Green BN Journal of Sports Chiropractic and Rehabilitation  2000  Sep;  14(3): 75-83

ABSTRACT: Objective: To describe and discusses the management of a patient presenting with osteoarthrosis and concomitant psoriatic arthritis using chiropractic adjustments,nutritional guidance, soft tissue strategies and exercise.

Clinical Features: A 38 year old male had cervical and thoracic stiffness and soreness of eight years duration that had not responded favorably to previous medical and chiropractic care. He consumed up to 4000mg. of pain relievers a day. The following findings were present: psoriatic skin lesions,limited cervical and thoracic range of motion, elevated erythrocyte sedimentation rate,radiographic findings of osteoarthrosis in the cervical and thoracic spine and psoriaticarthritis in the left hand, left hip and left sacroiliac joint. The clinical diagnosis was osteoarthrosis of the cervical and thoracic spine and inactive psoriatic arthritis of the left fifth finger, left hip and left sacroiliac joint.

Intervention and Outcome: Gradefour mobilization to the cervical and thoracic spine, one chiropractic adjustment perspinal region each week for twelve weeks was provided, active stretching of the same spinal regions, aerobic exercise and dietary modifications were implemented from the beginning of care. After twelve weeks the patient had achieved maximal clinical improvement experiencing pain free periods for up to twelve days without the use of pain relievers. The patient was followed up for one month and maintained improvements.

Conclusion: Management of a patient with osteoarthrosis in the cervical and thoracic spine and concomitant inactive psoriatic arthritis of the hand and pelvis by a chiropractic rehabilitation program that included manipulation of joints, soft tissue therapies,exercise and nutritional recommendations is discussed. Based upon previous care provided to the patient, it seemed that this type of program was necessary to resolve the chief complaint.

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