HEMME APPROACH TO SOFT-TISSUE THERAPY

38
CONTRAINDICATIONS
Even though diagnosis is not considered part of soft-tissue therapy,
evaluations are necessary for two reasons: (1) to decide if soft-tissue
therapy is contraindicated for any reason and (2) to identify the best course
of therapy for each patient. Without evaluations, patients could be exposed
to potentially dangerous treatments because of failure to identify
contraindications. Even if soft-tissue therapy is indicated, the quality of
treatment is likely to suffer if the patient's condition is not properly
evaluated.
Soft-tissue therapy is contraindicated by the vast majority of serious
pathological findings. The ones most frequently cited are malignancies,
cardiac or circulatory disease, and severe respiratory disease. Even though
soft-tissue therapy is less likely to cause bone damage than high-velocity,
low-amplitude manipulations, the risk of fracture is always present,
especially if bones are weak because of disease or recent trauma.
Soft-tissue therapy is contraindicated by spinal cord lesions, nerve root
damage, or severe neurologic dysfunction. These conditions are often
characterized by extreme pain that remains constant regardless of position,
paresthesia, anesthesia, or weakness that occurs with or without pain.
Conditions involving acute inflammation, infection, or bleeding are
normally contraindicated. The signs of inflammation are pain, swelling,
heat, redness, and loss of function. Soft-tissue therapy is contraindicated if
treatments cause unexplained sickness, dizziness, nausea, or disorientation.
Some conditions, diseases, or injuries are contraindicated when acute but
indicated when subacute. Pregnancy, age, general health, and psychological
fitness can also be factors. If there is any doubt, refer the patient to a
specialist and get a written prescription before treatment.
The following conditions may contraindicate soft-tissue therapy.
acute bursitis Active inflammation of the bursa.
agenesis of the odontoid process Failure of the odontoid process to
develop properly.
HEMME Approach to Soft-Tissue Therapy