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May 2014

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• Reduction in Cardiovascular Disease Risk Factors Following Chiropractic Care
• Improvement in Symptoms of ADHD and Functional Outcomes with Chiropractic
• Seizures Gone with Chiropractic Care
• Pregnant Women with Low Back Pain Helped with Chiropractic According to Study
• Resolution of Torticollis, Plagiocephaly & Breastfeeding Difficulties Following Chiropractic
• Misdiagnosed: Docs' Mistakes Affect 12 Million a Year

Research published in the Annals of Vertebral Subluxation Research on April 23, 2014, document the case of a patient with Cardiovascular Disease (CVD) risk factors of high cholesterol and triglycerides levels being lowered with chiropractic.  The study authors begin by noting that two of the commonly stated risk factors of cardiovascular disease are high cholesterol and high triglycerides.

Reporting how common this problem is, the authors' state, "CVD is the leading cause of mortality and a major cause of morbidity worldwide; particularly prevalent in the United States due to Western diets and inactive lifestyles where more than 80 million individuals are diagnosed."

In this case, a 30-year-old male went to a chiropractor's office after a diagnosis of high cholesterol and high triglycerides by his medical physician.  His blood laboratory test showed that his triglycerides were 577 mg/dL with a normal range being from 35-150 mg/dL.  His cholesterol was 246 mg/dL with the normal range from 130-200 mg/dL. According to the normal values established by the Center for Disease Control (CDC), the patient’s cholesterol and triglyceride levels classified him as a high risk for cardiovascular disease. He also reported signs and symptoms of gout and secondary low back pain of six weeks duration.

A chiropractic examination was performed which consisted of motion and static palpation, visual postural evaluation, orthopedic tests, neurological tests, deep tendon reflexes for upper and lower extremities, and paraspinal thermography instrumentation. Based on the finding of the examination procedures, it was determined that spinal subluxations were present. Specific chiropractic adjustments began at twice per week to correct the subluxations. As part of a healthy regimen, the patient also started lifestyle changes in diet and exercise.

By the second visit, the patient noticed improvement in his symptoms and other complaints, including less joint pain and lower back pain. The patient also reported improved sleeping patterns, and improved digestion. The patient also discontinued his cholesterol and triglyceride medications after consulting with his MD.

About five weeks into his chiropractic care, the patient's MD did another blood workup to see if the levels of cholesterol and triglyceride had changed. The patient's blood test results were as follows: normal triglycerides of 126 mg/dL with a range from 35-150 mg/DL, normal cholesterol of 188 mg/dL with a range from 130-200 mg/dL. 

In their conclusion the authors wrote, "This case study suggests that adults with cardiovascular disease may lower the risk factors utilizing a combination of chiropractic care, along with lifestyle modifications."

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A study published in the Annals of Vertebral Subluxation Research on April 27, 2014, documented chiropractic care helping four children with ADHD. According to the National Institutes of Health (NIH) Medline Plus website, "Attention deficit hyperactivity disorder (ADHD) is a problem of not being able to focus, being overactive, not being able control behavior, or a combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person's age and development."   

The rate of ADHD in the population continues to rise at an alarming rate with the NIH noting that the diagnosis of ADHD has increased an average of 3% per year from 1997 to 2006. The increase has continued with the NIH reporting, "The percentage of children with an ADHD diagnosis continues to increase, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011."

The study authors state that medical treatment for children with ADHD commonly consists of stimulant medication in addition to psychotherapy.  The medications, however, carry some serious side effects according to the study. "Common adverse effects of stimulants include nausea, upset stomach, decreased appetite, insomnia, and headache. More rare adverse effects include motor tics, irritability, mood lability, hallucinations, growth defects1 (decreased height), epilepsy, seizures, psychotic symptoms, sudden death, liver failure, suicide-related events."

In this case series, four children between the ages 8 to 12 years of age were brought to a chiropractic clinic for help with their symptoms of ADHD. All four children had been previously diagnosed with ADHD by a medical doctor and were suffering from either inattention or impulsivity, or both. Three of the children were on prescription medication for ADHD, and the fourth was previously on medication.

The children received chiropractic examinations which included digital postural assessment, surface paraspinal electromyography, infrared paraspinal thermography, heart rate variability and spinal range of motion analysis.  A standardized ADHD symptom questionnaire, completed by the child's primary caregiver, was used to measure the symptoms of their ADHD. Each child received specific chiropractic care based upon their individual examinations and analysis.

