May 2017

Stroke Patient Improves Under Chiropractic - A Case Study

In the April 17, 2017, issue of the Annals of Vertebral Subluxation Research is a published study documenting the case of a man who had suffered a stroke 18 years earlier being helped by chiropractic.

According to the study authors, "Stroke is the leading cause of disability, third leading cause of mortality, and fifth leading cause of death in the United States."  They continue, "The Centers for Disease Control and Prevention defines stroke as something that occurs to interrupt blood flow causing brain cells to die within minutes due to the lack of available oxygen."  It is estimated that approximately 800,000 people suffer a stroke in the United States each year.  

There are three types of stroke: ischemic, hemorrhagic and transient ischemic attack (TIA).  Ischemic strokes, either transient or permanent, occur when there is some sort of blockage of an artery that brings oxygenated blood to the brain. These types of strokes account for 80% of the cases. The remaining 20% of strokes are hemorrhagic strokes, which is when an artery in the brain ruptures and leaks blood.

Statistics show that 40% of stroke survivors will experience moderate to severe impairments that require some form of specialized care. Of those, 25% will have minor impairments, and only 10% of those that have a stroke will recover almost completely. The statistics show that 14% of those who suffer one stroke will have another one. The mortality rate of those that suffer a stroke is not encouraging. Within 10 years of suffering a stroke, 32% of stroke victims die.

In this case, a 58-year-old man went to the chiropractor seeking relief from left hip pain that he rated as 8 out of 10 in severity. The man had tried therapy and cortisone shots which gave little relief. In his history, he noted that he had suffered a stroke 18 years earlier which left him with some residual paralysis bilaterally with little to no control over his fine motor skills and widespread muscle spasticity. His right hand was contracted in a complete fist which left it unusable. His motor skills were also impaired such that he had trouble putting on his jacket, buttoning it, or zipping it up. The man's medical doctor told him that these effects were permanent.

A chiropractic examination was performed which included a postural evaluation, range of motion, palpation and spinal x-rays. Based on the finding of the presence of subluxations, chiropractic adjustments were started on a regular basis.

After a short period of time, the patient reported that his back pain had eased considerably. However, in addition to his back pain being helped, it was also noted that after two months of chiropractic, the man was able to turn the pages of a book with his right hand, something he had not been able to do since his stroke. Additionally, after eight months, he reported improvement in his fine motor skills, reduction of muscle spasticity, and overall easier movement. Over time, he was able to take his right hand, which had been locked in a fist, and flatten it out on a table. He also reported that he was able to move well enough to put on his own jacket, snap the buttons, and zip it without help. He also noted that he was able to workout on his home workout equipment, which was something he was unable to do since his stroke.

The man also noted one other interesting effect that he attributed to his chiropractic care. After chiropractic, the man visited his optometrist and was told that for the first time since his stroke, his eyewear prescription did not change. The man found this strange because at each optometrist evaluation visit since his stroke, his eyes had gotten worse.

In the conclusion of this study, the authors wrote, "The clinical progress documented in this case suggests that chiropractic care addressing the vertebral subluxation."


Woman Experiences Improved Quality of Life and Decreased Pain with Chiropractic

The Annals of Vertebral Subluxation Research published a case study on April 24, 2017, documenting the improvement from chiropractic of a woman suffering from pain in a variety of places who had been diagnosed with Polymyalgia Rheumatica.

According to the Mayo Clinic website, "Polymyalgia Rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Symptoms of Polymyalgia Rheumatica usually begin quickly and are worse in the morning. Most people who develop Polymyalgia Rheumatica are older than 65."

In this case, a 64-year-old woman sought chiropractic care for multiple pain complaints. Her pain included low back pain, bilateral shoulder pain, right elbow pain, right knee pain, neck pain, numbness of the left hand and left and right thumb pain.  The lower back pain started over 40 years ago after a car accident. The woman described the pain as a constant sharp and dull pain, rating it as a 9 out of 10. The pain was worse at the end of the day and would last 2-3 weeks at a time.

Her right knee pain had been off and on for 20 years. She blamed the knee pain on the hip dysfunction she had before she had bilateral hip replacements. The pain, which she rated as a 10 out of 10, was worse in the evenings as well as with certain activities. The woman's bilateral thumb pain started 15 years ago. She did not recall any particular reason for it starting. Initially, she rated the pain as 10 out of 10, that was made worse by exercising and writing.  She had been medically diagnosed with osteoarthritis and Polymyalgia Rheumatica.

