April 2014


MRI Confirmed Lumbar Disc Herniations Helped with Chiropractic - Study Shows

A research paper published in the March/April 2014 issue of the scientific periodical, the Journal of Manipulative and Physiological Therapeutics (JMPT), showed that patients with lumbar disc herniations found on MRI were helped by chiropractic.  The authors explain, "The purposes of this study were to evaluate patients with low-back pain (LBP) and leg pain due to magnetic resonance imaging–confirmed disc herniation."

In the opening of the report the authors write, "Approximately 70% of the population will have back pain at some point in time.1 Low-back pain (LBP) with associated leg pain due to a herniated intervertebral disc is one of the most severe and disabling forms of back pain."

The study looked at patients with either chronic long term back pain or acute lower back pain, and followed their results for up to a year after the onset of chiropractic care. The researchers compared the patients, "...short-, medium-, and long-term outcomes of self-reported global impression of change and pain levels at various time points up to 1 year."

In this study, 148 patients between the ages of 18 to 65 years with lower back pain and leg pain who were also confirmed to have lumbar disc herniation from an MRI study, were given chiropractic care.  The process, described by the researchers as, "high-velocity, low-amplitude spinal manipulation," was delivered by doctors of chiropractic in Zürich, Switzerland.

Patients accepted for the study were evaluated at the time frames of 2 weeks, 1 month, 3 months, 6 months and 1 year after the initial chiropractic consultation.  The patients were asked to self-evaluate themselves into one of the following categories which included, "much worse, worse, slightly worse, no change, slightly better, better, and much better."

The results of the study showed that after only 2 weeks of care, 69.9% considered themselves better or much better. After one month of chiropractic care, 79.6% were better or much better, as were 90.5% of the patients at the three-month evaluation. After that point, with no additional chiropractic care being rendered, the results remained at 88% better or much better with only 2.8% reporting that they were worse to some degree.

The authors said that in all the patients included in this study, "There were no adverse events reported."  In their conclusion, the authors noted that the results were very good for both those patients who had acute or chronic lower back issues due to disc herniation. "A large percentage of acute and importantly chronic lumbar disc herniation patients treated with chiropractic spinal manipulation reported clinically relevant improvement."


Is Modern Technology Affecting Our Children’s Musculoskeletal and Neurological Development?

In the March 2014 issue of the Journal of Clinical Chiropractic Pediatrics, author Sharon A. Vallone, DC, FICCP, emphasizes the importance of educating patients about chiropractic and a healthy lifestyle in the article with the headline above.

Children, especially, can benefit from education about chiropractic and a healthy lifestyle as this can affect their overall development.  "Educating children, as well as adjusting the pediatric spine can have a vital impact on their growth and development including cognition, motor function and imagination," Vallone writes.

Dr. Vallone also addressed the use and possible abuse of present-day technology. She pointed out that this can have major negative influence on developing children as it floods their environment with data and communication but deprives them of old fashion stimulation.  "Four years ago the iPad didn’t exist, and now people wonder how they ever survived without one. How many office visits are "calmer" because of a child being allowed to pacify themselves with a tablet or cell phone while their parents receive their chiropractic adjustment? But we should all be aware of the potential hazards of these constant pacifying activities especially with those younger than two years of age (American Academy of Pediatrics’ most current policy statement issued in 2011)."

Stimulation of all the senses is necessary for developing function and structure in children’s brains. "Children’s sensory experiences (sight, hearing, touch, taste, smell and movement) stimulate neural activity that differentiates and creates the complex nerve networks that are key for optimum development in early life (Cynader & Mustard, 1998), Mustard, 2008)," Vallone writes.

The use of an iPad coloring app deprives a child of holding and smelling the crayon, hearing the scratchy sound of the crayon on paper, observing the differences in shading in the color while applying the crayon to paper, as well as, possibly, the taste of the crayon, according to Vallone. She warns that the iPad coloring app is not as stimulating an experience as the old fashion crayon and paper coloring experience, thereby resulting in sensory deprivation for the child and possible under-development of brain function and nerve networks.

A child’s learning can also be negatively impacted from the use of technology as children learn from other humans by mirroring behaviors. "Neuroscientists have also found that repeated observation of actions (either passive or active with the intention to reproduce the action) increases brain activity and can result in experience dependent changes (Chong et al., 2008). It is hypothesized that through the mirror neuron system, children develop the ability to understand the actions of others, to imitate and to teach others (Blakemore et al., 2005)," writes Vallone.

