Thomas A. Souza - Differential Diagnosis and Management for the Chiropractor

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Publisher: Cathy L. Esperti

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Associate Editor: Kayla Dos Santos

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Library of Congress Cataloging-in-Publication Data

Souza, Thomas A., author.

Differential diagnosis and management for the chiropractor : protocols and algorithms / Thomas A. Souza. Fifth edition.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-284-02230-8

I. Title.

[DNLM: 1. Chiropracticmethods. 2. Algorithms. 3. Clinical Protocols. 4. Diagnosis, Differential. WB 905]

RZ250

615.534dc23

2014029050

6048

Printed in the United States of America

18 17 16 15 14 10 9 8 7 6 5 4 3 2 1

To Aaron.

CONTENTS

ACKNOWLEDGMENTS

I would like to express my appreciation to those who have contributed to editing the Fifth Edition. This includes many of the academic deans and department chairs at various chiropractic colleges and suggestions from practitioners and students. As usual, a task this size is not possible without the dedication and hard work of the editorial and production staff at Jones & Bartlett. Special thanks to Kayla Dos Santos, Joanna Lundeen, Ryan Angel, Vastavikta Sharma, Julie Searls, and everyone else who assisted in this project.

INTRODUCTION

I n the five years since the previous edition of this book, there have been dramatic changes to the U.S. healthcare system that, in concept and evolution, will be placing more demand on evidence and outcomes. The literature has been exponentially growing, providing more evidence not only in the area of diagnostic accuracy but also outcomes. With that carries a larger responsibility for the average practitioner who has little time to keep up with these advances. The intention, always, with this text is to provide a predigested and critiqued summary of what is known and is likely to be relevant to the practicing chiropractor as well as to students who will need to understand processes of critical thinking and also have a quick option for evaluating complaints.

Chiropractors are finally positioned to become part of what is coined the Patient-Centered Medical Home (PCMH) or whatever future evolution this may involve. As part of a healthcare team, chiropractors can not only participate as spine specialists but also apply their broader knowledge to be participants in a well-integrated support group for patients.

In 2013, the North American Spine Society, in its guidelines for lumbar disc-related radiculopathy, listed manipulation as a viable option. In addition, other approaches such as directional-preference exercise approaches are good adjunctive and safe procedures.

In the field of physiotherapy and rehabilitation, some new approaches, or older approaches with new evidence, are dominating the discussion, including the use of shockwave therapy, low-level laser treatment, injections such as plasma rich protein (PRP), and vibration therapy, among others. The literature is growing and indicates that these alternatives are possible options to surgical management.

At the same time, gene-related approaches in both medication selection and surgical options are growing. In the case of stem-cell research, with advances in the use of adipose-derived cells, new opportunities for replacing worn-out or damaged tissues have become a potential reality in the near future.

New to this Edition

As usual, there have been a number of major revisions and additions to this new edition. These include but are not exclusive to the following: