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January 2015

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• Improvement in Quality of Life with Multiple Sclerosis from Chiropractic Care
• Violent Outbursts Reduced in a 10-Year-Old Boy with Chiropractic Care
• Resolution of Carpal Tunnel Syndrome Following Chiropractic Care
• Resolution of Chronic Cervicogenic Headaches with Chiropractic
• Injury Risk with Chiropractic 76% Lower Compared to Primary Care Physicians - Study Shows
• The Medical Monopoly: Protecting Consumers or Limiting Competition?

From the Annals of Vertebral Subluxation Research on December 11, 2014, comes a research case study documenting the improvement in the quality of life of a woman with Multiple Sclerosis (MS). The study reported on both the functional and symptomatic improvement noticed by this MS patient.

The study authors begin by explaining that, "Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder that affects the white matter of the brain, spinal cord, and optic nerves."  They note that MS affects 250,000 to 350,000 people in the United States with a total of 2.5 million people worldwide.

Most cases of MS appear between the ages of 20 to 40, with those in their 30s being the most common decade for the problem to occur. Women are twice as likely to have MS, and many people relapse over time.

For the study rational the authors commented, "Because MS is a neurologically-based disease and chiropractic deals with the function of the nervous system as it relates to the brain-body connection, investigation into the effects of chiropractic care on MS patients is appropriate."

In this case, a 36-year-old woman went to the chiropractor with a diagnosis of MS by her medical physician. She was suffering with a large variety of symptoms related to her MS including fatigue, difficulty sleeping, low back pain, mid back pain, neck pain, lack of mobility of the cervical spine, headaches, dizziness, loss of concentration, nervousness, tenseness, numbness in arms and feet, burning sensation in feet, irritability, and mood swings.

A chiropractic examination was conducted which included palpation, range of motion, thermal scans, surface EMG scans, and spinal x-rays. It was determined that spinal subluxations were present and chiropractic care was begun.

After the first visit, the woman reported immediate improvement in a number of her symptoms. At the one-month mark, she reported that she had a "... 60% improvement in neck pain, clearer thinking, more alertness, more energy, a feeling of being more relaxed, better ease with standing, lifting, bending and driving, improvements in balance, more confidence and strength during gait, more ease in falling asleep and improved quality of sleep, and more mobility and increased cervical ROM (range of motion)."

The researchers noted that one case study does not mean that all cases will respond with the same improvement. However, this case does add to the body of evidence provided by a prior larger study performed in 2004 showing the link between chiropractic and the improvement of MS.  "A retrospective analysis of 44 patients with multiple sclerosis showed that 90% of these patients reported improvement of their symptoms while undergoing a five year course of IUCCA (a specific type of chiropractic adjustment), upper cervical care. Twenty-eight of these patients (70%) showed improvement with or absence of the majority of their symptoms. No further progression of the disease was reported by any of the 44 patients during the care period."

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In the November 2014 issue of the Journal of Clinical Chiropractic Pediatrics is a case report documenting behavioral improvement in a boy after chiropractic care.  The authors note that although there have been numerous studies on children who were diagnosed with a variety of conditions that are associated with behavioral issues, this is the only study of its kind where the subject did not have such a prior diagnosis.

In this case, a 10-year-old boy was brought to the chiropractor because of behavioral issues. It was reported that the boy would go from  being calm and relaxed to sudden outbreaks of violence. His mother also reported that he suffered from frequent panic attacks and periods of anxiety. The boy had been suspended from several schools, and was only allowed to attend his present school for 50 minutes each day.  Due to being out of school so much, he was not given an evaluation that may have led to a diagnosis.  He was also having difficulty sleeping and was unable to sleep by himself in a room.

The history showed that he had a difficult birth and had suffered from multiple ear infections and tubes placed in his ears as a small child. He also had a history of bowel issues suffering with both constipation and diarrhea.  He was given medication for his behavior, but that was discontinued as it caused weight gain.

The boy's mother was given a questionnaire to rate and document her son's condition and any changes from chiropractic care. This questionnaire was repeated regularly during care to evaluate any changes. Initially, she rated her son's issues at the highest level of severity.  Chiropractic care was then begun with specific chiropractic spinal adjustments being administered.

