Issue Category: Volume 31

In this issue, our contributors review several interesting topics including multisensory myelopathy and central sensitization.

Dr. Brett Winchester’s Feature Article highlights how information from different sensory modalities may be integrated by the nervous system, and the considerable role of spinal manipulation, soft-tissue massage and rehabilitation in modulating dysfunctional afferent feedback.

Dr. Donald Murphy outlines the clinical relevance of cervical spine myelopathy, a common but at times overlooked source of neurological pain. He delivers an evidence-informed approach for managing myelopathy highlighting the importance of a thorough consultation and examination, along with a discussion of its appropriate management and careful monitoring.

In his Audio Lecture, Dr. Jeffrey Remsburg describes the pathophysiology behind nociception, including centrally-mediated pain or central sensitization. In addition, he provides clinical insights for managing chronic pain such as patient education, exercise and lifestyle changes.

Dr. Brian Gleberzon continues his Juris-Proofing series by exploring what constitutes “informed consent,” and Dr. Yasmeen Khan reviews the literature examining the effects of manual therapy on functional neurology.

I trust that you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, DC, MS, PhD
Editor-in-Chief

Welcome to the Summer 2019 issue of D.C. Tracts! In this issue, our contributors review the clinical consequences of thoracic spine pain. Although thoracic spine pain is a common clinical presentation, much of the scientific literature examining spinal conditions is focused on neck and low back pain, while the impact of thoracic spine pain on health and well-being seems generally overlooked.

This issue’s Feature Article provides an overview of thoracic spine pain, including the incidence/prevalence rates along with its health-burden and risk factors for thoracic impairments. In addition, it details the clinical significance of “red flags” and differential diagnoses for thoracic spinal conditions.

In his audio lecture, Dr. Patrick Battaglia delivers an in-depth analysis of the assessment of thoracic spine pain, including differentiating between specific and nonspecific causes of mid-back pain. He begins his lecture with a provocative quote from Dr. Nikolai Bogduk that explains that the understanding of thoracic spine pain, including its assessment and effective management, has scarcely advanced within the last century.

Dr. Adam Yoder’s lecture emphasizes evidence-informed management of thoracic spine pain, highlighting the role of exercise and manual therapy for managing thoracic conditions. More specifically, Dr. Yoder discusses the effectiveness of mobilization and manipulation as well as stabilization and strengthening exercises, along with the role of postural considerations.

In our abstracts and commentaries section, Dr. Yasmeen Khan highlights the role of chiropractic technique in the manual assessment of thoracic spine dysfunction, along with a case report emphasizing the importance of identifying warning signs and mindful diagnosis.

In addition, Dr. Gleberzon continues his Juris-Proofing discussion underscoring the role of patient communication, including the importance of complete disclosure of office policies and details related to patient management.

I trust that you will find this issue of D.C. Tracts both informative and interesting, and it will enrich both your clinical expertise and patient services.

Best Regards,
Bryan M. Bond, BSc, BS, DC, MS, PhD
Editor-in-Chief

This issue of D.C. Tracts is a thorough, insightful review of temporomandibular disorders (TMDs) related to their structural, functional, psychosocial and clinical characteristics. Considering TMD’s relatively high prevalence and significant financial burden, a comprehensive discussion of the clinical effects and conservative management is important.

In his lecture, Dr. Justin Hildebrand provides a brief overview of the anatomical and biomechanical considerations of TMD, as well as the clinical presentation and examination of the issue. He also shares some clinical insight for conservative management including modalities, soft-tissue massage and dry needling.

Dr. Christopher Kinslow lectures on the clinical relevance of TMD and the substantial cost of management. He further highlights the psychosocial factors associated with TMD such as stress, anxiety and depression, emphasizing the role of chiropractors in identifying risk factors and appropriately referring for co-management. Finally, he outlines the role of chiropractors in managing TMD through patient education, lifestyle recommendations and patient reassurance.

Dr. Bradley Muir’s feature article delivers an in-depth review of the anatomy and biomechanics of the temporomandibular joint. He outlines the functional and structural importance of the joint capsule, musculature, articular disc and ligaments, and conveys the importance of variations in normal resting jaw position.

I trust that you will find this issue of D.C. Tracts both informative and interesting, refining your clinical expertise and patient services.

Best regards,

Bryan M. Bond, BSc, BS, DC, MS, PhD
Editor-in-Chief