October 2016

• Majority in U.S. Say Chiropractic Works for Neck and Back Pain
• Female Infertility Helped with Chiropractic Care: A Case Series
• Bilateral Sciatica Helped with Chiropractic According to Study
• Lowering the Bar: Adult ADHD, a Risky Diagnosis?
• Motion and Pain Improved with Chiropractic in 75-Year-Old Man
• Patient With Neck-Tongue Syndrome: A Case Report

The Gallup Poll released the results of a survey on August 26, 2016, showing that 35.5 million U.S. adults saw a chiropractor in the past year. The study also noted that one in four adults sought care for neck and back pain in the prior 12 months.

The Gallup survey, in conjunction with Palmer College of Chiropractic, found that 65% of adults said that they suffered back and neck pain serious enough to cause them to seek a health care provider at some point in their lives. When asked by the survey, "When was the last time that you had neck or back pain significant enough that you saw a healthcare professional for care?," approximately 11% responded it was in the last four weeks.

In a release from Palmer College, Cynthia English, Gallup research consultant in charge of the study noted, "Many Americans reported dealing with significant neck or back pain." Ms. English noted that a high percentage of those sought chiropractic care. "Among U.S. adults who sought professional care for neck or back pain, seven in 10 (71 percent) tell us they have been to a doctor of chiropractic."

This survey was the second annual Gallup survey on chiropractic in partnership with Palmer College. The first showed that  two-thirds of Americans said that chiropractic was effective for neck and back pain. It also showed that many adults said that chiropractors think of patient's best interest, and that more than 33 million U.S. adults saw a chiropractor in the previous year.

In the current poll, Americans rated physical therapy and chiropractic as the most effective method of care for neck and back problems. These were in contrast to drugs or surgery which ranked much lower.  Similarly, physical therapy and chiropractic were also ranked as safer by the public than drugs or surgery.

In the Palmer College release, it was noted that chiropractic care is very well received as demonstrated by the poll results. "Nearly 62 million U.S. adults (25 percent) went to a chiropractor in the last five years, with more than half (35.5 million) saying they went in the last 12 months. Adults who’ve seen a chiropractor in the last 12 months are generally very positive about their experience. About three in four of these adults (77 percent) describe the treatment they received as 'very effective.' Eighty-eight percent of recent chiropractic patients agree the quality of care they received was a good value for the money."

Christine Goertz, D.C., Ph.D., vice chancellor for research and health policy at Palmer College of Chiropractic, commented on the study, "Low-back pain and neck pain place a tremendous burden on our society." Dr. Goetz concluded, "The opioid-overuse epidemic in the United States demonstrates that Americans need safe, effective, conservative health-care alternatives to prescription pain killers."

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From the September 15, 2016,  issue of the Journal of Upper Cervical Chiropractic Research comes a case series showing that chiropractic care resolved two documented cases of female infertility.  The Centers for Disease Control and Prevention (CDC) define infertility as the inability to conceive after one year of attempting to do so.

The study begins by noting that infertility affects approximately 11% of reproductive-age women, which accounts for approximately 6.7 million individuals. Many different mechanisms have been attributed to female infertility including hormonal issues, cysts, and ovarian dysfunction.

Medical assistance to achieve pregnancy includes several procedures such as in-vitro fertilization. The costs of these can range over $10,000 per attempt. These procedures and the drugs included are very invasive and can carry significant side effects.  For these reasons, the study reports that more people have been turning to alternatives such as chiropractic.

In this case series, two individual women who were unable to conceive received chiropractic care. In the first case, a 28-year-old teacher with a primary complaint of infertility was recommended by a friend to seek chiropractic care.  In addition to her infertility, she was also suffering from occasional headaches, allergies, indigestion, low energy, trouble sleeping, and depression. She also revealed a history of two significant motor vehicle accidents.

An examination revealed a significant reduction of range of motion in her neck. X-rays showed spinal misalignments in the upper neck. The conclusion was that subluxations were present and specific chiropractic adjustments were given to address the subluxations. Approximately one month into her care plan, the patient reported that she was pregnant.

The second case involved a 37-year-old woman suffering with upper back and shoulder tension, and infertility issues. She had two daughters that were conceived through fertility treatments. As with the woman in the first case, this woman also had a history of 2 significant motor vehicle accidents years prior to seeking chiropractic care.

An examination consisting of palpation, range of motion, thermographic studies, and x-rays confirmed the presence of subluxations in the woman's spine. Specific chiropractic adjustments were performed to address the subluxations.

In this case, the woman noted a number of health improvements including less tension in her shoulders, improved sleep quality, more energy, more relaxed, fewer colds, increased overall comfort, and increased neck comfort, and an overall improvement in health in general. Within months of starting chiropractic care, the woman became pregnant without the assistance of medical fertility treatments of any kind. 

In their discussion, the study authors explain that subluxations affect body function that can lead to a variety of health issues. They quote the Association of Chiropractic Colleges definition of subluxation which may explain subluxation best as "...a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health."

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On September 22, 2016, a study was published in the Annals of Vertebral Subluxation Research documenting chiropractic helping a patient with bilateral sciatica.  Sciatica is a term that means pain down the sciatic nerves which run on each side from the buttocks down the back of the leg to the foot.

The sciatic nerve is the largest nerve in the body. It is actually comprised of fibers from several nerve roots exiting from several levels of the spine.  In addition to pain, sciatica can also involve weakness, numbness, or a loss of motor control down the leg. Sciatica usually involves some type of mechanical compression on the sciatic nerve or the sources of the sciatic nerve.

According to the National Institute of Occupational Safety and Health, 70% of the population in industrialized countries will suffer back pain at some time. It is estimated that between 13 to 40% of the public will suffer from sciatica at some time in their lives. Annually, it is estimated that between 1 and 5% of the population deals with this issue in a given year.

In this case, a 77-year-old man went to the chiropractor. The man was suffering from bilateral sciatica which started a year earlier after a car accident. The pain was so severe that the man was unable to walk more than four steps. In addition to the sciatica, the patient was suffering from diabetes, depression, and constipation.

A chiropractic examination was performed on the man which included range of motion, palpation, infrared paraspinal thermal scans, spinal x-rays, and motion x-rays. The man's range of motion was limited due to pain, and palpation showed areas of tenderness over the pelvis at the origin of the sciatic nerve. From the examination and x-ray findings, a determination was made that subluxations were present in the patient's spine.

Specific chiropractic adjustments were given to address the subluxations found to be present. After a month and a half, totaling eleven visits, a re-examination was performed. At that time, the man reported that his sciatica had been significantly reduced. He also reported that he was able to walk for a longer distance than before. His range of motion was also greatly improved.

In their conclusion the authors wrote, "Sciatica and other lumbar radicular syndromes are painful conditions that can cause significant disability to a patient."  They also noted that specific chiropractic care for the reduction of vertebral subluxations can have a positive effect on bilateral sciatica symptomatology.

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Lowering the Bar: Adult ADHD, a Risky Diagnosis?

The above headline comes from a September 10, 2016, article on MedPage Today that calls into question the growing numbers of adults taking ADHD medications. The article begins by noting that opioid abuse has recently been the focus of much public attention, but less talked about is the growing problem of abuse and the growing numbers of people using ADHD drugs.

The article notes that since 2013, the FDA has received 19,000 reports of complications from ADHD drugs. The vast majority of these come from stimulants like Adderall, Concerta, Ritalin, and Vyvanse. Adults seem to be far more likely to suffer adverse events involving hospitalization or death than are children.

According to the latest federal estimates, Adderall has led the way for increased usage going from 345,000 people in 2006 to 1.4 million in 2014. The number of emergency room visits due to Adderall and Ritalin have increased fivefold over the past 7 years. Between the years 2010 and 2015, sales of ADHD drugs increased from $7.9 billion to $11.2 billion.

One concern is that ADHD drug testing on adults lasts only several weeks or months and falls far short of the years that many other drugs are tested. This means that the long-term effects of these drugs are not known.

The article gives two basic reasons for the jump in usage. First is the aggressive marketing by the drug companies that produce these drugs. Second, they note that the diagnostic criteria for prescribing these drugs has been greatly relaxed allowing more people to fall within the diagnosis that is treated with these drugs. In other words, “The bar has been lowered.”

A panel from the American Psychiatric Association made the recommendations to lower the criteria in 2013. The article noted that 78% of the experts making the recommendations had financial ties to drug companies who benefited from the panel’s recommendations.

