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July 2013

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• Study Shows Chiropractic Can Help Depression and Anxiety
• Chiropractic Valuable in Accountable Care Organizations
• Migraines and Neck Curve Helped With Chiropractic According to Case Study
• Chiropractors Support Increased Physical Activity in U.S. Schools
• Complications Following Brain Surgery Improved With Chiropractic Care: A Case Study
• 7 out of 10 Americans Take a Prescription Drug

A case study published in the Journal of Upper Cervical Chiropractic Research on June 20, 2013, reports on the results of a case series showing chiropractic helping patients with depression and anxiety.  This case series was looking for follow up on previous surveys showing that chiropractic patients felt chiropractic care helped with their mental and emotional states.

The authors begin by reporting that a previous study showed that in a survey of 2818 patients who completed chiropractic care, 76% of those patients reported a mental/emotional improvement, as well as positive changes in stress and life enjoyment over a period of several months following the chiropractic care. Additional prior studies also showed chiropractic care assisting patients with these types of mental health disorders.

This case series study involved six patients who responded to an Internet posting looking for people suffering from mild to moderate depression or anxiety who wished to be a part of a study involving chiropractic. The patients were not under any psychotherapy at the time and were given tests using standard scales of psychological testing to determine and measure their mental state prior to and after the chiropractic care.

All six of the participants also suffered from a variety of problems including musculoskeletal pains, asthma, hypertension, gastrointestinal issues, and sleep disorders. Those who were taking medications made no changes to their medications during the study to rule out any improvement due to medication.

For the purposes of this study, care was limited to only 12 chiropractic visits over a six week period. A specific analysis and form of chiropractic adjusting was used to correct nerve system interference from subluxations. To measure patient progress, a number of protocols were used both to monitor the chiropractic correction of subluxations as well as to see any improvement in depression or anxiety.

The results of the study were recorded for five of the six participants as one participant left the program due to a family emergency. The remaining five participants all showed positive results in most of the areas that the researchers measured.  All five also showed positive test results for a decrease in nerve interference from subluxation. All five participants showed a "...significant decrease in depressive symptom ratings."  All five measured a "...significant decrease in anxiety."

Additionally, four of the five participants who completed the study also reported a self feeling of improvement with their depression, enough to state that they would recommend this type of care to others with depression. Four of the five participants also reported significant improvements in the other health issues and problems they were suffering from at the beginning of the study.

In their conclusion the authors wrote, "The results provide tentative support for the effectiveness of upper cervical (neck) chiropractic care for anxiety and depression symptoms." They also stated, "The present study found reduction in anxiety and depression symptoms and reduction in overall psychological distress among individuals with mild to severe depression, anxiety or both."

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In a release dated June 26, 2013, The Foundation for Chiropractic Progress (F4CP) issued a report titled, "Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care." This report demonstrates the value that chiropractic care offers in the new Accountable Care Organizations.

According to the website for the Centers For Medicare & Medicaid services, "Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.  The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors."

"Chiropractic care represents a non-invasive, evidence-based, drug-free approach that should serve as a key deliverable in the ACO model,” states Gerard Clum, DC, spokesperson, F4CP and lead author. “With ongoing positive outcomes for successfully addressing low back and neck pain, DCs are well positioned to help ACOs contain costs. Avoidance of surgical procedures and associated hospitalizations will have a profound impact on ACO achievements."

Included in the report are statistics comparing costs to health plans for "Individuals With and Without Chiropractic Coverage."  When compared for costs and patient satisfaction, chiropractic groups with chiropractic consistently performed better than those plans that did not include chiropractic. For example, the average cost of lower back pain care was 12.5% lower for the group with chiropractic coverage inclusion. 

Injured workers with lower back problems have a 42.7% chance of having spinal surgery if their primary caregiver for  this condition was a surgeon.  However, if chiropractic was used, the percentage of patients who eventually have expensive spinal surgery drops to only 1.5%.