The study showed that each of the children improved under chiropractic care. The authors then combined the data into the following results:

• Impulsivity/Hyperactivity decreased in regularity by 23.8%
• Impulsivity/Hyperactivity decreased in severity by 24.1%
• Inattention decreased in severity by 15.8%
• Combined regularity and severity of symptoms decreased by 21.0%
• Total Dysfunction rating decreased by 17.3%

In their discussion, the study authors commented, "The results of this case series seem to indicate that Chiropractic care improves patient outcomes and prognosis in the management of ADHD in both medicated and unmedicated children."

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The Annals of Vertebral Subluxation Research published a study on April 10, 2014 documenting the case of a young girl with pseudoseizures being helped with chiropractic care.

The study authors reported, "A seizure is characterized by an abnormal discharge of nerve cells in the brain that can cause altered awareness or abnormal sensations, involuntary movements or convulsion."  Similarly, pseudoseizures are identical in their presentation and symptomatology to grand mal seizures, but lack the presence of neurological activity measured on an EEG.

In this case, a 14-year-old girl was brought in for chiropractic care by her mother who reported that her daughter had been suffering from 30-40 seizures per month for the previous three months. The history noted that the young girl's seizures often occurred in multiples on one day with two to three seizures at a time and one to two minutes of quiet in between. The frequency and severity of the seizures was continually getting worse since their onset. Her problems were so severe that she had to discontinue traditional school in favor of being home schooled.

Prior to the chiropractic examination the girl had been examined by her primary care doctor, an allergist, a neurologist, a psychiatrist and a psychologist. She had been subject to a battery of tests including multiple MRI’s, EEG’s, CT’s and blood work. The tests had not shown any pathology, so the medical diagnosis given was that the girl was suffering from pseudoseizures.

A chiropractic examination and analysis revealed the presence of vertebral subluxations. Specific chiropractic care was then rendered to correct the subluxations. Care began at the rate of 2 to 3 visits per week.

The study showed that by the girl's sixth visit, she had gone without a seizure for eight days which was the longest time period since her seizures began three months prior. She experienced one additional seizure during her eighth visit to the chiropractor, and was adjusted at that time. This event was followed by another eight days of her being seizure-free.

As chiropractic care continued, the girl's seizures continued to decrease in frequency.  After 5 months of chiropractic care, the girl would still get the pre-conditions and feelings like a seizure was coming, but no seizure would ensue. She continued to remain seizure-free and was able to return to school after 8 months of chiropractic care.

"It is postulated that a relationship between subluxation, specifically upper cervical subluxation, and childhood seizure disorders exists," the authors noted in their conclusions. "Evidence from this case supports the elimination of vertebral subluxations as an effective management approach in the care of children with seizures."

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Results of a study published on April 1, 2014, in the scientific periodical, the Chiropractic & Manual Therapies, showed that chiropractic helped pregnant woman suffering with lower back pain. The research was conducted in Switzerland, and compiled at the Department of Chiropractic Medicine, Orthopedic University Hospital Balgrist, University of Zürich, in Zürich, Switzerland.

Study authors begin by noting that lower back pain in pregnant women is so common that it is almost considered a normal part of the process. They estimate that between 50% and 80% of pregnant women will suffer back pain during their pregnancy, and this pain does have an effect on their quality of life.

In this study, pregnant women over the age of 18 with low back pain, pelvic pain, or both of any duration who had not undergone chiropractic, or any form of manual therapy in the prior 3 months were recruited from chiropractic practices in Switzerland.

Data was collected on a total of 115 women who participated in the study and received chiropractic care during their pregnancy. The data included a numerical rating scale (NRS) for pain, where "0" means no pain, and "10" would be the worst pain imaginable. Additionally the patient's global impression of change (PGIC) scale was used so the women could rate their own overall progress from chiropractic care.

Data was obtained using accepted standardized questionnaires after chiropractic care was started at intervals of one week, one month, three months, six months, and finally one year after the initiation of chiropractic care.

The study results showed that all groups at all timeframes showed positive results from their chiropractic care. The results also improved as chiropractic care continued. The data showed that 52% of the pregnant women with back pain were improved at 1 week. The percentage of pregnant women with a improvement in their back pain increased to 70% at 1 month, and 85% at 3 months. At 6 months, 90% reported improvement, and, after a full year, that percent was statistically the same with 88% saying they were improved.

