A conservative management protocol for calcific tendinitis of the shoulder.

OBJECTIVE: This paper presents a management protocol for calcific tendinitis and describes its effective application in 2 cases of calcific tendinitis of the supraspinatus tendon in middle-aged women. CLINICAL FEATURES: Two patients presented to a chiropractic clinic with previously diagnosed calcific tendinitis of the supraspinatus tendon. Both patients complained of chronic pain and tenderness in the shoulder region and had a limited range of shoulder motion as a result of the pain. Radiographs demonstrated calcific deposits in the region of the supraspinatus tendon. INTERVENTION AND OUTCOMES: Both patients were admitted to a treatment protocol involving approximately 20 sessions of phonophoresis (driving of medication into tissue by ultrasound) with Movelat cream followed by cross-friction massage to the supraspinatus tendon and range of motion exercises. A second set of radiographs was requested. The calcific deposits, clearly seen on the previous radiographs, were no longer visible, and symptoms were resolved. At 4-month follow up, both patients continued to be symptom-free. CONCLUSION: The result of these studies indicates that the management of calcific tendinitis falls within the scope of chiropractic practice and supports the use of a trial period of conservative management in cases of calcific tendinitis before consideration of surgical treatment.

The epidemiology of male adolescent low back pain in a north suburban population of Melbourne, Australia.

OBJECTIVE: To determine the prevalence of low back pain (LBP) in an Australian metropolitan, male adolescent population. DESIGN: Self-reported, pretested questionnaire that included a definition of LBP and a description of the body area it affects. SETTING: Three government operated secondary schools in a growth corridor of north suburban Melbourne, Australia. SUBJECTS: Six hundred ten males attending secondary (high) school, aged between 12 and 19 yr. INTERVENTION: None. MAIN OBSERVATIONS: The point prevalence of LBP was found to be 16.7% and the sample prevalence 57%. The typical sufferer of adolescent LBP (ALBP) reported chronic LBP experienced up to a few days at a time, several times a month. CONCLUSIONS: The high prevalence of ALBP found by studies in other populations is confirmed in Australia. There is a clear need for further study of the etiology and potential preventative factors of ALBP, and for consideration of whether nontraumatic occupational LBP results more from an aggravation of a preexisting (adolescent) condition than from an unsafe or unsuitable work environment.

Some anthropometric dimensions of male adolescents with idiopathic low back pain.

OBJECTIVE: To determine whether there were anthropometric dimensions associated with low back pain (LBP) in a male adolescent population. DESIGN: Objective measurement of selected anthropometric dimensions by pretested computer assisted goniometer. SETTING: Temporary laboratory space in three government operated secondary schools in a growth corridor of north suburban Melbourne, Australia. SUBJECTS: Males attending secondary (high) school, aged between 12 and 19 yr. Of 64 subjects that were symptomatic for idiopathic (mechanical) LBP, 38 reported pain at the time of measurement. These were matched by decimal age to a control group of 38 asymptomatic subjects with no history of LBP, drawn from the same population. INTERVENTION: None. MAIN FINDINGS: The dimension "upper body segment" was significantly greater in the group with idiopathic LBP, as was the dimension "sitting height." Contrary to previous findings from adult subjects, the dimension "standing height," while greater for the LBP group, was not significantly so. The dependent measurements "pelvic height" and "suprapelvic height" were significantly greater, confirming previous findings from adult subjects. CONCLUSIONS: The presence of these significantly different anthropometric dimensions in an adolescent population suggests that some adult correlates of LBP may have value as predictors of LBP, detectable in adolescence. Longitudinal observation is warranted to determine their validity as such. The early identification of adolescents with these dimensions may allow the development of appropriate screening programs which in turn may lead to the design and introduction of suitable prophylactic interventional programs for persons found to be potentially prone to idiopathic LBP, otherwise known as mechanical LBP, thus reducing the onset of this expensive problem in adulthood.