In the report the authors summed up their findings when they stated, "The addition of a chiropractic benefit to a person’s insurance profile did not increase the cost of healthcare; rather, it was associated with a lower cost of healthcare on a global level."

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From the June 24, 2013, issue of the scientific periodical, the Journal of Pediatric, Maternal & Family Health, comes a case study documenting the improvement of migraines and neck curvature in a young girl under chiropractic care.

The authors of the study describe migraines as "...a very common and frequent health problem in children and adolescents which has been described as an intolerable pain preventing the child from their daily activities such as going to school or social events." They note that migraine headaches are so common that they are ranked among one of the top five health problems of childhood. Overall, 75% of adolescents and 25% of younger children will suffer from headaches of various types.

In this case, a 12-year-old girl was brought to the chiropractor suffering from severe migraines. The migraines, which had started six years earlier, had gotten so severe that she was missing a large amount of school and had missed two months at one time. The migraines would occur two to three times per week and would last several hours each episode. When asked to rate her pain on a scale of 1 to 10, with 10 being worst, the girl described the pain as an 8, with many times being a 10.

A chiropractic examination was performed which included thermography (motion x-rays known as videofluoroscopy), palpation, and other chiropractic checks. The x-rays of the side of the neck showed that the girl's neck was curving in the reverse direction from the normal forward curve. It was determined that vertebral subluxations were present and a course of specific corrective adjustments was initiated.

The study reported that over the course of the young girl's 5 weeks of care, she only suffered from one minor migraine and overall showed a 90% improvement of her migraine symptoms. A second set of motion x-rays was performed documenting that the girl's neck had shifted from a reverse curve to a curve in the forward direction (lordosis). Additionally, the thermal scans and other tests were returning toward normal. 

In this case, a 12-year-old girl had her life significantly improved with chiropractic care.  In their conclusion the authors noted this achievement by stating, "Chiropractic care in this patient was able to increase her quality of life allowing her to not miss school and have a 90% improvement of her symptoms after 6 visits."

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On June 27, 2013, the Foundation for Chiropractic Progress (F4CP) issued a release in support of the recommendations of the Institute of Medicine (IOM) for increased physical activity in U.S. schools.  The IOM report issued on May 23, 2013, is titled, "Educating the Student Body: Taking Physical Activity and Physical Education to School." 

According to the F4CP release, 12.5 million children in the U.S.  are obese and another third are overweight. "Doctors of chiropractic serve at the frontlines in the battle against childhood obesity,” states Gerard Clum, D.C., spokesperson, F4CP. Dr. Clum continued, "Physical activity and education are critical to a child’s physical, cognitive and emotional development as well as to academic success, and the F4CP strongly supports its inclusion in schools."

The IOM is a nonprofit, non-governmental organization that works to provide unbiased and authoritative advice related to healthcare. In their report, the IOM gave a rationale for their recommendations: "Because the vast majority of youth are in schools for many hours, because schools have important infrastructure and are critical to the education and health of children and adolescents, and because physical activity promotes health and learning, it follows that physical activity should be a priority for all schools, particularly if there is an opportunity to improve academic achievement."

Contained in their report, the IOM offered a number of recommendations which include:

• Students should engage in additional vigorous or moderate-intensity physical activity throughout the school day through recess, dedicated classroom physical activity time, and other opportunities.
• Additional opportunities for physical activity before and after school hours, including but not limited to active transport, before- and after-school programming, and intramural and extramural sports, should be made accessible to all students.
• Increasing the amount of time youth spend in physical activity through brief classroom breaks or incorporating physical activity directly into academic sessions.
• Working with parent groups and parent-teacher associations to create a demand for physical activity and mobilize this effort.

"The F4CP supports the IOM initiatives to educate the public on the importance of physical activity and good health,” adds Dr. Clum. “With sufficient physical activity and key behavioral changes, such as healthier food choices and attention to weight management goals, America’s youth will improve in areas of fitness, academics, self-esteem and physical performance, while lowering risks of obesity and Type 2 diabetes."

