Clinical trial: measurINg forceS durInG cHiropractic Treatment (NCT02409797)

Eligibility criteria:
Inclusion Criteria:

          -  Able to demonstrate the necessary abilities (English language, literacy) needed to
             provide informed consent without the assistance of another person (e.g., a proxy,
             spouse, family member or other support person)

          -  Self-reported low back pain (acute, subacute or chronic) at the time of examination
             and enrollment

        Exclusion Criteria:

          -  Weight > 300lbs

          -  Spinal Pathology or conditions contraindicating study procedures or compromising
             participant safety

          -  Inflammatory arthropathy involving the spine (e.g. Ankylosing spondylitis, Rheumatoid
             arthritis)

          -  Spinal fracture in the past 6 months

          -  Other conditions requiring referral (e.g. self-reporting alcohol/substance dependence
             or abuse, unstable spinal segments, and cauda equina syndrome)

          -  Pregnant or planning to become pregnant within the next 5 weeks

          -  Unable to tolerate study procedures safely

          -  Altered Mental Capacity

          -  Sensitivity to adhesives used in the study

          -  Uncontrolled hypertension

          -  Co-morbidity requiring simultaneous clinical management that compromises ability to
             deliver study procedures or assess the participant's heath status or poses as a
             scheduling burden

          -  Retention of legal advice or seeking a health-related insurance claim

          -  Compliance concerns (e.g. scheduling conflicts, moving from the quad city area,
             unwilling to undergo required study procedures or receive treatment from study
             doctor(s))

          -  Quebec Task Force Classification of 10 or 11: (chronic pain syndrome,
             visceral/infectious source of LBP)
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 65 Years

Patient description (medical language): A 57-year-old man comes to the emergency department due to constipation.  His last bowel movement was 2 days ago. He complains of spending about 30 minutes once attempting to defecate. He also has lower back pain.  There is no history of trauma. The pain is not relieved with over-the-counter pain medications.  His vital signs are within normal limits.  Examination shows low back pain that is worse with back flexion and raising of the legs; it radiates into his left leg.  Pinprick in the perianal area does not cause rapid contraction of the anal sphincter.  The rest of the neurologic examination is normal. He is suspected of Cauda Equina syndrome and referred to a spinal MRI.

Patient description (patient's own words): I'm a 57 year-old-man, and I had to go to the ER because I couldn't go defecate. My last trip to the toilet was 2 days ago, and I tried too many times, during 30 min, to get my poop to get out. I also have terrible lower back pain. The doctor did not notice any trauma. I tried to get the pain away using over-the-counter medications, but it simply did not work! Back in the ER my vitals were normal. My pain was even more intense with back flexion, and when I raised my legs, it radiated into my left leg. The doctor did an anus exam where he had to pinch it and it was not reacting! However the rest of my neurologic exam was normal. The doctor suspects a Cauda Equina syndrome and referred me to a spinal MRI.

Does the patient match the trial criteria? Contradiction