January 2018

Urinary Incontinence, Low Back Pain, and Radiating Pain Helped with Chiropractic

The Journal of Alternative, Complementary & Integrative Medicine published a study on November 13, 2017, demonstrating the positive results chiropractic care had for patients with urinary incontinence, low back pain and radiculopathy.  Urinary incontinence is a common problem with associated lower back pain, as some of the same nerves involved in back pain also control the bladder.

Urinary incontinence is the inability to control the bladder. It can manifest as an occasional simple leakage when coughing or sneezing, or it can be severe where the urge to urinate comes on so suddenly and severely that there is not time to make it to the bathroom. The study reports that lower back pain is the most common type of pain in adults with one in four reporting some form of lower back pain the previous three months.

In this study, the records of 1367 patients suffering from lower back pain with radiating leg pain were reviewed. Of these, 119 patients, (8.7%) also had urinary incontinence. With the consent of these patients, their care was reviewed. Urinary incontinence with lower back pain is more common in women than in men. Of the total of 119 who met the criteria, 108 were female while only 11 were male. The age range for these patients was from 47 to 70.

All the patients in this study had been suffering from lower back pain for at least two years and had reported urinary incontinence for at least two months. Chiropractic and orthopedic examination procedures were performed to confirm lower spine problems. Additionally, an MRI study of all the patients confirmed a lower spine disc herniation that affected nerves in that area.

Chiropractic adjustments were given to each of the patients in accordance with the spinal findings. The average number of visits for patients included in this study was between seven and eight. The average time frame for chiropractic care was between one and eight weeks of care. The type of chiropractic care varied based upon the condition of the patient, their spine structure, age, and other factors specific to their situation.

In this study, the primary outcome measured was how often the patient had to urinate at night as well as any leakage or incidence of urinary incontinence episodes. The study results showed that 64.74% of the patients had complete remission of their urinary incontinence as a result of their care. Additionally, 30.25% showed at least a 25% or more improvement. Only 5.04% of the patients in this study did not show a significant change.

In their discussion and conclusion, the authors of this study point out that past discussions seem to discuss the idea that urinary incontinence was from a physical response to lower back pain. This new study suggests that the relationship between urinary incontinence and lower back and leg pain is more based upon neurological factors than physical ones. They state, "It is conceivable to the authors that chiropractic spinal manipulation exerts positive physiological responses in these patients. The results of this study are very promising with 113 (94.95%) patients reporting improvements."


Tourette Syndrome and Chronic Tic Disorder Helped with Chiropractic

The Chiropractic Journal of Australia published a case study in their December 2017 issue documenting the case of a patient suffering with Gilles de la Tourette syndrome (GTS) and chronic tic disorder showing positive improvements due to chiropractic care.

According to the Tourette Association of America, Gilles de la Tourette syndrome (also known simply as Tourette syndrome), "...is a neurodevelopmental disorder that becomes evident in early childhood or adolescence. It is part of the spectrum of Tic Disorders and is characterized by motor and vocal tics."

This issue is not as rare as most people think. According to the study authors, "The current estimates are that 1 out of every 160 children between the ages of 5-17 in the United States has TS and that 1 out of every 100 children has TS or another tic disorder.

The symptoms of Tourette syndrome can include repeatedly blinking of the eyes, shrugging of the shoulders or blurting out unusual sounds or offensive words. The tics, or involuntary movements associated with this condition typically appear between the ages of 2 and 15 years of age. Boys are three to four times more likely to have this problem.

In this study, a 19-year-old man went to the chiropractor for an evaluation. At the age of 12, he fell from a chair. Shortly thereafter, he began to develop uncontrollable tics and muscle spasms. At the age of 14, he was officially diagnosed with Tourette syndrome by his medical doctor. The spasms the boy was suffering from mainly focused in his face, jaw and vocal cords. He also suffered with bilateral spasms of the muscles of his feet. He was treated medically with medication, which had a minimal effect.

Upon presentation to the chiropractor’s office, his tics were objectively evaluated using the Yale Global Tic Severity Scale. This scale is an effective way of measuring the severity of the tics for comparison later in care. According to this scale, his overall impairment due to his condition was rated at 40 percent.

A chiropractic examination and x-rays showed a number of postural abnormalities as well as a reversal of what should be a normal forward curve in the neck. From these findings, it was determined that subluxation was present.

Specific forms of chiropractic care along with certain focused exercises were performed on this patient. Due to the severity of this case, the patient was initially seen five times per week. The patient was visiting the United States from Canada for 12 weeks when he sought chiropractic care. He was therefore only available for care at this facility for 12 weeks before returning to Canada.

An examination was performed to evaluate his progress before he left the country. The results of that evaluation showed that the young man had reduced his overall impairment by half, going from 40% to a 20% impairment according to the Yale Global Tic Severity Scale.

