Osteology and Rheumatology · Vol. 2, No. 1 · 2025 · pp. 8–10 · e-ISSN 2996-5918
Alternative Effective Management of the Musculoskeletal Pain
Olena Plotkina, Andrei Bourdeinyi
Division of Clinical Sciences, Life University, Marietta, GA, USAUnited States
Division of Basic Sciences, Life University, Marietta, GA, USAUnited States
DOI: https://doi.org/10.17140/orhoj-2-e002 · Published 2025-09-11 · Licence: https://creativecommons.org/licenses/by/4.0 · © 2025 The Author(s)
Also available as PDF (figures and tables appear in the PDF).
Abstract
There is a considerable amount of evidence regarding the effectiveness of high-velocity low amplitude (HVLA) manipulation on virtually all joints of the human body, both in the spine and extremities.1-7 This type of manipulation therapy is also known as chiropractic, and is popular in the world, especially in the USA and Canada.8 However, in spite of this popularity and existence of many positive publications on this issue, our professional contacts and conversations with physicians, our attendance of various medical congresses, national and international, have shown us that the medical doctors have a quite poor notion about potentials of the HVLA manipulation and its position in the general health care system. In this presentation, we would like to place attention on the effectiveness of HVLA manipulation in the treatment of the musculoskeletal pain throughout the body, but we will not focus on the spine, for which efficacy has already been established. The use of HVLA manipulation as an alternative approach for the management of musculoskeletal pain in the extremities is especially little known among medical doctors.
Keywords: X-ray, HVLA, medicine, muscle strength
Acknowledgement
that microsubluxations are responsible for the development of a number of serious clinical painful syndromes and diseases. Several We would like to thank Professor Brent Russell from Life Univerexamples are: sity for his help and recommendations in the process of preparation of this material.
a) Shoulder pain which is considered by physicians in the majority of cases to rotator cuff dysfunction, and for which sur-
Conflicts Of Interest
12,15,16 gery usually is recommended; b) Pain in forearm and wrist, as well as neurological disorders The authors declare that they have no conflicts of interest. that produce numbness and tingling (for instance, in the carpal tunnel syndrome, although in reality the similar clinical mani-
References
- EvansRBronfortGNelsonBGoldsmithCH. Two-year 17-19 itself at all); follow-up of a randomized clinical trial of spinal manipulation 7,20 c) Low leg pain and foot drop;7,20 and two types of exercise for patients with chronic neck pain. d) Calcaneal pain which is usually considered as a manifestation Spine (Phila Pa 1976). 2002; 27(21): 2383-2389. doi: 10.1097/01. of achillobursitis or calcaneal spurs;21 BRS.0000030192.39326.FF e) Temporomandibular joint pain. Temporomandibular micro subluxation frequently leads not only to temporomandibular10.1097/01.of https://doi.org/10.1097/01.of
- EnixDESudkampKMalmstromTKFlahertyJH. A randomjoint (TMJ) pain but also to changes of the bite, which, in turn, ized controlled trial of chiropractic compared to physical therapy could be followed by sometimes traumatic surgical intervenfor chronic low back pain in community dwelling geriatric patients. 22,23 tions; Top Integr Health Care. 2015; 6(1). f) Severe chest pain caused by misalignment of the ribs. This kind of microsubluxations frequently imitates angina pectoris
