Which medication should lead a practitioner to avoid performing manipulations due to potential risks?

• A. Ibuprofen
• B. Acetaminophen
• C. Prednisone
• D. Tramadol

Answer: (C)

Prednisone is a corticosteroid medication that can lead to increased risks when considering surgical or manipulative interventions. Corticosteroids can weaken the integrity of connective tissues and affect healing processes, making patients more susceptible to complications during and after manipulative treatments. Additionally, prednisone can impact the immune response, raising concerns about infection and complicating recovery.

Moreover, the use of corticosteroids may lead to conditions such as osteoporotic bone changes or increased joint laxity, which can heighten the risk of fractures or dislocations during manual therapy. Therefore, clinicians typically exercise caution and may avoid manipulative procedures in patients who are taking significant doses of prednisone or have been on long-term corticosteroid therapy.

In contrast, common medications like ibuprofen and acetaminophen are generally safe and do not carry the same risks associated with manipulations, while tramadol, although an opioid pain reliever, does not have the same systemic effects on connective tissue integrity and healing that corticosteroids do. Thus, prednisone stands out as the medication that practitioners should be especially cautious about when considering manipulative therapies.