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December 2013

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• Improvement in Meniere’s Disease, Balance, and Coordination Following Chiropractic
• Resolution of Constipation, Vomiting, and Leg Pain in a Child Undergoing Chiropractic
• Increased Use of Chiropractic Care for Arthritis Says Report
• Doctors Told to Use Caution When Prescribing Antibiotics for Children
• Tic Disorder Helped in an 8-Year-Old Boy Following Chiropractic - A Case Study
• Medical Journal of Australia Does Study on Chiropractic Usage

The Annals of Vertebral Subluxation research published a case study on November 25, 2013, documenting the improvement of Meniere's disease through chiropractic care.

The study authors begin by noting, "Meniere's disease affects the inner ear and is characterized by intermittent episodes of vertigo, low frequency sensorineural hearing loss, tinnitus, and aural pressure."  According to the National Institutes of Health, "Ménière’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear."

In this case, a 56-year-old man went to a chiropractor complaining of bilateral carpal tunnel symptoms, bilateral numbness and tingling of the feet, and pain and fullness in the left ear. The history noted that his left ear pain and fullness followed a twenty-year history of vertigo and progressive hearing loss. He had previously been diagnosed by his MD as having Meniere’s Disease.

A chiropractic examination was performed that included thermography and surface electromyography (sEMG) along with palpation and a postural evaluation.  Based on these findings, chiropractic care was initiated.

The patient received an auditory exam four months after the start of chiropractic care which showed hearing improvements especially with lower frequencies.  The study also reported that over the course of the recorded care period, the patient reported improvements in multiple areas of his life, most notably with his symptoms of Meniere’s disease. Additionally, he experienced improved ability to communicate with his family.

In a long term follow-up about 2 years after the beginning of chiropractic care, a re-evaluation questionnaire was completed. In that questionnaire the patient reported noticeable improvements with the following: memory, cognition (his ability to think more clearly), mood, sleep, coordination, allergies, and immunity. He again noted significantly fewer incidences of sickness with a cold or the flu, and significant improvements in his breathing.

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A case study published in the Journal of Pediatric, Maternal & Family Health on November 14, 2013 documented the "Resolution of Severe Constipation, Vomiting and Leg Pain in a Child Undergoing Subluxation Based Chiropractic Care."

In noting the growing popularity of chiropractic care for children with serious health issues, the authors of this study state, "The use of complementary and alternative medicine (CAM) in the pediatric population continues to grow; particularly in those children with chronic conditions such as cancer, asthma, ADHD, diabetes, ear-nose-throat infections, and irritable bowel disease, to list a few. Of the practitioner-based CAM therapies, chiropractic is the most popular and highly utilized for children."

The term "complementary and alternative medicine", or "CAM" for short, is a common term used in healthcare research to describe healthcare that does not directly fall under the medical model. Although most chiropractors do not describe chiropractic as an "alternative", many medical and scientific references consider chiropractic to fall under the alternative category. 

In this case, a 6-year-old boy suffering from constipation and leg pain was brought to the chiropractor by his mother. The boy was suffering with severe constipation since age 2, and had been on medication for the past 2 years.  At the time he was brought to the chiropractor, the boy was on four different medications daily.

A chiropractic examination was performed which revealed postural abnormalities along with multiple areas of the boy's spine showing inflammation and sensitivity.  It was determined that multiple areas of subluxation were present and, with the mother's consent, a course of specific corrective chiropractic care was initiated.

On the third visit, the boy's mother reported that her son was having bowel movements on a daily basis.  The bowel movements were no longer painful, as they were prior to care. By the sixth visit the boy's mother reported that, since her son was responding to the chiropractic care so well, she had decided to stop all of his medications. By the boy's seventh visit, his appetite was better, he was reported as eating "much better", and he started to gain weight. The boy's leg pain also resolved.

