Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2004; 9: 28–9
A 67-year-old retired school-mistress reported excellent left knee surgery 4 years previously, but immediately after the operation the non-operated knee gave pain with swelling and loss of mobility.
Based on Cajal’s neurone theory, neural symmetry was assessed from cortex to neuraxis, incorporating orthopaedic and neurophysiological tests. Diagnosis focused on the neural longitudinal level of the lesion, rather than the instability of a painful knee.
Reduced left knee-joint afferentation (following surgery) to the right cortex producing diaschesis: loss of integration between the right cortex, right cerebellum, mesencephalon, ponto-medullary area and ‘escape’ of the sympathetic nervous system in the spinal cord, contributing to right knee instability.
Treating the painful knee exacerbated the pain. Right cortical stimulation by left Ia afferentation – slow muscle stretch, dry-needling the operation scar and bandaging the good knee – reduced the knee pain: increased right cerebellum inhibition by Ib proprioceptive input by chiropractic manipulation and rehabilitation.
After three treatments the patient reported 90% reduction after 4 years of pain. After six treatments, the knee could lock almost in hyper-extension – she now felt in control of her right knee and discarded her walking stick.
Functional lesions may be addressed by diagnosing and designing treatment to fit the neuro-physiological level of the lesion by interpreting pain as a resultant rather than causal force. Research is needed into brain-based behaviour as a contributing factor in functional problems. Investigations should also be undertaken comparing the efficacy of diagnosis-driven treatments with modality-based approaches.
