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Sakthivelnathan V, Somerson JS, Alijanipour P. Clinical Diagnosis of Common Overlapping Shoulder and Cervical Spine Disorders: A Review of Current Evidence. JBJS Rev 2023; 11:01874474-202311000-00006. [PMID: 37976388 DOI: 10.2106/jbjs.rvw.23.00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
» Pain in the shoulder is a common orthopaedic complaint that can be caused by shoulder or neck pathologies.» Shoulder and neck pathologies often coexist, among which one may be a predisposing factor for the other.» History, physical examination, and diagnostic injections can be used to discern the cause of shoulder pain and guide treatment.
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Affiliation(s)
| | - Jeremy S Somerson
- Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas
| | - Pouya Alijanipour
- Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas
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Unlocking Athletic Potential: The Integration of Chiropractic Care into the Sports Industry and Its Impact on the Performance and Health of Athletes and Economic Growth in China and Hong Kong. Cureus 2023; 15:e37157. [PMID: 37034139 PMCID: PMC10075015 DOI: 10.7759/cureus.37157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
This study explores the significant role chiropractic care can play in the sports industry, with a focus on countries like China and Hong Kong. As a vital component of sports medicine, chiropractic care can enhance athletic performance, health, and competitiveness by addressing biomechanical imbalances and optimizing neuromuscular function. The potential impact of chiropractic care on the sports industry includes attracting international events and investments, leading to increased economic opportunities, and the overall growth of the industry. Key strategies for promoting chiropractic care in the sports industry encompass developing a robust chiropractic care infrastructure, raising public awareness through targeted campaigns, and implementing supportive policies by governments and sports organizations. The integration of chiropractic care within sports medicine not only benefits individual athletes but also contributes to the broader development and success of the sports industry as a whole.
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Chu EY, Mok TKS, Ng GSN, Chu ECP. Pediatric Text Neck Syndrome. Cureus 2023; 15:e38034. [PMID: 37101802 PMCID: PMC10123387 DOI: 10.7759/cureus.38034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 04/28/2023] Open
Abstract
Text neck syndrome is a growing concern in the pediatric population due to the increased use of mobile devices and screens, potentially leading to long-lasting musculoskeletal issues. This case report presents a six-year-old boy with a one-month history of cephalgia and cervicalgia, who initially received insufficient care. After nine months of chiropractic intervention, the patient reported significant improvements in pain relief, neck mobility, and neurological symptoms, supported by radiographic findings. This report emphasizes the importance of early recognition and intervention in pediatric patients, as well as the role of ergonomics, exercise, and proper smartphone usage habits in preventing text neck and maintaining spinal health.
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Affiliation(s)
- Eden Yt Chu
- Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Tze Kwan Sharon Mok
- Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Gabriel Siu Nam Ng
- Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Eric Chun-Pu Chu
- Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
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Lin AFC, Chu ECP, Chu VK, Chan V, Leung AC, Lau RP, Lam KK, Yeung JC, Leung K, Ng L. Recognizing Hong Kong Chiropractors’ Sick Leave Authority: Valuing a Conservative Approach to Workers’ Compensation. Cureus 2023; 15:e36879. [PMID: 37009394 PMCID: PMC10060046 DOI: 10.7759/cureus.36879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 03/30/2023] Open
Abstract
Although registered under Hong Kong's legislative framework, chiropractors are not able to certify sick leave, restricting the effectiveness of their services for patients with musculoskeletal issues requiring time away from work. This paper explores the evolution of chiropractic regulation in Hong Kong, the growth of the profession, and the tardy recognition of chiropractors' power to issue sick leave certificates. The chiropractic profession and its patients have long lobbied for this authority, but the government has been slow to respond. This document presents a comprehensive analysis of the benefits and restrictions of allowing chiropractors prescriptive authority for sick leave and requests that this change in policy be considered. Developing responsible criteria for chiropractors to prescribe sick leave within their scope of practice could legitimize chiropractic's position in the population's health and interdisciplinary pain care while lowering the burden on injured workers.
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Chu ECP, Lee WT, Chau C, Wong E, Cheng HY. Temporomandibular Disorder Treated With Chiropractic Therapy. Cureus 2023; 15:e36377. [PMID: 36945237 PMCID: PMC10025577 DOI: 10.7759/cureus.36377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/23/2023] Open
Abstract
Temporomandibular disorders (TMDs) are common and affect the temporomandibular joint (TMJ) and surrounding musculoskeletal tissues. Although traditional rehabilitative treatments such as physiotherapy, occlusal splints, orthodontics, and electrotherapy effectively manage TMDs, chiropractic therapy is emerging as a promising non-invasive treatment option. We report a 39-year-old female patient with TMD who underwent chiropractic therapy, including spinal adjustments, soft tissue therapy, and exercise rehabilitation. After four weeks of treatment, the patient reported a complete resolution of symptoms and an improved quality of life score. Thereafter, the patient continued chiropractic treatment monthly for six months, during which she reported no symptoms and demonstrated improvements in her spinal range of motion, open-mouth anatomy, and cervical lordosis. This case study highlights the efficacy of applying an interdisciplinary approach to treating TMD and the potential of chiropractic therapy as a valuable treatment option for managing TMD.
