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Contraindications Of Chiropractic Manipulation Under Anesthesia

Saturday, November 26th, 2016

Contraindications of Chiropractic Manipulation Under Anesthesia


Ron Ayalon

According to the latest statistics, musculoskeletal injuries are the most common form of injuries seen in individuals of all age groups. While choosing a therapy whether surgical, medical or alternative medicine; the need is to choose a therapy that is cost-effective, economical and suitable for the injury. Chiropractic manipulation is helpful in a number of cases. Chiropractors are registered healthcare professionals who can identify, diagnose and treat injuries or pathology involving neuromuscular tissues.

Chiropractic procedures are generally safe but if spinal manipulation has to be performed, it is recommended to opt for manipulation under anesthesia considering the severity of pain and discomfort during procedure. However, it is a matter of personal choice and most patients who opt for spinal manipulation under anesthesia must have undertaken at least 6 to 8 sessions of non-manipulative chiropractic management to make the final choice.

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In some circumstances, spinal manipulation has to be performed under anesthesia for better muscle control. The benefits of using anesthesia under spinal manipulation are many. Spinal manipulation under anesthesia is mostly performed in patients with chronic fibrosis or repeated back surgeries that lead to scar formation and result in an overall decreased spinal range of movement. Using anesthesia in these patients improves the muscular motion by shutting off spasmodic muscular pain giving a higher degree of liberty to the chiropractor to perform manipulation. It is also performed in chronic nerve entrapment syndromes. Under the influence of anesthesia, inflamed and irritated nerves also get sedated that makes it easier for the chiropractor to perform spinal manipulation and it will also be easier for patient to bear the pain. Chronic torticollis and fibromyalgia are also special indications in which spinal manipulation under anesthesia is performed. Under anesthesia, the chiropractor can loosen up scar tissue and adhesions by optimal relaxation of small muscle groups. Nerve issues like pseudo-sciatica in which the nerves are sensitive and inflamed is another indication. The risk of procedure induced pain and stiffness is very high with manual manipulation unless anesthesia is used.

Manual spinal manipulation must be avoided in certain conditions where manipulation may affect the integrity of bones or may lead to a life threatening sequelae. This includes deranged bones that are weak and fragile, disorders of bone that are associated with local bone destruction (like tumor or bone abscess) and other circulatory or neurological disorders.

The contraindications of spinal manipulation under anesthesia include complicative bone disorders like tumor causing cord compression as any manipulation may distort bone and may lead to tumor lysis syndrome that may prove life threatening. Acute gouty attack or acute attack of arthritis is another contraindication for the procedure as the inflamed tissue is more sensitive to pain and post-procedure pain and discomfort may significantly alter normal daily activities. Moreover, the healing process will also be slow and impaired in inflamed tissues. Fracture of the neighboring bone is an absolute contraindication to any spinal manipulation and in any such case, the procedure should be delayed until the fracture is reduced and healed. This is because fractured bony fragments may dislodge from the site of manipulation and may affect the integrity of neighboring soft tissues. Active bone infections or the presence of abscess like state (Syphilitic arthritis, Gonorrheal arthritis) or osteopenic bone disorders like osteoporosis are an absolute contraindication for chiropractic manipulation under anesthesia due to the risk of post-procedure sepsis and risk of fractures as a result of bone fragmentation respectively. Other contraindications include uncontrolled diabetic neuropathy and similar issues.

Although chiropractic manipulation under anesthesia is a great choice in individuals who are not ideal candidates for manual spinal manipulation, certain medical and organic issues can interfere with the efficacy of therapy. It is therefore recommended to discuss your case with your healthcare provider before choosing chiropractic manipulation under anesthesia.

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Contraindications of Chiropractic Manipulation Under Anesthesia