Page 111 - طب بديل مقصه_Neat

area of the spine, yet beneficial in another re gion.For example, hypermobility may be a
relative contraindication to manipulation in one area of the spine, although it may be
compensating for movement restriction in another where manipulation is the treatment
of choice.
Absolute contraindications: Absolute contraindications to spinal manipulative therapy are
conditions that should not be manipulated; these contraindications include;
1. Anomalies such as dens hypoplasia, unstable os odontoideum, etc.
2. Acute fracture
3. Spinal cord tumors
4. Acute infection such as osteomyelitis, septic discitis, and tuberculosis of the spine
5. Meningeal tumor
6. Hematomas, whether spinal cord or intra-canalicular
7. Malignancy of the spine
8. Dislocation of a vertebra
9. Internal fixation/stabilization devices
10. Signs or patterns of instability

Relative contraindications: are conditions where increased risk is acceptable in some
situations and where low-force and soft-tissue techniques are treatments of choice; these
contraindications include osteoporosis. Although most contraindications apply only to
manipulation of the affected region, some neurological signs indicate referral
to emergency medical services; these include sudden and severe headache or neck
pain unlike that previously experienced. Indirect risks of chiropractic involve delayed or
missed diagnoses through consulting a chiropractor.

Accidents and adverse reactions

Spinal manipulation is associated with frequent, mild and temporary adverse effects,
including new or worsening pain or stiffness in the affected region. They have been
estimated to occur in 33% to 61% of patients, and frequently occur within an hour of
treatment and disappear within 24 to 48 hours; adverse reactions appear to be more
common following manipulation than mobilization. The most frequently stated adverse
effects are mild headache, soreness, and briefly elevated pain fatigue.

Causes of complications and adverse reactions
• Lack of knowledge
• Lack of skill
• Lack of rational attitude and technique.

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