The woman did try to lead a healthy lifestyle as her diet consisted of 4-5 servings of fruits and vegetables daily, lean meat such as chicken, some white pork, some beef, tofu, turkey, and fish. Additionally, she claimed to drink about 6 to 8 glasses of water per day. She avoided things such as caffeinated beverages, tobacco, alcohol or recreational drugs. She slept about 7 hours per night and rated her sleep as good. She was taking a number of prescriptions for her problems as well as dietary supplements she felt were helpful.

A chiropractic examination was performed. She demonstrated difficulty in walking, with her gait being more of a shuffle. She needed assistance to sit or stand. She also experienced difficulty standing by herself or lying down. Her posture showed multiple abnormalities and her mobility was significantly restricted. X-rays of her spine showed multiple areas of calcification, degeneration, and subluxations.  

With the determination of the presence of subluxations, specific chiropractic adjustments were started. After only the second visit to the chiropractor, it was noted that the patient was able to get up and down with less difficulty. By the third visit, the patient reported that she was able to do some cooking on her own without difficulty. As care progressed, she continued to show improvement, and by the sixth visit, she was able to clean her house by herself with little problem. By the ninth visit, the woman stated that she felt "more like her old self", and was able to get around by herself without difficulty. By the eleventh chiropractic visit, she reported that she was able to start sewing again. As the woman continued with her chiropractic care, she progressed even further. She reported being able to engage in such activities as water aerobics and work-outs.  

In their discussion, the authors noted that the woman was not only receiving chiropractic care. They commented, "Over the course of the six months of combined Chiropractic care, functional rehabilitation, and co-management with a Rheumatologist, this patient has gained more mobility, more range of motion, increased degree of ambulation, decreased level of pain, and ability to do her regular activities."


Resolution of Breech Presentation and Successful Vaginal Birth After Cesarean with Chiropractic

The Journal of Pediatric, Maternal & Family Health published a case study on April 13, 2017, describing the successful chiropractic resolution of a frank breech presentation in a pregnant woman.  The woman had previously had a cesarean birth, but was able to deliver this baby vaginally.

According to the study, the incidence of breech presentation occurs in 3%-4% of all labors and in 7% of all pregnancies at 32 weeks. The most common breech presentation is what is known as a "frank breech presentation" and occurs in 64% of all breech pregnancies. A frank breech presentation is when the fetus's head is up, the legs are flexed at the hip with both knees extended, and the buttocks is down toward the birth canal.

Medically, very few breech presentations spontaneously turn after 34 weeks, thus leading to a caesarean delivery rate of between 80% to 100% of these cases. The study noted that, overall, the rate of caesarean births has increased over the years in the United States to where, according to the Centers for Disease Control and Prevention, 32.2% of all deliveries in the U.S. were delivered by cesarean in 2014.

The medical approach for correction of a breech presentation is external cephalic version (ECV). This involves the baby being pushed or manipulated by pressure through the mother's abdominal wall in an attempt to move the baby into a head down position. This ECV procedure is only successful 50% of the time in selective cases.

In this case, a 35-year-old woman in her 34th week of pregnancy came to the chiropractor. An ultrasound by her obstetrician confirmed that her pregnancy was a frank breech presentation. This was her third child. The previous 2 pregnancies both went to full term with the first resulting in a cesarean section and the second resulting in a vaginal birth.

A chiropractic examination was performed which included postural analysis, thermography, and palpation. From the examination, chiropractic care was started including the specific application of a procedure known as the Webster technique. The International Chiropractic Pediatric Association defines the Webster technique as "...a specific chiropractic analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of subluxation and/or sacroiliac (SI) joint dysfunction. In so doing, neurobiomechanical function in the sacral/pelvic region is improved." This technique has long been recognized to have a positive result on breech pregnancies with the result being a spontaneous turn into a vertex position.

The woman was adjusted 4 times over the next two weeks. On her fifth visit, the woman reported that the fetus had turned and was now in the normal vertex position. This was confirmed by an ultrasound performed after her fourth chiropractic visit. The woman was able to go on to have a normal vaginal birth with no complications.  

