M.Tech. / Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was hypothesised that both treatment protocols would be effective in the treatment of mechanical neck pain, although the combined therapy would be more effective. Method: Patients were recruited by way of advertisements placed in and around the University of Johannesburg, Doornfontein campus and their health clinic. Thirty patients with mechanical neck pain were recruited and randomly divided into two groups. Group one received manipulation to the affected joints of the cervical spine and group two received manipulation to the cervical spine combined with magnetic field therapy on acupuncture points. Procedure: Each patient in each group attended six treatment sessions; three in the first week and three in the second week. The Vernon Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale (subjective measurements) were completed by each patient and the Cervical Range of Motion instrument (objective measurements) was used to collect readings from each patient in both the control and experimental groups, subjective and objective measurements were taken before treatment one, three and six. Specific treatment protocols were then adhered to. Results: The results indicated that both treatment protocols were effective in reducing mechanical neck pain although not one group was more effective than VI the other. Both groups improved subjectively and objectively as they had cervical spinal manipulation directed at joint dysfunction. Conclusion: The experimental group who received spinal manipulative therapy to correct joint dysfunction in conjunction with magnetic field therapy on acupuncture points was not more effective than the control group who received spinal manipulation only, in the treatment of mechanical neck pain.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / Impingement syndrome of the shoulder is a very common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this investigation was to investigate the effectiveness of the chiropractic adjustment in order to determine whether or not it is an effective approach in the treatment of impingement syndrome / M

M.Tech. / Purpose: Posterior mechanical neck pain is considered a debilitating musculoskeletal problem and is one of the most common reasons for visiting an emergency sector (Murphy, 2000). This study aims to compare the effects of Chiropractic manipulative therapy directed at the thoracic spine to that directed at the cervical spine for the treatment of chronic neck pain with regards to pain, disability and cervical range of motion. Method: This study was a comparative study and consisted of two groups of fifteen. The participants were between the ages of eighteen and forty-five, with a half male to female ratio. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The method of treatment administered to each participant was determined by group allocation. Group 1 received chiropractic spinal manipulative therapy to restriction(s) of the upper thoracic region only. Group 2 received chiropractic spinal manipulative therapy to restriction(s) of the cervical spine only. Objective and subjective findings were based on the above treatment protocols. Procedure: Treatment consisted of six treatment consultations with an additional follow up consultation over a three week period, with two consultations being performed per week interval. Objective and subjective readings were taken at the beginning of the first, fourth and seventh consultations. Subjective readings were taken from the Vernon-Mior Neck Pain and Disability Index as well as from the Numerical Pain Rating Scale (NPRS). Objective readings were taken from measurements taken from the Cervical Range of Motion device (CROM). Analysis of collected data was performed by a statistician. The Chiropractic manipulative techniques used were based on restrictions identified during motion palpation and were applied at the first six consultations, with the seventh consultation consisting of data gathering only. Results: Clinically significant improvements in both Group 1 and Group 2 were seen over the course of the study with regards to cervical spine range of motion, pain and disability. However group 1 showed greater statistically significant improvements in their mean cervical range of motion whereas group 2 showed a greater statistically significant improvement in their subjective readings of pain and disability.

