Carpal tunnel ultrasonographic findings

The authors of a recent paper on electrodiagnostics and sonography suggest that carpal tunnel syndrome is the most common peripheral focal mononeuropathy. Demyelination of the median nerve at the wrist is the early underlying pathology, and ultrasonography can help differentiate carpal tunnel syndrome from radiculopathy and brachial plexus irritation. Read more

Complexity of spinal manipulation research

The Spine Journal has published a systematic review and meta-analysis suggesting that “there is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain”. Going further, the authors (Coulter, Crawford, Hurwitz et al) state that “manipulation appears to produce a larger effect than mobilization.” Importantly they also state that “Both therapies appear safe.”

The same edition of the journal publishes a response from O’Keefe, Griffin and O’Sullivan that is critical of the study, saying that they have excluded papers that could have been included; that in 7 of the 9 included studies it would be impossible to determine the contribution of manipulation to the treatment effect; and that the review was not registered in advance. Read more