In the authors' conclusion and discussion, they explain how nerve system interference could create this type of issue by noting, "Altered spinal biomechanics associated with abnormal posture may cause significant neurological stress and malfunction." They also explained, "The central nervous system (CNS) is the master control system of the human body and ultimately controls and coordinates all body and cellular function. Since the CNS is housed inside the skull and spine, it can be subjected to consequent adverse mechanical tensions."

In relating to this man’s specific situation, the authors said, "Since the patient reported a traumatic fall at age 12, we propose that the cause of the abnormal spinal configuration was a result of trauma. Through the restoration of normal biomechanical structure and curvature, these abnormal stresses and strains were removed from the spinal cord and neural elements, which led to the improvement in function in this patient."


Quality of Life Improves for Pregnant Women Under Chiropractic According to Study

The Journal of Alternative and Complementary Medicine published a study on December 20, 2017, showing that pregnant women who were under chiropractic care experienced an improvement in their quality of life as measured by specific scientific tests.

The authors of the study begin by pointing out that, "During pregnancy, the expectant mother is faced with many physiologic and biomechanical changes that affect her emotional, physical, and mental well-being. Complementary and alternative medicine (CAM) is popular for women of childbearing age with prior use as the most significant independent associated factor for CAM use during pregnancy."

Even though chiropractic is a separate and primary portal of entry form of non-medical care, it is often classified as complementary and alternative medicine (CAM) according to governmental authorities and the medical community at large. Other forms of healthcare are also included as CAM, including natural products or supplements, breathing exercises, meditation, acupuncture, massage, yoga, and homeopathy.

Pregnant women seek CAM procedures for a number of reasons including musculoskeletal problems, nausea, labor issues, lactating disorders, and delivery issues, to name a few.  The authors note that, "Of the various practitioner-based CAM therapies, chiropractic has been shown to be popular among women before, during, and after their pregnancy."

The study was conducted by reviewing information from a scientifically designed questionnaire given to patients of participating doctors of chiropractic. The criteria for patient participation was that the patient was at least 18 years of age, had agreed to informed consent to participate in the study, and the patient was pregnant during the course of the study.

The study results were determined from 343 participating pregnant women who met the criteria for this study. The average age of the women was 30.96 years. The educational level of the women showed a high level of education in the group with 31% having completed two years of college, 44% obtained a four year baccalaureate degree, and 20% had a master's degree. On average, the women presented themselves for chiropractic care in their 25th week of their pregnancy, with the breakdown being that 13.1% were in their 1st trimester, 32.9% were in their 2nd trimester, and 53.9% were in their 3rd trimester of pregnancy.

When asked who was their primary provider for their pregnancy, 57% indicated that it was an OBGYN, 9% said it was a nurse midwife, 27% said a midwife, 3% said a medical doctor, and 3% said other. The results of the study showed a significant improvement in quality of life issues for the pregnant women for physical functioning, sleep disturbance, satisfaction with participation in social roles, pain interference, and fatigue.

In their discussion, the study authors gave an overview of the study when they stated, "The purpose of this study was to understand the characteristics and reasons why women seek chiropractic care and to test whether the changes in QoL (quality of life) observed after starting chiropractic care were greater than the changes they would expect based on chance alone."  In reporting the results of the survey, the authors concluded that the women were highly satisfied with their chiropractic care, and reported that their quality of life measures had statistically improved.


Double Footling Breech Presentation Resolved with Chiropractic

On December 11, 2017, the Journal of Pediatric, Maternal & Family Health published a case study documenting the resolution of a pregnant mother's footling breech presentation under chiropractic care. A footling breech presentation is when one or both of the baby’s feet are in the downward position and are therefore more likely to be born first instead of the normal head first position.

The study begins by noting that about 3-4% of pregnancies result in a breech presentation. Current medical thinking is that a breech birth represents a significant medical threat and therefore a Cesarean birth is normally recommended in these cases. Since, for many reasons, a normal head-first vaginal birth is preferable to a cesarean birth, any reasonable process that can correct the breech should be explored.

In this case, a 38-year-old pregnant woman sought a chiropractic consultation and evaluation. The woman was in her 30th week of a pregnancy with twins that were in the footling breech position. She had previously had three individual pregnancies and delivered each child without complication. The woman had never experienced chiropractic care before. She was physically active by playing volleyball and swimming.

A chiropractic examination included palpation and a postural analysis. This showed a forward position of her head, as well as an uneven pelvis. There was also an abnormal motion of the pelvic bones when put through a range of motion test. Based on the findings, chiropractic adjustments were given.

Over the next 11 days, the patient was seen 5 times. In that time, both of the fetuses turned from the footling breech position down to a normal vertex, head-down position. This correction of the position of her fetuses allowed her to deliver her twins vaginally, without complication or medication.

The study also reviewed several previous studies showing chiropractic helping correct breech presentations and allowing for normal vaginal delivery. In one of those documented cases, a breech presentation self corrected after four chiropractic adjustments. In another case, the breech corrected after one week of chiropractic.