In their discussion, the researchers point out that the results of this study add to the growing body of evidence from prior studies showing that chiropractic is beneficial for pregnant women suffering from back pain. "The results of this current study which showed that a high proportion of pregnant patients with LBP undergoing chiropractic treatment reported clinically relevant improvement support those published in a recent cohort study as well as the recent randomized clinical trial (RCT) looking at chiropractic treatment for pregnant patients with low back or pelvic pain."

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A case study published in the Journal of Pediatric, Maternal & Family Health on April 24, 2014, documented the resolution of torticollis, plagiocephaly and breastfeeding problems in a baby who received chiropractic care.

Plagiocephaly is a flattening of a baby's skull. This problem can lead to developmental issues as the child grows older. This can occur from the birth process itself, or can develop in the infant in the first few months. The study authors note that an increase in plagiocephaly has been reported since the "Back to Sleep" campaign was initiated by the American Academy of Pediatrics in an attempt to prevent sudden infant death syndrome.

Torticollis literally means "twisted neck" in Latin. According to the National Institutes of Health (NIH) Medline Plus website, "Torticollis is a twisted neck in which the head is tipped to one side, while the chin is turned to the other."  The authors report that there are two types of torticollis including "Congenital Torticollis" and "Acquired Torticollis."

In this case, an 8-month-old male baby was brought to the chiropractor with a diagnosis by his pediatrician of torticollis and plagiocephaly. The boy was one of twins, but his sibling did not share any of the same issues. At about the time of the baby's two-month check-up, his mother noticed that her son's back and right side of his head were a little mis-proportioned. She discussed this with the pediatrician, who decided to render no care at that time but rather follow him closely for the next couple of months. 

At the six-month check-up, the mother told the pediatrician that she was having difficulty breast-feeding her son. The pediatrician noticed that there had not been much improvement in the asymmetry of the baby's head. At this point, his mother decided to have him examined by a cranial specialist at the local children’s hospital. The result of that examination led to a diagnosis of plagiocephaly.  The baby was fitted with a special helmet in an attempt to re-shape the head. The time of wearing the helmet was increased until he was wearing it 23 hours per day. No improvement was noticed, and the boy's mother then sought chiropractic care.

A chiropractic examination was performed and showed many abnormalities in the positioning and movement of bones in the neck and skull. A determination was made that subluxations were present, and a specific form of chiropractic adjustments were begun on the neck and skull areas.

The study records that the boy's mother saw immediate results following her son's first adjustment. She was also able to nurse her baby without difficulty. By the second adjustment, his torticollis had been reduced by 75%, and his skull asymmetry was reduced by 25%. There was also an improvement in the baby's neck motion as well as improvement in his head tilt. By his third visit, his torticollis was 100% resolved, and he no longer needed to wear his helmet.

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The headline above is from an April 16, 2014, NBC News story reporting on research published April 21, 2014, in the prestigious British Medical Journal (BMJ). The research, partially funded by the Agency for Healthcare Research and Quality and the Department of Veterans Affairs, titled "The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations" shows that approximately one in every 20 Americans who seek medical outpatient care will receive the wrong diagnosis.

Researchers examined data from three previous studies evaluating things such as unexpected return visits, and lack of timely follow-up. This large sample size allowed the researchers to project their finding to the general US population.

The data led the researchers to conclude that as many as 12 million Americans a year, or more than 5 percent of all patients, are misdiagnosed.  Of these errors, it was estimated that as many as 6 million Americans could potentially suffer serious harm.

The study results reported, "Combining estimates from the three studies yielded a rate of outpatient diagnostic errors of 5.08%, or approximately 12 million US adults every year. Based upon previous work, we estimate that about half of these errors could potentially be harmful."

"Misdiagnosis is clearly a serious problem for the health care field," said Hardeep Singh, M.D., M.P.H., chief of the health policy, quality & informatics program at the Center for Innovations in Quality, Effectiveness and Safety. "This population-based estimate should provide a foundation for policymakers, health care organizations and researchers to strengthen efforts to measure and reduce diagnostic errors."

"The findings of this study are consistent with recent data from the general public about diagnostic errors," Singh said. "This study is significant because it is based on a large sample size and is the most robust estimate thus far to address the frequency of diagnostic error in routine outpatient care."

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