M.Tech. (Chiropractic) / Introduction: Neck pain is a common condition which affects up to 70 percent of people at some point in their lives, and at any given time about 10 to 20 percent of the population reports neck problems. Although spinal manipulation on its own is effective in the treatment of chronic neck pain, chiropractors continue to search adjunctive modalities to improve the positive outcomes of their treatment. Therefore, it is important to look for the best possible treatment protocol as well as research alternatives, should contraindications for present protocols, such as spinal manipulation, arise. One such alternative could be Kinesio® taping. The purpose of this study was to determine the efficacy of utilising Kinesio® taping, spinal manipulation or the two therapies combined, for the treatment of chronic neck pain. It will also provide further evidence on the efficacy of spinal manipulation and Kinesio® taping in isolation. Method: This study was a comparative study consisting of three groups of ten participants. The method of treatment was determined by random group allocation. Group 1 received spinal manipulation to restriction(s) of the cervical spine only. Group 2 received Kinesio® taping to the longissimus cervicis muscles only. Group 3 received a combination of spinal manipulation and Kinesio® taping as previously described. Subjective measurements consisted of the Vernon-Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale (NPRS) and objective measurements was assessed in degrees by making use of the Cervical-range-of-motion (CROM) instrument. Procedure: There were seven consultations in total. There were six treatment consultations over three weeks. The seventh consultation consisted of data collection only. Subjective and objective measurements were taken prior to treatment on the first and fourth consultation, and on the seventh consultation where no treatment took place. Subjective readings were taken from the Vernon-Mior Neck Pain and Disability Index and the NPRS. Objective readings were assessed in degrees by making use of the Cervical-range-of-motion (CROM) instrument. Results: It was evident from the data that all three groups responded well to their respective treatment protocols. With regards to the subjective measurements Group 1, 2 and 3 demonstrated statistically significant improvement in both neck pain severity and functional disability. As Group 1 had the highest clinical improvement with regards to the NPRS, it indicates that the Group 1 treatment protocol was more effective in decreasing the pain intensity throughout the treatment period. All three groups responded similarly with regards to the Vernon-Mior Neck Pain and Disability Index, although Group 1 responded the best clinically. With regards to the objective measurements Group 1, 2 and 3 demonstrated statistically significant improvement in all ranges of motion of the cervical spine. However, it was found that Group 3 clinically responded best to treatments in all the ranges of motion except for right lateral flexion in which Group 2 responded best to treatment. Conclusion: The study showed that the treatment protocols for Group 1, 2 and 3 were effective in treating chronic neck pain. The evidence suggests that the Group 1 treatment protocol, which received spinal manipulation, is more effective than Kinesio® taping alone and the two therapies combined in decreasing pain intensity and functional disability in the treatment of chronic neck pain. The evidence further suggests that the Group 3 treatment protocol, which received spinal manipulation in combination with Kinesio® taping, is more effective than spinal manipulation and Kinesio® taping alone in increasing all cervical spine ranges of motion in the treatment of chronic neck pain.

M.Tech. (Chiropractic) / Purpose: The aim of this comparative study was to compare the effects of spinal adjustment with static passive stretch to the cervical spine, and spinal adjustment with proprioceptive neuromuscular facilitation to the cervical spine in the treatment of chronic posterior neck pain with regards to pain, disability and cervical spine range of motion. These effects were based on a questionnaire consisting of a Numerical Pain Rating Scale, a Vernon-Mior Neck Pain and Disability Index Questionnaire, and on cervical spine ROM readings taken using an analogous cervical spine ROM inclinometer. The questionnaire was completed and the ROM readings taken prior to treatment at the first, fourth and seventh consultation. Method: Thirty participants who met the inclusion criteria were randomly diversified in number and gender between two groups of equal size (15 participants each). Group one received spinal adjustment/s to restricted cervical spine joints followed by static passive stretching. The second group received spinal adjustment/s to restricted cervical spine joints followed by proprioceptive neuromuscular facilitation. Participants were treated six times out of a total of seven sessions, over a maximum three week period. Procedure: Subjective data was collected at the beginning of the first and fourth consultations, as well as on the seventh consultation by means of a Numerical Pain Rating Scale (NPRS) and a Vernon-Mior Neck Pain and Disability Questionnaire in order to assess pain and disability levels. Objective data was collected at the beginning of the first and fourth session, as well as on the seventh consultation by means of a cervical spine range of motion inclinometer in order to assess cervical spine range of motion. Analysis of collected data was performed by a statistician. Results: Clinically significant improvements in group 1 and group 2 were noted over the duration of the study with reference to pain, disability, and cervical spine range of motion. Statistically significant changes were noted in group 1 and group 2 with reference to pain, disability, and cervical spine range of motion over time except for cervical spine extension range of motion.