In a follow up 15 months after the initiation of chiropractic care, the boy's problems had not returned. His mother noted that her son’s appetite was "voracious," and he was continuing to gain weight. It was also noted that the prior year the boy had missed 45 days of school, but since starting chiropractic care he had only missed 2 days.

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A November 21, 2013 release by the Foundation for Chiropractic Progress (F4CP) reports on the increased usage of chiropractic care and other complementary and alternative medicine (CAM) procedures by people suffering from arthritis pain.

The F4CP release starts by noting that a recent article in Medscape Rheumatology in September entitled "CAM for Arthritis: Is There a Role?" discussed the growing trend of people with these problems seeking CAM procedures, including chiropractic. The Medscape article begins by stating, "The Centers for Disease Control and Prevention estimates that up to 50 million US adults have some form of arthritis, including one half of those older than 65 years. With lifestyle modification and pharmacotherapies often only providing partial relief, many patients turn to complementary and alternative medicine (CAM) therapies,..."

In the Medscape article, rheumatologist Nathan Wei, MD, stated, "Chiropractic is a CAM that the American Medical Association called "snake oil" -- until a Supreme Court ruling came down in favor of the chiropractors. There's little question in my mind that chiropractic works, particularly for acute musculoskeletal pain. Also, chiropractors know musculoskeletal anatomy better than most rheumatologists." 

Gerard Clum, D.C., spokesperson for the F4CP, noted in their release, "Doctors of chiropractic (D.C.s) are trained in the management of musculoskeletal conditions, such as arthritis. The evidence-based, hands-on care provided by a D.C. helps to significantly relieve arthritic symptoms, such as joint pain and swelling, and improve range of motion, endurance and muscle tone and strength."

Although many chiropractors now consider their care more main-stream than an alternative, the F4CP reports that chiropractic care is documented as one of the most popular among consumers, according to research published in the Annals of Internal Medicine.

The Medscape article reports that, according to the Centers for Disease Control and Prevention, 50 million US adults have some form of arthritis, including one half of those older than 65 years. In light of this information the F4CP urges people to consider chiropractic.

"In one’s journey to manage the wearing condition of arthritis, it is essential all available options be considered," says Dr. Clum. “Mounting evidence confirms choices, such as chiropractic care, present an opportunity for less risky and more effective clinical outcomes as well as higher levels of patient satisfaction. As the public becomes better educated and appreciates these findings, I expect that utilization of these services will only continue to rise."

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The headline above is from a Reuters article published on November 18, 2013, in the Washington Post. This article, as well as several in other publications, reports on a new study by the U.S. Centers for Disease Control (CDC) on November 18, 2013, that addresses the issue of antibiotic usage in children.

The problem noted in the Washington Post article and CDC report is that children with upper respiratory infections are often prescribed antibiotics even though most of  these infections are caused by viruses and will not respond to antibiotics.  Theoklis Zaoutis, a member of the American Academy of Pediatrics Committee on Infectious Diseases, warns, "People tend to not recognize how big of a problem this is."

A press release by the CDC on the study explains, "Every year as many as 10 million U.S. children risk side effects from antibiotic prescriptions that are unlikely to help their upper respiratory conditions. Many of these infections are caused by viruses, which are not helped by antibiotics."

Our primary goal is the best outcome for a child," said lead report author Dr. Mary Anne Jackson, a member of the American Academy of Pediatrics committee on infectious diseases. "The best treatment for a child doesn't always include an antibiotic."

Dr. Lauri Hicks, a coauthor of the report noted, "Many people have the misconception that, since antibiotics are commonly used, they are harmless. Taking antibiotics when you have a virus can do more harm than good."  The biggest harm being reported in the articles is the growing antibiotic resistance to bacterial infections caused by what are being called "Superbugs." 

The CDC release clearly stated the danger overuse of antibiotics creates in their release, "Antibiotic resistance occurs when bacteria evolve and are able to outsmart antibiotics, making even common infections difficult to treat. According to a landmark CDC report from September 2013, each year more than two million Americans get infections that are resistant to antibiotics and 23,000 die as a result."