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Affiliation(s)
- Eric Chun-Pu Chu
- Department of Chiropractic, New York Medical Group, EC Healthcare, Kowloon, HKG
| | - Wai Ting Lee
- Department of Chiropractic, New York Medical Group, EC Healthcare, Kowloon, HKG
| | - Cherie Chau
- Department of Chiropractic, New York Medical Group, EC Healthcare, Kowloon, HKG
| | - Emmanuel Wong
- Department of Chiropractic, New York Medical Group, EC Healthcare, Kowloon, HKG
| | - Hay Yeung Cheng
- Department of Chiropractic, New York Medical Group, EC Healthcare, Kowloon, HKG
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Chu ECP. Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina. J Med Cases 2022; 13:545-550. [PMID: 36506762 PMCID: PMC9728145 DOI: 10.14740/jmc4025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/28/2022] Open
Abstract
Patients presenting with chest pain to the emergency department constitute a diagnostic challenge as 77% of the patients' symptoms are not cardiac. Diagnostic uncertainty is a pervasive issue in primary care. A 56-year-old man presented with non-traumatic chest pain and chronic neck pain for 2 years, as well as numbness in his right third and fourth fingers for 6 months. It was not associated with palpitation, orthopnea or pedal edema. Except for hyperglycemia, no abnormal findings were found in diagnostic tests. At that time, he was being treated for type 2 diabetes using glucose-lowering drugs in order to lower his blood glucose and lessen his risk of heart disease. The cause of his chest pain remained unknown. Following a second opinion from an orthopedist, the patient was diagnosed with cervical radiculopathy and was treated with analgesics and physical therapy. Because the treatments had only provided temporary pain relief for the previous 6 months, he sought chiropractic care for pain relief. The patient's vital signs were stable and within normal limits during the assessment. A restricted neck movement, a positive Spurling test, and hypoesthesia in the right C7 dermatome were seen. Cervical radiographs revealed degenerative spondylosis with right C5/C6 neuroforaminal stenoses and bilateral C6/C7 neuroforaminal stenoses. A provisional diagnosis of cervical spondylotic radiculopathy associated with cervicogenic angina (CA) was made. Chiropractic procedures, including cervical manipulation, instrumented soft tissue mobilization, and motorized intermittent neck traction, were performed two to three times per week. After 3 months, the patient reported that the chest pain, neck pain, and radicular symptoms had completely resolved. Repeated radiographs taken during the 11th month follow-up revealed a comparable improvement in the increased spacing of the restricted neuroforamina, which could signify a beneficial alteration related to cervical function retrieval. CA is an angina-like chest pain caused by cervical spine disorders. This study adds to our understanding of the biomechanical impact of cervical radiculopathy on chest pain, which has largely been overlooked during diagnostic workups. Once cervical radiculopathy has been identified, CA symptoms can be eased by alleviating the noxious input stemming from the pinched nerve roots.
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Affiliation(s)
- Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Center, Hong Kong, China.
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Chu ECP, Chen ATC, Chiang R, Trager R. Unusual worm-like radiopacities in the radiographs of patients with cervical spondylosis. J Med Life 2022; 15:1449-1454. [PMID: 36567841 PMCID: PMC9762373 DOI: 10.25122/jml-2022-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/22/2022] [Indexed: 12/27/2022] Open
Abstract
This report describes three patients with cervical spondylosis whose diagnostic radiographs showed worm-like, irregularly curved radiopaque lines and strings in the head and neck region during routine chiropractic examinations. Such artifacts are frequently misinterpreted as parasitic infection, electrostatic discharges, detector image lag, fracture, or ligature wires. All three patients with worm-like radiopacities disclosed their 15-20 years of history of acupuncture treatment to relieve neck pain. The present cases of unexpected and coincidental findings may suggest a possible acupuncture-caused radiographic artifacts in the neck and jaw bones. In particular, the patient had previous gold thread treatments possibly associated with the observed radiographic artifacts. These cases may emphasize the importance of having a thorough understanding of patient history regarding unexpected radiographic artifacts.
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Affiliation(s)
- Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China,Corresponding Author: Eric Chun-Pu Chu, New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China. E-mail:
| | - Alan Te-Chang Chen
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China
| | - Ricky Chiang
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Robert Trager
- Connor Whole Health, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States of America
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Chu ECP. Preventing the progression of text neck in a young man: A case report. Radiol Case Rep 2022; 17:978-982. [PMID: 35106108 PMCID: PMC8784282 DOI: 10.1016/j.radcr.2021.12.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
Text neck describes an overuse injury of the cervical spine resulting from the repetitive stress of prolonged forward head flexion while looking down on a mobile screen. This case report describes a 24-year-old young man who presented with a 12-month history of head and neck pain and paresthesia of the right upper limb. The patient worked as a YouTuber and has been editing and posting videos on the website for three years. One year prior to referral for chiropractic assessment, the patient first visited his family physician for similar complaints. Based on cervical radiographs, the diagnosis of cervical spondylosis was given. Previous management included pain medication and muscle relaxants. Interventions included repeated physical therapy, cervical traction, and acupuncture, with some temporary relief during the subsequent year. However, severe flare-up of the symptoms occurred, which was brought about by working for extended periods on his smartphone, for which the patient sought chiropractic attention. X-ray imaging showed cervical kyphosis with C5 vertebral rotation, hypertonicity of the paraspinal muscles, and paresthesia in the right C6 dermatome distribution, which were consistent with text neck syndrome associated with cervical spondylosis and right C6 radiculopathy. The intervention consisted of improving posture while texting, cervical manipulation, and extension traction therapy. After 9 months of treatment sessions, the symptomatic and functional improvement was reflected by the radiographic changes in the cervical curve correction and the normalized paraspinal muscle tension on surface electromyology. Frequent breaks along with correct posture while using smartphones will be the key entities to prevent the occurrence of text neck syndrome.
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Affiliation(s)
- Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Centre, 41/F Langham Place Office Tower, 8 Argyle Street, Hong Kong SAR, China
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