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Many people who go to chiropractors have had surgery of some kind. Often, they are concerned as to whether  they can get chiropractic after surgery. This case study, documented in the Journal of Upper Cervical Chiropractic Research, on June 14, 2013, may help answer this question.

In this case, a 17-year-old girl came to the chiropractor with health concerns that included an astrocytoma that was surgically removed from her cerebellum four years earlier. According to the American Brain Tumor Association, "Astrocytomas are tumors that arise from astrocytes—star-shaped cells that make up the 'glue-like' or supportive tissue of the brain."  The authors of the study explain that the cerebellum is part of the central nervous system (CNS) and has no direct ability to cause muscle contraction, but if harmed or removed, body movements become uncoordinated and abnormal.

In addition to the brain tumor removal, the young girl also reported a history of scoliosis, headaches, tremors, fatigue, loss of balance, and dizziness.  After her brain surgery, the girl experienced a significant decline in her postural control, her speech began to slow and was slurred, and her balance became difficult to maintain. Her balance got so bad that she was no longer trusted to drive. She also had fatigue and headaches that were debilitating and caused her to vomit.  Her history noted that, prior to these symptoms, she was an avid dancer and soccer player, and was not taking any medication.

A chiropractic examination was performed which included palpation, thermography, and x-rays.  From this examination, it was determined that the young woman had subluxations in the upper neck creating nerve system interference. A series of specific corrective chiropractic adjustments was initiated for the correction of the subluxations.

The patient stated that she began noticing changes by her second visit. By the 24th visit, the patient reported that her balance had improved from a 6 out of 10 to a 9 out of 10 since starting chiropractic care.  She also stated that her speech had improved over 90% since beginning care, and that she feels it is smoother and less choppy.

In their conclusion the authors wrote, "This case report outlines subluxation-based chiropractic care of a 17-year-old female who was experiencing a loss of balance, difficulty with speech and postural problems following the removal of an astrocytoma from her cerebellum.  This is one case demonstrating an improvement in balance, speech and posture while under chiropractic care."

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The headline above is from a June 27, 2013, HealthDay article that appeared in the US News and World Report health section of their news website. The article, and several others on this subject, are reporting on a study published on June 21, 2013, in the Mayo Clinic Proceedings.

Another article on the Mayo report in PharmaLive on June 19, 2013, starts with the results of the study by noting, " Nearly 70 percent of Americans are on at least one prescription drug, and more than half take two, Mayo Clinic and Olmsted Medical Center researchers say."  Even more ominous is that the study showed that a full twenty percent of patients are on five or more prescription medications. The study found that  antibiotics, antidepressants, and painkilling opioids are most commonly prescribed.

Study author, Jennifer St. Sauver, Ph.D., a member of the Mayo Clinic Population Health Program in the Mayo Clinic Center for the Science of Health Care Delivery, added that, "...the second most common prescription was for antidepressants — that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature."

The study also showed that medication usage, as expected, was higher in the elderly. However, the study also noted that women are more likely to be taking prescription medications than men. In people under the age of 19 years, the most common drugs prescribed are vaccines, antibiotics, and anti-asthma drugs .

The trend toward increased prescription drug usage is alarming. The PharmaLive article writes, "Prescription drug use has increased steadily in the U.S. for the past decade. The percentage of people who took at least one prescription drug in the past month increased from 44 percent in 1999-2000 to 48 percent in 2007-08. Spending on prescription drugs reached $250 billion in 2009 the year studied, and accounted for 12 percent of total personal health care expenditures. Drug-related spending is expected to continue to grow in the coming years, the researchers say."

Chiropractic represents a drugless approach to healthcare. In response to this new study, Dr. Michael McLean, President of the International Chiropractors Association commented, "America is awash with drugs. These numbers speak to a problem with how healthcare is viewed in the United States." He continued, "In the US, we spend more money, take more drugs, and have more chronic disease than any other advanced nation in the world. It is time we as a society question the practice of taking more drugs, as it has not yielded improved health."

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