciate the risks involved with cervical spine surgery and how limited the evidence is for its long-term effectiveness in many cases of mild to moderate radiculopathy.

Most cases of radiculopathy will respond well to conservative chiropractic care that includes traction, soft tissue massage, mobilization, and exercise. Carefully applied HVLA manipulation to the involved spinal region is not necessarily contraindicated and is often helpful to restore proper spinal motion. Patients should be closely monitored, and if a patient develops true motor weakness or loss of sensation in the upper extremities or signs of spinal cord pressure, including loss of bowel or bladder control, timely referral for a surgical consultation is necessary to avoid potentially permanent nerve damage.

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