M. Tech. / Purpose: Many studies have shown the effect of treatment of the cervical spine on parts distant to the spine itself, which are linked anatomically, biomechanically or neurologically, e.g. the temporomandibular joint (Curl, 1994). Curl (1994) reports a neurological link between the cervical spine and the temporomandibular joint, and Reggars (1994) reports a biomechanical link between the temporomandibular joint and cervical spine. These links may affect the cervical spine when adjusting the temporomandibular joint. For these reasons, further study is necessary to establish the possibility of temporomandibular joint involvement in the formation of neck pain, and the possibility of chiropractic manipulative therapy delivered to the temporomandibular joint as a successful alternative treatment for neck pain. The purpose of the study was to determine the effectiveness of chiropractic adjustment of the temporomandibular joint, compared to cervical spine adjustment of the upper cervical spine as a treatment form for neck pain, with regards to pain, disability and cervical spine range of motion. Method: This study consisted of two groups of 15 participants between the ages of eighteen to thirty-five, similar in age and gender ratios. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The method of treatment administered to each participant was determined by group allocation. Group 1 received chiropractic adjustment techniques delivered to the temporomandibular joint and group 2 received cervical spine adjustment techniques delivered to restrictions of the upper cervical spine.

M.Tech. / Purpose: Posterior mechanical neck pain is considered a debilitating musculoskeletal problem and is one of the most common reasons for visiting an emergency department (Murphy, 2000). Anti-inflammatory creams and gels are readily available to individuals suffering from musculoskeletal pain. The purpose of this study was to determine the effectiveness of Traumeel®S ointment together with chiropractic spinal manipulative therapy as a treatment form for posterior mechanical neck pain, with regards to pain, disability and cervical spine range of motion. Method: This study was a comparative study and consisted of two groups of fifteen. The participants were between the ages of eighteen and forty-five, with a half male to female ratio. The potential participants were examined and accepted according to the inclusion and exclusion criteria. Group A received chiropractic spinal manipulative therapy followed by the application of aqueous cream over the upper trapezius muscle area of the posterior neck. This was the placebo group. Group B received chiropractic spinal manipulative therapy followed by the application of Traumeel®S ointment over the upper trapezius muscle area of the posterior neck. This was the experimental group. Objective and subjective findings were based on the above treatment protocols. Procedure: Treatment consisted of seven consultations over a three week period. Objective and subjective readings were taken at the beginning of the first, fourth and seventh consultations. Subjective readings were taken from the Vernon-Mior Neck Pain and Disability Index as well as from the Visual Analogue Scale (VAS). Objective readings were taken from measurements taken from the Cervical Range of Motion device (CROM). At the first to the sixth consultations participants received spinal manipulative therapy with either the application of aqueous cream or the application of Traumeel®S ointment depending on whether they were in group A or group B. Results: Clinically and statistically significant improvements in both group A and group B were seen over the course of the study with regards to cervical spine range of motion, pain and disability. Conclusion: The results show that both treatment protocols were effective in decreasing cervical spine pain and disability and increasing cervical spine ROM. Group B receiving Traumeel®S ointment did show a greater increase in cervical spine ROM clinically, but statistically there was no significant difference between the two groups.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Musculoskeletal disorders (MSDs) are a significant and common occupational health concern, consequently impacting work attendance and performance. High prevalence rates of MSDs have been reported amongst school teachers. Studies have linked these higher prevalence rates to typical daily teaching activities including prolonged standing, awkward postures, heavy lifting, bending and repetitive movements. Objectives: To determine the prevalence of neck, shoulder and low back pain among primary school teachers in the Central Durban area; to identify any risk factors associated with neck, shoulder and low back pain; and to establish the relationship, if any, between the prevalence and risk factors of neck, shoulder and low back pain among primary school teachers. Methods: This was a quantitative, descriptive and cross-sectional study, conducted in 12 selected public primary schools within the Central Durban area. Volunteers who met the inclusion criteria (n = 97) were invited to complete self-administered questionnaires. Results: Of the 97 completed questionnaires 83.1 percent (%) reported neck and shoulder pain and 71.0% low back pain. Neck and shoulder pain were significantly associated with a forward-bent head posture (p = 0.001), ethnicity (p = 0.001), and history of a severe trauma/injury (p = 0.006). Similarly, significant associations were noted with regards to medical conditions (p = 0.006), a backward-bent head posture (p = 0.016), lifting of heavy loads (p = 0.045) and treatment for severe injury (p = 0.047). Associations were also noted between low back pain and prolonged standing (p = 0.000), ethnicity (p = 0.008), transportation methods (p = 0.023), medical conditions (p = 0.031) and a history of a severe trauma/injury (p = 0.049). Conclusion: This is a first South African study, to our knowledge that highlights increased prevalence rates for both neck and shoulder pain and low back pain amongst teachers, with a variety of associated risk factors. This draws attention to the urgent need for intervention programs to be implemented to prevent/reduce the development of musculoskeletal pain amongst teachers. / M