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In the Journal of Upper Cervical Chiropractic Research, a case study was published on November 18, 2013, documenting the case of a child who was medically diagnosed with a "tic" disorder being helped by chiropractic care.

The study authors begin by explaining that, "Tics are described as rapid involuntary contraction of skeletal muscle in functionally related groups. They are nonrhythmic stereotyped movements or sounds. These tics occur primarily between the ages of 3-10. Tics lasting over the span of 1 year are considered to be chronic."

In this case, an 8-year-old boy was brought to the chiropractor after his pediatrician diagnosed him with a tic disorder. The study reports that, according to the boy's mother, her son began having symptoms at the age of 6. Symptoms started with head nodding and twisting multiple times a day. The boy's mother was concerned that this problem could affect her son's self-esteem and might keep her son from experiencing a normal childhood.

A chiropractic examination was performed which included a postural analysis, palpation, thermography, range of motion, and specific postural spinal x-rays. The conclusion of these tests was that there was a subluxation in the upper cervical spine. A subluxation is when a vertebrae of the spine is misaligned and creates some form of interference to the function of the nervous system. Many in chiropractic feel that the upper neck is the most critical area as it is so close to the brain stem.

Specific chiropractic care was begun for the correction of subluxation. After the first visit, it was reported that the boy had a decrease in the frequency of the tics he was experiencing. Prior to the second visit, the frequency returned, but the tics were lower in intensity. Following the second adjustment, the tics subsided.

A reevaluation was performed 17 days after the onset of care. At that point, the boy had not experienced any tics since before his second adjustment visit. At a one year follow up, the mother stated her son had not experienced a single tic episode.

In their conclusions the authors wrote, "This case report demonstrates the improvement of one male child with a tic disorder that underwent chiropractic treatment. The results in this case lend support to the subluxation based care of children with motor tic disorders."

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A study published in The Medical Journal of Australia in November 2013 discusses chiropractic clinical practices, patient demographics, patients’ reasons for seeking care, the health problems the chiropractors found, as well as the chiropractic care delivered. The study reported that during 2005, 16 percent of Australians, over 3 million people, consulted a chiropractor at least once at an out-of-pocket cost of $905 million.

The information in this study was collected on 4464 chiropractor–patient encounters from 52 chiropractors between December 11, 2010, and September 28, 2012.  The authors note that there are 4400 registered practicing chiropractors in Australia, making chiropractic the eighth largest registered health profession in that nation.

The results of the study can be useful for chiropractic education, health care policy, and workforce development. The information can also be compared to studies conducted on the same subject in the United States.  According to the Australian study, "Despite the large number of people who receive chiropractic care, very little is known about why people seek this care and what care chiropractors provide."

Musculoskeletal issues produced the most reasons for people seeking chiropractic care at 60 percent. However, wellness care, chiropractic maintenance, and check-ups rated at 39 percent of the reasons people sought chiropractic services.  The study authors noted, "Chiropractic wellness care is considered by an indeterminate proportion of the profession as an integral part of chiropractic practice, with the belief that regular chiropractic care may have value in maintaining and promoting health, as well as preventing disease."

Patient demographics identified most patients being in the age range of 25-64 years (71 percent), and 1 percent of the patients being infants aged 12 months or less. Other children, 15 years of age and younger, rated at 9 percent, and adults 65 and older rated at 13 percent. Patients were most often referred to the chiropractor by other patients, with this percentage measuring 52 percent.

In conclusion, the study authors state, "In workforce development, education can be aligned with health conditions commonly managed by chiropractors. Health care policy can be guided to ensure that provision of services is directed to areas of greatest need. Future research relevant to the chiropractic profession can be guided to ensure it is directed towards the most common presentations, so it can potentially help the most people."

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