Care Plan 1:   Simple Joint and Muscle Dysfunction

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

ETIOLOGY: Joint and muscle dysfunction may arise out of unanticipated or unprepared loading, repetitive postural stresses, reflexively from other involved areas, secondary to congenital biomechanical defects (scoliosis, short leg, etc.) or idiopathically (cause unknown).

The associated joint restrictions and muscle spasms tend to reinforce each other. Simple dysfunction usually resolves quickly, without residuals. It may have a propensity to recur as it is thought to come from activities of daily living, and some individuals may be predisposed to such dysfunction.

APPROPRIATE CARE: Spinal adjusting, manipulation, myofascial soft tissue work, simple home mobility and stretching exercise, postural and ergonomic counseling.

EXPECTED FREQUENCY AND DURATION OF CARE: 2 to 3 sessions per week, decreasing in frequency over a 2-4 week period. A one-month follow up exam is recommended.
TOTAL : UNDER 9 VISITS IN 8 WEEKS.

WEEK	CARE	PROGRESS	M	T	W	T	F	S
1	Pain control (Ice) Gentle myofascial work Gentle adjusting	50% subjective pain reduction 50% increase in ROM	X		X			X
2	Same as above	Same as above		X			X
3	More aggressive adjusting Home exercise	Near asymptomatic			X
4	Same as above	Same as above			X
5-8	One 30 day followup exam	Discharge			X

ATTENUATING FACTORS:Activities of daily living or repetitive postural stresses are likely to cause a flare up requiring 1-3 additional sessions. The likelihood of this diminishes with good compliance in home instructions. Older aged individuals or those with or general health problems may delay recovery or require greater frequency after week 2.

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