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Background: Myofascial pain is the most common cause of persistent regional pain such as back pain, shoulder pain, tension-type headaches and facial pain. A variety of therapeutic modalities are proposed in the treatment of myofascial pain including massage. A variety of massage oils are available on the market, each claiming therapeutic efficacy. Most of these claims, however, have not been verified through clinical trials. Methods: A double-blinded placebo controlled study in which 80 subjects were randomly divided into 4 groups of twenty. Subjects in Group 1 received unscented mineral oil, those in Group 2 received scented mineral oil. Subjects in Group 4 received Arnica Massage oil while those in Group 4 received Blue Steel Arnica Massage oil. Results and Conclusions: The use of Arnica Massage oil or Blue Steel Arnica Massage oil resulted in almost 50 % pain reduction in the subjects after five days of self-administered treatment. Both these products can be recommended for the treatment of myofascial pain syndromes but one cannot be placed in preference to the other, as the results were similar with regards to their effectiveness.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background Literature has shown that clinical and radiological diagnoses do not always correlate in patients with neck pain (Ferrari and Russel, 2003; Peterson and Hsu, 2004). It is not known if this applies to the Chiropractic Day Clinic (CDC) at the Durban University of Technology (DUT) and if the radiological diagnosis leads to a change in the patient’s initial management plan. The impact of cervical spine plain film radiographs will therefore be investigated in the diagnosis and management of patients that presented with neck pain to the CDC at the DUT. It is also not known whether the reason for referral for cervical spine plain film radiographs is always indicated as per the indications in the clinic handbook and radiological referral guidelines. Objectives Objectives were: (1) To determine the suspected pre-radiographic clinical diagnosis and management of the selected clinical records prior to referral for cervical spine plain film radiography; (2) To record the reasoning to send for cervical spine plain film radiographic imaging and to establish whether these are in line with proposed guidelines for referral as found in the literature; (3) To determine the relationship between the suspected pre-radiographic clinical and the radiological diagnoses of patients with neck pain; (4) To determine the number of incidental findings in the selected patients’ plain film radiographs; (5) To determine any change in the pre-radiographic clinical diagnoses and management following radiological reporting of the selected patient’s plain film radiographs. Method This was a quantitative, retrospective, clinical study. The archives at the CDC at the DUT were searched for cervical spine plain film radiographs between 1 January 1997 to 31 December 2013 and these were matched with the corresponding clinical records. After applying the inclusion and exclusion criteria, 73 records were included in the study. The patient’s personal information was coded to ensure confidentiality (Appendix A) and specific clinical and radiological information was recorded (Appendix B). Statistical analysis included the use of frequency counts, percentages, mean, standard deviation and range for the descriptive objectives. Results A total of 73 clinical files and corresponding plain film radiographs were assessed. The mean age of the patients was 44 years. The gender distribution was 64.4% (n=47) females and 35.6% (n=26) males. The most frequent primary radiological diagnosis was loss of lordosis at 41.1% (n=30) followed by cervical spondylosis at 35.6% (n=26) and old cervical spinal trauma at 12.3% (n=9). Sixty four percent (n=47) of patients in this study were sent for cervical spine plain film radiographs after their initial clinical consultation. Reasons that are not considered relevant indications for plain film radiographic referral were present in 46.2% (n=34) of cases; these described non-specific mechanical disorders. The most common reason for plain film radiographic referral was due to positive orthopaedic tests 57.5% (n=42). A total of 27.4% (n=20) of clinical files reviewed had a change in their initial clinical diagnosis and 72.6% (n=53) of these patients had no change in diagnosis. All of the post-radiographic clinical diagnoses were non-specific mechanical conditions. Numerous treatment modalities were utilized by the students with the most common pre-radiographic treatment being soft tissue therapy at 63.0% (n=46). A total of 75% (n=55) of patients had a change of treatment after plain film radiographs were performed and spinal manipulative therapy (SMT) was the main treatment added in 41% of cases. Conclusion Cervical spine plain film radiographs have little impact on the diagnosis of patients with non-specific mechanical neck pain without red flags. It was however found that plain film radiographs had an impact on the management in the majority of cases, especially with an increase in SMT use after plain film radiographs. / M