- GhroubiSElleuchHBakloutiSElleuchMH. Chronic low attacks, or manifestations of degenerative disc disease, or is back pain and vertebral manipulation. Ann Readapt Med Phys. 2007; considered as intercostal neuralgia of unknown etiology. The 50(7): 570-576. doi: 10.1016/j.annrmp.2007.02.012 24-27 typical medical diagnosis is “Undifferentiated Chest Pain”; 6,12 g) Hip and knee pain;6,1210.1016/j.annrmp.2007.02.012 https://doi.org/10.1016/j.annrmp.2007.02.012
- Scholten-PeetersGGThoomesEKoningsS. Is manipuh) Some frequent types of headaches (e.g. occipital headaches, lative therapy more effective than sham manipulation in adults?: or even migraine), which poorly respond to the analgesics;28 A systematic review and meta-analysis. Chiropr Man Therap. 2013; i) Lower abdominal pain, which is not associated with any vis- 21(1): 34. doi: 10.1186/2045-709X-21-34 ceral pathology.2910.1186/2045-709x-21-34 https://doi.org/10.1186/2045-709x-21-34
- CorcoranKLDunnASFormoloLRBeehlerGP. Chiropractic A very important feature of micro subluxation is the relamanagement for US female veterans with low back pain: A rettive ease of its diagnosis. It does not require the performance of rospective study of clinical outcomes. J Manipulative Physiol Ther. expensive tests or expensive device exams and does not take much 2017; 40(8): 573-579. doi: 10.1016/j.jmpt.2017.07.001 time. There is a high correlation between symptoms caused by microsubluxations and their locations that also facilitate the process10.1016/j.jmpt.2017.07.001 https://doi.org/10.1016/j.jmpt.2017.07.001
- BourdeinyiAPlotkinaO. Hip pain: High effectiveness of math of diagnosis. nipulation therapy. Abstract, presenting in the 17th World Congress on Pain, Boston, USA, September 12-16, 2018; PFR323. Web A short summary of benefits associated with correction site. https://www.iaspworldcongressonpain.org/wp-content/upof microsubluxations: loads/2018/11/Program-Book-Final-only-posters.pdf 1. Microsubluxations are perhaps one of the common causes
- SchneiderMMurphyDHartvigsenJ. Spine care as a frametheir potential side-effects. work for the chiropractic identity. J Chiropr Humanit. 2006; 23(1): 4. The regular correction of microsubluxations could lead to a 14-21. doi: 10.1016/j.echu.2016.09.004 restoration of the articular surface congruency, and thus supposedly to the prevention of the progression of the degenera-10.1016/j.echu.2016.09.004 https://doi.org/10.1016/j.echu.2016.09.004
- Sözen T, Başaran NÇ, Tınazlı M, Özışık L. Musculoskeletal tive joint diseases. problems in diabetes mellitus. Eur J Rheumatol.. 2018; 5(4): 258-265. doi: 10.5152/eurjrheum.2018.18044 Osteol Rheumatol Open J. 2019; 2(1): e1-e3. doi: 10.17140/ORHOJ-2-e002 https://doi.org/10.5152/eurjrheum.2018.18044
- Perrot S, Cohen M, Barke A, Korwisi B, Rief W, Treede RD. patient with insidious onset of foot drop. Ann Vert Sublux Res. The IASP classification of chronic pain for ICD-11: Chronic 2017; 2017(1-2): 119-121. secondary musculoskeletal pain. Pain. 2019; 160(1): 77-82. doi: 10.1097/j.pain.0000000000001389 21. Santos BD, Corrêa LA, Santos LT. Combination of hip strengthening and manipulative therapy for the treatment of plan- https://doi.org/10.1097/j.pain.0000000000001389
- HawkerGA. The assessment of musculoskeletal pain. Clin Exp tar fasciitis: A case report. J Chiropr Med. 2016; 15(4): 310-313. doi: Rheumatol. 2017; 35 Suppl 107(5): 8-12. 10.1016/j.jcm.2016.08.00110.1016/j.jcm.2016.08.001 https://doi.org/10.1016/j.jcm.2016.08.001
- BattagliaPJD’AngeloKKettnerNW. Posterior, lateral, and an- 22. Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temterior hip pain due to musculoskeletal origin: A narrative literature poromandibular disorders: A revietiology, clinical management, review of history, physical examination, and diagnostic imaging. J and tissue engineering strategies. Int J Oral Maxillofac Implants. 2013; Chiropr Med. 2016;15(4): 281-293. doi: 10.1016/j.jcm.2016.08.004 28(6): e393-e414. doi: 10.11607/jomi.te2010.1016/j.jcm.2016.08.004 https://doi.org/10.1016/j.jcm.2016.08.004
