STRUCTURAL REHABILITATION OF THE SPINE AND POSTURE - RATIONALE FOR TREATMENT BEYOND THE RESOLUTION OF SYMPTOMS

Objective: To provide a rationale for active chiropractic rehabilitati ve treatment that extends beyond the single goal of resolution of symp tomatic complaints. Data Collection: A manual search of available refe rence texts and a search of MEDLINE were collected with an emphasis on tissue healing sequelae and the role of mechanical loading on this pr ocess. Results: The reviewed material indicates that all tissue growth and repair is influenced by mechanical loading and body posture and i s positively affected by body postures that normalize/minimize adverse mechanical stresses and strains. Altered alignment of the human frame may lead to poor healing of the body tissues and eventual pathologica l architectural changes may occur in muscle, ligament, bone and centra l nervous system. Minimization of altered postural/structural loading of the human frame may take longer than resolution, or maximal reducti on, of offensive symptoms. By itself, a patient's perception of pain i s not a valid indicator of health. Conclusions: Because mechanical loa ding of the neuromusculoskeletal tissues plays a vital role in influen cing proper growth and repair, chiropractic rehabilitative care should focus on the normalization/minimization of aberrant stresses and stra ins acting on spinal tissues. Manipulation alone cannot restore body p ostures or improve an altered sagittal spinal curve. Therefore, postur al chiropractic adjustments, active exercises and stretches, resting s pinal blocking procedures, extension traction and ergonomic education are deemed necessary for maximal spinal rehabilitation. Chiropractic s tudies that demonstrate structural improvements are sorely lacking and needed. The use of passive treatment modalities as the sole means of chiropractic intervention for the management of patients suffering wit h neuromusculoskeletal dysfunction no longer has a place in modem chir opractic practice after the acute phase of healing has passed.