Vallone acknowledges that technology is an important tool for education and communication, and that academics are embracing technology for teaching children. However, Vallone concludes, "Multi-sensory experiences of normal, everyday life are actually far richer than getting to experience everything in the world through the screen of a tablet."


Infant with Difficulty Breastfeeding Helped with Chiropractic

A case study research paper was published in the March 2014 issue of the Journal of Clinical Chiropractic Pediatrics documenting the improvement with chiropractic care of a seven-week-old infant with difficulty breastfeeding.

In this case, a seven-week-old infant girl was brought to the chiropractor with what her mother described as tummy pain.  It was noted that the infant was in distress, did not want to sleep on her back, was drawing her knees up to her chest, vomited after feedings, and had unusual stools. She was also having recent trouble breastfeeding after having no problems doing so since birth. She would only feed on her mother's left breast and had great difficulty trying to feed on her mother's right side.

The chiropractic examination indicated the child was in significant distress and pain. The infant showed a significant restriction in movement in the neck which could partially explain her inability to breastfeed on one side.  It was determined that subluxations were present at the base of the skull and upper neck area. Subluxations in this area can affect the nervous system in many ways including the ability of the child to move her head properly and therefore breastfeed.

Care was initiated for correction of the subluxations and restoration of proper movement of the infant's neck. After one week, it was noted that the child could move her head better and was able to breastfeed more normally. Her initial stool after her first adjustment was normal.  Over the next few weeks, her other symptoms decreased and eventually cleared. 

The authors reported, "A follow-up chiropractic progress examination was performed when the infant was 6 ˝ months. During this examination the infant was found to be happy, symptom free and developing well."

In their conclusion the authors wrote, "Craniocervical subluxations are often identified in infants as a result of the birth process. In this case, chiropractic care restored optimal cervical range of motion and cranial alignment. Consequently, the infant no longer showed a preference to feed on the left breast. This demonstrates how chiropractic treatment may be beneficial in correcting breastfeeding difficulties that have a biomechanical cause."


Weight Limit Recommendation in Backpack Use for School-Aged Children

Backpacks can be a heavy burden for school-aged children, and a literature review of studies of weight limit recommendations was discussed in the March 2014 issue of the Journal of Clinical Chiropractic Pediatrics by Dr. Valérie Lavigne, author, and chiropractor in Montreal, Quebec, Canada.

The paper warns that children can experience back pain from their backpacks due to excessive weight in the backpacks, backpack design, how the backpack is worn on the back, and/or a lack of physical fitness. Educating children and adults on weight limits for backpacks and the proper way to wear a backpack can reduce back pain in children.

"Back pain in school-age children is becoming a common complaint, with a prevalence ranging from 30%-65%. Unfortunately, some evidence in the literature shows that children suffering from low back pain may still have pain into adulthood; therefore, prevention is becoming important," according to Lavigne.

With 90 percent of school-aged children in developed countries wearing backpacks, the issue of weight limits has become a hot topic for parents, school administrators, and health professionals-including chiropractors. Studies report a wide range of weight in backpacks, and researchers believe that excessive weight could be the cause of reported back pain in children.

"Negrini and Carabalona (2002) reported that the average daily load of Italian students over a week ranged from 22% body weight (BW) to 27.5% BW with some students wearing backpacks weighing as much as 46% of their BW, exceeding the 30% bodyweight/load ratio proposed for physically fit adults."

In addition, because children are growing, the spine can be easily injured which can result in postural deformities. Proper use of the backpack is critical during these growth stages in children.

Lavigne continues, "As well, it is shown that by adding weight to the back with a backpack, the center of gravity is shifted forward toward the rear of the base of support. Postural compensations are needed to maintain balance and functional motion during gait; however, with improper loading of backpacks these postural compensations can result in injuries to the child’s spine. Some of these compensations include an increased forward head carriage, an increase in forward lean of the trunk, as well as changes of pelvic positions and gait patters."

Additional factors such as time wearing the backpack, and the child’s height in relation to the size of the backpack were considered as causal to back pain in school-aged children. "Backpacks have an influence on back pain in children and the weight limit should not exceed 10-15% of the child’s body weight," Lavigne concluded.