In explaining how chiropractic could help this woman with her breech pregnancy, the authors described the process in their discussion section. "Chiropractic adjustments, often for the purpose of correcting vertebral subluxation, confer measurable health benefits to people regardless of the presence or absence of symptoms. These health benefits are unique for each individual person and involve many physiological and/or biomechanical changes. The Webster Technique specifically addresses the subluxation complex of the sacrum and the pelvic articulations with the round ligament."


Improvement in Motor Function, Postural Stability, Joint Position and Reaction Time with Chiropractic

A study published on April 10, 2017, in the scientific journal, the Annals of Vertebral Subluxation Research, documented the case of a 74-year-old man who showed improvements in function, reaction time, postural stability, and joint position awareness due to chiropractic care.

The study begins by pointing out that the processing of sensory input from one's environment involves combining information from multiple sensory sources into the brain.  Sensory processing is most efficient when both central and peripheral sensory organs are functioning properly. Since the nervous system controls all sensory organs, it is imperative that the nervous system be functioning at peak levels for the sensory input to be correct, and the body to formulate a proper response to the input.

The authors note that, as a person gets older, there is a decrease in the ability to properly process sensorimotor information. The result could include a reduction in postural stability, joint position sense, vibration perception and touch thresholds  as well as a decrease in simple and complex reaction times.

To test if chiropractic could have a positive effect on the decrease in processing of sensory input, a chiropractic research trial was created.  In this case, a 74-year-old man with no immediate symptoms was included in the clinical trial. His joint position sense, reaction time and postural stability were all measured prior to chiropractic care, and recorded as a base-line to be compared against during and after chiropractic.

The man's joint position sense was measured using a computerized Macroderma Proprioception test platform (MTP-2). In this test, the patient is instructed to move their ankle to a specific position, then move it around and return it to the original position. It is then measured and averaged over 20 repetitions. This showed that his pre-chiropractic MTP-2 result was 2.26 degrees.

Reaction time was measured using a Macroderma Reaction Platform MP-3 device which measured how quickly a patient could move their feet into a position in response to a light.  After 20 repetitions, the man's average for this test was 1151ms.

The man's postural stability was measured using a computerized balance platform (CAPS). This tested his ability to keep postural position with his eyes closed. Initially, he was unable to keep his balance with his eyes closed during the this test.

A series of specific chiropractic adjustments were then performed on the man on a regular schedule based upon the findings of a chiropractic examination.  At the 4 week and 12 week period, the man was re-tested for his joint position sense, reaction time, and postural stability.

The man's joint positioning improved from 2.26 to 1.34 after just 4 weeks, and to 1.58 after 12 weeks of chiropractic care. This represented a 30% improvement when compared to his initial evaluation. Likewise, his reaction times improved by 15%, going from 1151ms initially to 1007ms after 4 weeks, and to 984ms after 12 weeks of chiropractic. His postural stability went from not being able to perform the test prior to chiropractic, to where the man was able to keep his balance with his eyes closed during the testing.

In summing up the positive results of this case, the authors stated in their conclusion, "This case report documents significant improvements in sensorimotor function in an asymptomatic 74-year-old male receiving chiropractic care. This suggests that chiropractors may have a role to play in caring for older people even if they are asymptomatic."


Back Pain, Headaches, Dizziness, and Unrelenting Cough with Pneumonia Helped by Chiropractic

In the Annals of Vertebral Subluxation Research comes a published case study on April 27, 2017, documenting the case of a woman suffering with lower back pain, headaches, dizziness, and a persistent cough, who was also diagnosed with Extramedullary Plasmacytoma and pneumonia, being helped by chiropractic.

Medscape describes a plasmacytoma as "...a discrete, solitary mass of neoplastic monoclonal plasma cells in either bone or soft tissue." The soft tissue variety is known as Extramedullary Plasmacytoma and is often associated with multiple myeloma.  Since this is a type of cancer, it is often treated medically with radiation and/or chemotherapy.

The results of this type of treatment often cause the patient to have a lowered immune function which can be measured by various immune markers and blood levels, including neutrophils. The normal percentage of neutrophils present in the white blood cells should be between 42 and 80 percent.