By the fourth visit, the mother reported that she started to notice a significant change in her son's behavior. By the ninth visit, her son had improved by over 80% as rated by the questionnaire. At the time of this report, the boy still had some violent outbursts. However, these were fewer and easier to get him out of than before his chiropractic care.  The boy's mother also reported that her son was sleeping better and was able to sleep in his own bed.  He had no panic attacks, and his eating and bowel issues had improved. 

The study authors concluded by writing: "This case report demonstrates that chiropractic spinal adjustments, the only treatment being rendered, were effective in improving the child’s behavior. This study suggests that chiropractic care helped to reduce violent outbreaks as well as to improve the patient’s sleep, with additional improvements to satiety and frequency of panic attacks."

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Published on December 15, 2014, in the  Annals of Vertebral Subluxation Research is a case study documenting the resolution of bilateral Carpal Tunnel Syndrome (CTS) following chiropractic care.  The study authors note that CTS occurs in about 1 to 5% of the general population and as high as 14.5% among specific occupational groups.

The authors explain the impact this problem has by noting: "Carpal tunnel syndrome is one of the most common peripheral entrapment disorders in the United States. It has been estimated that approximately 5 million workers suffer from the disorder with cost estimates for medical care placed over $2 billion annually."

The National Institute of Neurological Disorders and Stroke defines CTS by stating: "Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move."

In this case, a 57-year-old woman went to a chiropractic college clinic with complaints of bilateral hand pain with numbness of her first three fingers that radiated towards her left arm. She had been experiencing numbness and pain in her right hand for the previous ten months, and for eight months in her left hand. She had not seen a medical doctor for her problem prior to going to the chiropractor. Her pain was worse when sleeping and when performing repetitive motions. Anti-inflammatory drugs and ice provided only some temporary relief.

A chiropractic examination was performed that included a posture review, palpation, range of motion, orthopedic and neurological tests. Based on the history and examination findings, the patient was given a diagnosis of right and left wrist carpal tunnel syndrome with vertebral subluxation. Chiropractic care was then begun on this patient. The woman was also given some home exercises to perform on her own.

The case study reports that results were almost immediate. The woman experienced significant pain relief following the first visit. After the fourth visit she said, "I don’t wear my brace anymore and there is no more tingling or pain."

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In the Journal of Pediatric, Maternal & Family Health is a study published on December 12, 2014, describing the case of a boy who was suffering with chronic headaches being helped by chiropractic care. The authors begin by clarifying that in order for headaches to be classified as chronic they must occur for a duration of more than 15 days per month, and for 3 months or greater than 180 days in a year. They note that approximately 3 to 4% of the general population suffer from chronic headaches.

In this case, a 6-year-old boy was brought by his mother to the chiropractor for consultation and possible care for the boy's chronic headaches.  According to his mother, the boy went to the MD two years prior complaining of headaches that were occurring either daily or every other day. The MD told the boy's mother to give him ibuprofen for his headaches.  This was ineffective and subsequently the boy was sent to a Children’s Hospital for further medical work-up.

MRIs and computer tomography were performed on the boy but failed to show any medical reason for the child’s chronic headaches.  The boy was also seen by a concussion specialist and a neurologist without any help.  The patient and his mother returned to his pediatrician who made the suggestion of chiropractic care.

A chiropractic examination was performed and revealed areas of spinal irregularity on palpation. X-rays also confirmed malpositioning in the boy's neck. From the examination, it was determined that the boy had subluxations in his cervical spine. Chiropractic care was begun with the boy being seen two times per week.

On the third visit to the chiropractor, the boy reported that he had not had any headaches since his prior visit. On the fourth visit, he did report having another headache.  However, from the fifth visit forward, the boy did not suffer any additional headaches.

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A study published in the medical journal Spine on Dec. 9, 2014, showed that among Medicare beneficiaries, a visit to the chiropractor was much safer than a visit to the primary care physician.  A second study published by Hindawi Publishing on Dec. 25, 2015, showed that there was no evidence of injury after chiropractic adjustments.

In the study published in Spine, researchers reviewed records for Medicare beneficiaries who had gotten chiropractic care in 2007 looking for reports of injuries. Specifically, they reviewed records for "...older adults with a neuromusculoskeletal complaint, to evaluate risk of injury to the head, neck or trunk following an office visit for chiropractic spinal manipulation, as compared to office visit for evaluation by primary care physician."