- BergmannTDonahueTDonahueSDodyM. Manipula- 23. Pavia S, Fischer R, Roy R. Chiropractic treatment of temporotive assessment and treatment of the shoulder complex: Case mandibular dysfunction: A retrospective case series. J Chiropr Med. reports. J Chiropr Med. 2003; 2(4): 145-152. doi: 10.1016/S0899- 2015; 14(4): 279-284. doi: 10.1016/j.jcm.2015.08.005 3467(07)60079-2 24. Marks EM, Chambers JB, Russell V, Bryan L, Hunter MS. The10.1016/s0899-2015 https://doi.org/10.1016/s0899-2015
- Osteoarthritis. Robbins and Cotran Pathologic Basis of Diseases. Elrapid access chest pain clinic: Unmet distress and disability. QJM. th sevier Saunders, 7th Edition, 1999: 1304-1305. 2014;107(6): 429-434. doi: 10.1093/qjmed/hcu009 https://doi.org/10.1093/qjmed/hcu009
- SteinmetzASeidelWMucheB. Impairment of postural sta- 25. Stochkendahl MJ, Vach W, Hartvigsen J, et al. Reconstrucbilization systems in musicians with playing-related musculoskeltion of the decision-making process in assessing musculoskeletal etal disorders. J Manipulative Physiol Ther. 2010; 33(8): 603-611. doi: chest pain: An exploratory study using recursive partitioning. J 10.1016/j.jmpt.2010.08.006 Manipulative Physiol Ther. 2012; 35(3): 184-195. doi: 10.1016/j. jmpt.2012.01.00910.1016/j.jmpt.2010.08.006 https://doi.org/10.1016/j.jmpt.2010.08.006
- DunningJMouradFGiovannicoGMaselliFPerreaultTFernández-de-Las-PeñasC. Changes in shoulder pain and disabili- 26. Lawrence DJ, Smith M, Rowell RM. Management of chest ty after thrust manipulation in subjects presenting with second and pain: Exploring the views and experiences of chiropractors and third rib syndrome. J Manipulative Physiol Ther. 2015; 38(6): 382-394. medical practitioners in a focus group interview. Chiropr Osteopat. doi: 10.1016/j.jmpt.2015.06.008 2005; 13(1): 18. doi: 10.1186/1746-1340-13-1810.1016/j.jmpt.2015.06.008 https://doi.org/10.1016/j.jmpt.2015.06.008
- GemmellHMillerPJones-HarrisACookJRixJ. An alterna- 27. Colloca CJ, Polkinghorn BS. Chiropractic management of tive approach to the diagnosis and management of non-specific chronic chest pain using mechanical force, manually assisted shortshoulder pain with case examples. Clin Chiropr. 2011; 14(2): 38-45. lever adjusting procedures. J Manipulative Physiol Ther. 2003; 26(2): doi: 10.1016/j.clch.2011.01.007 108-115. doi: 10.1067/mmt.2003.810.1016/j.clch.2011.01.007 https://doi.org/10.1016/j.clch.2011.01.007
- Auyong S, Perez De Leon R. Chiropractic manipulative therapy 28. Racicki S, Gerwin S, Di Claudio S, Reinmann S, Donaldson of carpal tunnel syndrome. J Chiropr Med. 2002; 1(2): 75-78. doi: M. Conservative physical therapy management for the treatment 10.1016/S0899-3467(07)60007-X of cervicogenic headache: A systematic review. J Man Manip Ther. 2013; 21(2): 113-124. doi: 10.1179/2042618612Y.0000000025 https://doi.org/10.1016/s0899-3467(07)60007-x
- MurphyJFfloydRVarnumC. Resolution of bilateral carpal tunnel syndrome following subluxation based chiropractic care: A 29. Mieritz RM, Thorhauge K, Forman A, Mieritz HB, Hartvigsen case study. Ann Vert Sublux Res. 2014; 2014(4): 206-210. J, Christensen HW. Musculoskeletal dysfunction in patients with chronic pelvic pain: A preliminary survey. J Manipulative Physiol Ther
- SergentABoyleJMooreA. Chiropractic management of a 2016; 39(9): 616-622. doi: 10.1016/j.jmpt.2016.09.00310.1016/j.jmpt.2016.09.003 https://doi.org/10.1016/j.jmpt.2016.09.003