Technic and Practice of ChiropracticLoban, Joy Maxwell
Science
Technic and Practice of Chiropractic
Loban, Joy Maxwell
Chiropractic
A foot-note describing curvature may be appended to the record of
palpation. It should contain the special name of the curvature, whether
simple or compound, and the numbers of the first and last vertebrae in
it. For instance, note may read: “Right rotary scoliosis from D 3 to L
1 inclusive.”
Compensatory Curvatures
When a primary curvature is present one or two secondary curvatures
usually appear to preserve the equilibrium of the body. With a Dorsal
kyphosis there is often a Lumbar lordosis and sometimes less marked
lordosis in both Cervical and Lumbar. With a primary right scoliosis
in the Lumbar there will be a secondary left scoliosis above. The
secondary curvature is called compensatory. In selecting vertebrae for
adjustment it is well to neglect the compensatory curvature as much as
possible, leaving it to right itself as the primary one is corrected.
If, however, the primary curvature be a lordosis, and not adjustable,
work on the secondary curvature may gradually aid in reducing the
primary, to a certain extent at least.
Ankylosis
This topic is discussed here partly because it is so often associated
with curvature.
Ankylosis can be appreciated only by detecting the lack of normal
movement between adjacent vertebrae. Place a finger in the interspace
between suspected vertebrae and ask the patient to perform the movement
calculated to separate the spinous processes in a normally movable
spine. If in the Dorsals, ask him to drop the head and shoulders as far
forward as possible without bending at the hips. Alternate repetitions
of this movement with straightening and the spinous processes should
alternately separate and approach each other. Test several successive
vertebrae so as to note that all change their position except two.
In the Lumbars have the patient repeatedly bend the body forward from
the hips striving to make his spine convex backward. In the Cervicals
forward flexion of the head will serve. Occasionally general ankylosis
is found with curvature, as in Spondylitis Deformans.
Many Chiropractors mistake failure to move a vertebra with an attempted
adjustment for evidence of ankylosis. In nine cases out of ten such
failure is due to other reasons, ankylosis being very infrequent. It is
a much abused excuse for incapability. Free movement between spinous
processes is _absolute proof_ that the vertebrae are not ankylosed.
DIFFICULTIES IN PALPATION
The chief difficulty arises from failure to observe some of the rules
herein laid down.
Carelessness or inattention precludes accuracy.
Pain may cause the patient to assume an unnatural or cramped attitude
simulating curvature, especially of the Cervicals. More errors occur
from this cause in judging the laterality of C 2 than with any other
vertebra.
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