The article notes that some of the symptoms needed to reach an adult ADHD diagnosis include such vague items as an inability to focus on tasks, fidgeting, or interrupting others. Additionally the article reported that, “One study published in 2010 found that 22% of adults tested for ADHD had exaggerated their symptoms.”
 

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The Annals of Vertebral Subluxation Research published a case study on September 12, 2016, documenting the progress of an elderly man with limited motion being helped with chiropractic.  Mobility is a primary concern for the elderly and has a direct effect on the overall quality of seniors' lives.

The study begins by noting that the population of older people is growing rapidly worldwide. It is estimated that by the year 2050, people over the age of 60 will represent 21.1% of the worlds population with numbers greater than 2 billion.

The author of the study reviewed other studies involving chiropractic and motion in the elderly. In summarizing these studies he noted, "In recent studies chiropractic care, primarily focused on the correction of vertebral subluxation, has been shown to positively impact the older adults’ ability to remain independent, perform activities of daily living, and to be able to participate in life on many different levels, including physical and social functioning."

In this case, a 75-year-old man with a 20-year history of low back and neck pain went to a chiropractor. Due to his age, he believed he may not be able to improve and may have to "learn to live with it."  His history revealed that 48 years ago, the man had fallen over 22 feet down a sewage pit.

The man reported exhibiting discomfort while sitting and standing. His physical activity was curtailed to walking only short distances due to his pain and stiffness. His pain had gotten to the point where, over the prior four weeks before seeking chiropractic care, he had started taking over the counter pain medication. During the examination, the man rated his physical health as 4/10 and mental health as 7/10.

The examination showed that the man carried his head forward while also having an increased hunched-type curve in his middle back. His spinal range of motion was limited in most all directions.  Thermography and surface EMG studies also showed problem areas in the man's spine.

Chiropractic care was begun at the rate of 2 visits per month. The study stated that after the sixth visit, the man reported increased flexibility and was able to walk for longer distances than before.  On the seventh visit, the man commented, "It is important for me to be able to bend forward and move my head, I can do that easier now," He also commented, "I’ve noticed my posture is more upright and not bent forward."

As a result, the man's self rating of his health improved from a 4/20 to an 8/10, and his mental health improved from 7/10 to 8/10.  Additional improvements included increased range of motion in all of his movements, and he was able to discontinue his over-the-counter pain medication. 

In his conclusion the author wrote, "Chiropractic care to correct vertebral subluxation was associated with improvements in the patient’s presenting musculoskeletal complaints and resultant quality of life."

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The Journal of Chiropractic Medicine published a case report in the September 2016 issue documenting chiropractic helping a woman who was suffering from Neck-Tongue Syndrome. Neck-Tongue Syndrome (NTS) is a rare condition that involves pain on one side of the neck along with numbness on the same side of the tongue.

The study author notes that NTS is aggravated by neck movement. Although rare, NTS is estimated to occur in 2.2 people out of 1000 in the U.S. The diagnosis of this condition is rare as the findings can be overlooked or diagnosed as just neck pain with other non-related conditions.

In this case, a 34-year-old woman suffering from upper left neck pain went to a chiropractor. She reported that the pain was present 50% to 75% of the time. In addition to this, the woman reported that several times a week, she would experience some tingling, shooting, piercing, and electric shock–like sensations on the left side of her tongue. These sensations would last up to 30 seconds and would be brought on by a sudden turning of her neck to the left. The woman was a massage therapist and led an active lifestyle being an avid cyclist. Her problem hindered her activities due to the unpredictability of their onset.

An examination revealed a moderate forward head tilt and forward shoulders. Orthopedic tests performed were normal except some slight upper neck pain when placing pressure on the top of the head. Neurological tests in the neck and head area were also normal. Neck x-rays showed no underlying pathology.

Chiropractic care was initiated with special care being given to adjustments that would not elicit the patient’s pain or symptoms. The woman was also given 2 exercises to do at home to address her forward head position.

The study reports that the woman stopped experiencing tongue symptoms after her third visit to the chiropractor. Her neck pain was totally gone after 5 visits. Two years after the resolution of her Neck-Tongue Syndrome, she continued to remain symptom free.

In the conclusion the author wrote, “This patient with NTS responded favorably to chiropractic management. This result suggests that patients with a similar diagnosis may benefit from a course of chiropractic care.”
 

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