Baby with Gastro-Esophageal Reflux Disease Helped with Chiropractic

From the Journal of Clinical Chiropractic Pediatrics comes a case study published in the March 2014 edition that reviews the case of an infant with gastro-esophageal reflux disease improving while under chiropractic care. The author, Dr. Andrew Chuang, a chiropractor in Melbourne, Victoria, Australia, notes that prior to this study available literature discussing the use of chiropractic for cases of gastro-esophageal reflux (GER) and gastro-esophageal reflux disease (GERD) was sparse with a limited number of case reports showing up in scientific literature.

Dr. Chuang begins by highlighting the frequency of these problems by reporting, "Gastro-esophageal reflux disease (GERD) is common during the first year of life, peaking at 4 months of age." In noting a prior study he writes, "Regurgitation of at least 1 episode per day was reported in half of 0- to 3-month olds."

In this case, a 4-month-old female infant was brought in for chiropractic care by her mother. According to the infant girl's mother, her baby had been vomiting after feedings for the past 2 months. A prior visit to her MD yielded a diagnosis of gastro-esophageal reflux disease (GERD). The medical doctor then recommended the infant be placed on Ranitidine for the condition.  Her mother was hesitant to start her baby on medication at such a young age, and chiropractic care was sought as an alternative.

A physical examination revealed no physical abnormalities in development, except the child had not gained any weight in the past two months. A chiropractic examination which included a postural examination as well as static and dynamic palpation of the spine was performed. From this chiropractic examination, it was determined that the child had multiple subluxations in her neck.

Specific chiropractic care was begun to correct the spinal issues. The mother reported that after the first adjustment, her infant girl had a large bowel movement, and slept for a longer period of time than normal.  The study further noted that over the next 3 weeks both the number of episodes of vomiting and reflux per day decreased, and the number of days with vomiting decreased. After 4 weeks of chiropractic care, the mother reported that her baby was no longer having any episodes of reflux and vomiting.

In his conclusion, Dr. Chuang wrote, "In the case described here a 4-month-old patient’s GERD resolved while under chiropractic care. This study suggests to the possibility that similar patient groups may benefit from chiropractic treatment."


Premature Infant Returned to Normal Development Levels with Chiropractic

A case study published in the March 2014 issue of the Journal of Clinical Chiropractic Pediatrics documented the return to normal development of an infant born 12-weeks-premature.  Babies born prematurely often have a variety of health issues including developmental delays that put them far behind their peers.

"Prematurely is becoming more common and neonates are surviving at increased rates..." reports the study author. "This comes with their increased likelihood to exhibit various health conditions from sensory to perceptive to motor disorders, as well as decreased immune function, respiratory weakness and mental health concerns."

The author also notes that the increased time spent in neonatal intensive care units (NICU), and special care nurseries (SCN), can create deformities of the shape of the infant's head which can also lead to further "...neurodevelopmental disadvantage."

In this case, a pregnant woman started bleeding at the 11 week point in her pregnancy. The bleeding was off and on until the 20th week when it became continuous.  By the 25th week, the woman was hospitalized and a decision was made to deliver her baby by cesarean halfway through the 26th week, nearly 12-weeks-premature.

Her newborn baby son weighed only 2.4 oz. upon delivery, and was placed on oxygen to assist with difficulty breathing.  The infant also had numerous other health issues including infection, jaundice, and obvious developmental issues. Due to severe health problems, the infant remained 58 days in the NICU, followed by another 44 days in the SCN.

The baby boy was brought to the chiropractor and examined at the age of 104-days-old. Based on the chiropractic examination, a course of specific chiropractic adjustments was initiated at the rate of one per week for one year.  No adverse events were noted in this study as a result of the infant receiving chiropractic care.

The results of the care measured over time by multiple tests showed a steady gradual return to normal development for the baby boy. After a year of chiropractic care, scores given by specific medical testing showed that the baby was either normal or slightly above normal developmentally.

The study records the outcome, "The parents had no concerns about the child’s development. He presented as a healthy, well-grown boy with two older siblings who he enjoys playing with."

In his conclusion, the author wrote, "This case demonstrates the efficacy of chiropractic to promote normal neurological development, which can be assessed through cognitive ability, receptive and expressive language, fine and motor skills and general wellbeing."


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