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What are the main claims of the paper and how important are they?
The paper raises awareness that the actuator, a device used by chiropractors, may in some instances cause coccyx pain.
This is useful to know for pain clinicians.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
The report is original and describes a rare occurrence.
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Are the claims properly placed in the context of the previous literature?
Yes, they are.
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Do the results support the claims? If not, what other evidence is required?
This is only a case report. Further studies would be needed to address the safety issues of chiropractic treatments.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Not applicable.
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
The paper is sufficiently well written. Argumentation is sound and evidence based.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
No extra work needed.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
The paper is very interesting as it raises awareness about a topic too much neglected. Chiropractic and other manipulative treatments are increasingly used and we are witnessing a parallel increase in adverse events related to these treatments.
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Other Comments:
No.
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Invited by the author to review this article? :
Yes -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
I am a pain physician and also a practicioner of complementary medicine.
- How to cite: Luchetti M .An interesting case report on iatrogenic coccydynia[Review of the article 'Iatrogenic Coccydynia (Coccyx Pain) After Chiropractic Actuator Treatments: Case Report ' by Koon C].WebmedCentral 2015;6(11):WMCRW003255
Using a device that delivers a mechanical jolt to the sacrococcygeal region caused long lasting pain in that area.
The paper descibes an instance of coccydynia following a chiropracic treatment, that obviuosly caused some damage and pain.
This is the first report of such an incident, but application of traumatic forces are well known to cause injury and pain, wherever they are applied.
This is not a claim, but a factual statement.
This is a case report. Manual tretments if administered with out care can cause significant damage. There is no need for any further evidence.
Not applicable
This is not a research study towarrant experiments.
Not applicable.
No
This is a well written case report about a patient developing coccydynia after application of external forces to coccyx for a totally unrelated problem. I will not comment on the efiicacy of Chiropractic for the treatment of spinal pain.
Yes
No
None
I am an accredited Interventional Pain Medicine Consultant with more than 12 years experience working in United Kingdom. I deal with coccydynia and similar pain syndromes on a regular basis.