In this case, a 48-year-old woman came to a chiropractor for help from the problems of low back pain, headaches, and dizziness. She had also been suffering with an unrelenting cough for which she recently received a medical diagnosis of pneumonia.  The woman described her lower back pain as a burning feeling, and rated the severity as a 10 out of 10.

A chiropractic examination included palpation, thermography, and spinal x-rays. The examination revealed muscle tightness, edema, postural abnormalities, and thermographic temperature variations. From the examination, it was determined that subluxations were present and adjustments were started to correct them.

After about two weeks of care, the woman reported that her headaches and dizziness had been resolved. She also noted a significant decrease in her lower back pain, going from 10 out of 10 down to just 2 out of 10. However, she did report that her cough continued to persist, which led her to seek an additional medical opinion.

Through the use of computed tomography, the MD gave the woman a diagnosis of Plasmacytoma, and the chemotherapy drug Carfilzomib was started. One of the common and significant side effects of this type of drug is a decrease in the immune system that can be measured by checking the percentage of neutrophils present in the white blood cell count.

In this case, the woman's neutrophils percentage was checked on multiple occations and found to be 43%, 30%, 51%, 66%, and 61%. This means her neutrophils percentage remained within normal limits for all but one of the tests during the time she was receiving chiropractic and the drug Carfilzomib.

In their conclusion, the authors of the study focused on explaining how the immune function of this woman remained high even with the administration of a significant drug that normally lowers immune function. Through the correction of subluxation, the nervous system was allowed to function at a higher level and thus the control of the immune system was affected. The authors stated, "Scientific research has begun to focus on the connection between the immune system and nervous system. Current research has shown that the nervous system plays a vital role in helping regulate the immune system and its functions."


Arnold-Chiari Malformation Symptoms Gone Under Chiropractic Care - A Case Study

On May 1, 2017, the Journal of Upper Cervical Chiropractic Research published a case study documenting the improvement of a 6-year-old boy with symptoms from Arnold-Chiari Malformation being helped by chiropractic. According to the National Institute of Neurological Disorders and Stroke of the U.S. National Institutes of Health, "Chiari Malformations (CMs) are structural defects in the cerebellum, the part of the brain that controls balance."

Some form of Chiari Malformation, also known as "Arnold-Chiari Malformation" (ACM), is found in about 1 in every 1000 people. "There are four types of CMs each with a different type of malformation and severity. This condition is more common in women than men and can cause symptoms of headache, neck pain, vertigo, sensory changes, and  lack of voluntary coordination of muscle movements. Other symptoms can also included leg weakness, ringing in the ears, hearing loss, speech disorders, loss of consciousness, and scoliosis.

In this case, a 6-year-old boy was brought to the chiropractor by his parents. The boy had previously received a diagnosis of  Arnold-Chiari Malformation that was confirmed by an MRI. He was suffering from unrelenting daily headaches that began at the age of three. The history revealed that at the age of three the boy had fallen off the back-end of a toy wagon after the wagon was jerked forward by another child. The fall caused him to hit the back of his head on the ground. His parents reported that about 2-3 weeks later their son started having headaches.

The boy's headaches were made worse by movement of the head which also created neck pain as well. Months after his headaches started, the parents noticed that the boy also had a hearing loss, and developed an ear infection. After a number of unsuccessful medical treatments, an MRI was done from which a diagnosis of ACM was made. The options recommended by the pediatric neurologist were either surgery or to seek an alternative type of care. The boy's parents decided to try the alternative direction and brought their son to the chiropractor.

A chiropractic examination was performed focusing on the upper neck area near the brain stem. The examination included paraspinal thermographic scans and cervical spine x-rays. The conclusion of the examination was that subluxation was present in the upper neck. With this information, specific forms of chiropractic adjustments were started.

As care continued, follow-up x-rays and thermographic studies were performed and confirmed the ongoing correction of subluxation. The results of the care were that the boy  reported a discontinuation of his headaches as well as no more motion sickness. Eventually, he had recovered enough that he was able to return to sports activities.

In their conclusion, the authors noted that one single case can not draw definitive conclusions, but they commented, "This case study has shown a potential link between removing upper cervical vertebral subluxation and the reduction of symptoms concomitant of ACM and an overall increase in quality of life for this patient."