The results of this study clearly showed that a visit to the chiropractor who performed an adjustment was safer than a visit to the medical physician for an evaluation. The study did not take into account the possible increased risk for any form of medical treatment or drugs as the medical comparison was only done on "...those evaluated by a primary care physician."

The study reviewed the records for up to seven days after either the chiropractic or medical visit.  In calculating the risk of injury for both the medical visit and the chiropractic visits, the researchers reported that "The cumulative probability of injury in the chiropractic cohort was 40 injury incidents per 100,000 subjects, as compared to 153 incidents per 100,000 subjects in the primary care cohort."  This showed that although no form of healthcare is totally without some small risk, chiropractic care was much safer.

In their conclusions the authors wrote, "Among Medicare beneficiaries aged 66-99 with an office visit risk for a neuromusculoskeletal problem, risk of injury to the head, neck or trunk within 7 days was 76% lower among subjects with a chiropractic office visit as compared to those who saw a primary care physician."

In the second study published by Hindawi researchers performed a "randomized controlled trial" to look at blood-work after chiropractic adjustments, to see if there were any chemical changes that would normally be present after spinal injury.  They compared these results to a control group that received placebo or fake adjustments.

The results showed no indications of increased levels of any chemicals that would have been present if the subjects were injured. From these results the researchers concluded: "Our data show no changes in any of the studied damage markers. Although this study examined the outcomes in an asymptomatic population, lower cervical and thoracic manipulative techniques seem to be safe manual therapies techniques which cause no harm to the health of the subject. These data may be used as evidence of the safe application of spinal manipulation to healthy subjects."

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"The Medical Monopoly: Protecting Consumers or Limiting Competition?" is the title of a CATO Institute policy analysis paper issued on December 15, 2014. As the title suggests, the paper reports on how healthcare has been governed by a monopoly which has caused an increase in cost and a drop in quality.

The paper, by Sue A. Blevins, a writer and health policy consultant based in Boston, explains why healthcare is so expensive. "Licensure laws appear to be designed to limit the supply of health care providers and restrict competition to physicians from non-physician practitioners. The primary result is an increase in physician fees and income that drives up healthcare costs."

The monopoly in healthcare begins right at the beginning in the educational level explain Blevins. "It should be noted, however, that medical schools rely heavily on federal subsidies, while training for non-physician providers is predominantly funded with private money. For example, all of the 17 chiropractic schools in the United States are privately funded; none are state owned." She continues, "By contrast, 76 of the 126 medical schools are state owned."

Reviewing the monopoly against chiropractic, the paper points out that between 1963 and 1974, the AMA operated a Committee on Quackery, whose main purpose was the elimination of the chiropractic profession.  The AMA also lobbied the government to restrict chiropractic licensing and reimbursement for healthcare services such as Medicare.

In the paper Blevins reports: "In addition, the AMA recommended that Congress exclude payment for chiropractic services from federally supported health programs. As a result, Medicare recipients are restricted from using the full range of chiropractic services. Medicare policy limits patient access to chiropractors this way: Medicare reimburses chiropractors for performing "spinal manipulation" but requires that a diagnostic spinal x-ray be taken before chiropractic treatment. The catch is that Medicare does not reimburse chiropractors for performing x-rays, even though they have the training and are licensed to perform x-rays in all 50 states. That policy gives the medical profession control over managing back problems among elderly Americans."

The paper also reports that in 1976, four chiropractors filed an antitrust lawsuit against the AMA and 10 other medical organizations. The suit charged that there was a criminal conspiracy to destroy chiropractic. It took over a decade to resolve, but in 1987 the chiropractors prevailed. The AMA was found guilty of an illegal conspiracy and in violation of U.S. antitrust laws. In spite of this victory for the chiropractors, the damage was already done as the restrictions on chiropractic reimbursement remain in place today.

In her conclusion, Blevins puts forth a first step toward leveling the playing field and reducing the healthcare monopoly. She explains: "What should government do if it is serious about cutting health spending and improving access to affordable healthcare? The first step should be to eliminate the anti-competitive barriers that restrict access to low-cost providers, namely licensure laws and federal reimbursement regulations. Americans should not be forced to substitute providers against their will; rather, they should be free to choose among all types of health care providers."

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