The overall body of evidence for breech presentations being resolved under chiropractic continues to grow. The authors of this study reviewed several other studies showing that chiropractic helped in those cases. In this particular case, the results were especially important because of the woman being pregnant with twins. In their conclusion the authors wrote, "This case report provides supporting evidence on the benefits of chiropractic care for the pregnant woman with fetal malpresentation."


Resolution of Systemic Lupus Erythematosus Following Chiropractic Care

The Annals of Vertebral Subluxation Research published a case study on December 18, 2017, documenting the case of a patent with systemic lupus erythematosus being resolved following chiropractic. . The term Lupus is commonly used to mean SLE. However, Lupus actually represents a number of autoimmune diseases. SLE is the most common of the Lupus autoimmune conditions.

According to the U.S. National Library of Medicine’s Medline website, "Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs." SLE can occur at any age and is more common in woman than in men. It most commonly appears between the ages of 15 and 44, and is more common in African Americans and Asians than other races.

In most people, the immune system identifies and fights off dangerous pathogens and infections to help the body stay healthy. An autoimmune disease is when the body gets confused and attacks normal healthy cells such as the skin, joints, kidneys, brain, and other organs.

In this case, a 34-year-old woman came to the chiropractor in hopes of getting help from a large variety of health issues. The woman was primarily suffering from constant chronic pain, constant fibromyalgia related symptoms, constant fatigue/anxiety/depression related symptoms, constant Lupus related symptoms, and constant hypothyroid related symptoms.

Additionally, the woman also suffered from stiffness in the neck, menstrual disorders, stomach disorders, mid back pain, irritable bowel, numbness in her feet, low back pain, leg pains, chronic fatigue, Lupus, fibromyalgia, ADD/ADHD, anxiety, nervousness, and nausea. Most of her health issues had been causing problems for over a year, with several conditions being over five years in duration.

The woman had been to a number of medical doctors who diagnosed her with a variety of health issues including systemic lupus erythematosus, fibromyalgia, hypothyroid, nephrolithiasis, and vitamin D deficiency. With these diagnoses, she was given a number of prescriptions including Prednisone, Plaquenil, baby aspirin, Hydrochlorothiazide, Wellbutrin, Xanax, and Hydrocodone.

A chiropractic examination was performed which included palpation, paraspinal thermograohy, and both static and motion x-rays of her spine. The results of the chiropractic examination indicated the presence of several subluxations. With this, specific forms of chiropractic adjustments were performed.

The results reported in the study showed that the woman’s lower back pain started to improve early in care. Her leg pain completely resolved, as was the numbness in her feet. The woman also reported that her hypothyroid related symptoms were much improved, her menstrual disorder was completely resolved, and her stomach disorder was much improved.

As care continued, the woman noted that her irritable bowel syndrome symptoms were much improved, her systemic lupus erythematosus related symptoms were much improved, and her ADD/ADHD related symptoms were much improved. Her improvement was such that she was able to come off seven of her medications. Her follow-up thermography and motions x-ray examination confirmed spinal improvements due to the chiropractic care.


Resolution of Cervicalgia Following Chiropractic Care

The Journal of Upper Cervical Chiropractic Research published a case study on December 21, 2017, documenting the correction of cervicalgia, more commonly known as neck pain, under chiropractic.  Neck pain is one of the more common pain complaints that people will experience in their lifetime.

The authors of this study note that, although neck pain is very common, scientific studies on neck pain vary as there is no uniformity on the studies done on neck pain. This results in difficulty putting together the data from the studies done world-wide on this subject. However, it is estimated that in a given year between 10.4% and 21.3% of the population will suffer from neck pain. Unlike other types of musculoskeletal pain, neck pain is more common in people who work in office or computer types of employment.

Somewhere between 33% and 65% of musculoskeletal neck pain will self resolve within one year. However, the study reports that relapses are common, with about 25% having neck pain again within a year. Neck pain is more common in women than in men, and it is more common in high income nations and in urban areas. The risk of neck pain increases up untill between 35-49 years of age, after which the prevalence of the problem seems to decrease.

In this case, a 55-year-old woman with a chief complaint of long term neck pain went to the chiropractor. She described her neck pain as a dull and stiff ache that was made worse by long periods of sitting or standing. On a scale of 1 to 10, with 10 being the worst, she described her neck pain as a 5.

During a chiropractic examination, it was noted that the woman had difficulty bending her neck to either the right or the left side. A postural analysis also showed deviations from a normal balance posture with one shoulder being higher than the other. Palpation of the woman’s neck showed muscle spasm and tenderness of the paraspinal muscles with restricted motion of the top four bones in her neck.

A thermal study of the woman’s spine showed temperature differences from one side to the other as well as one level of her spine to the other. X-rays of her neck showed a reversal of the normal neck curve along with degeneration in her mid-neck spinal bones.

With a determination of the presence of subluxation, specific chiropractic adjustments were started. In this study, the patient was seen for one month and was reassessed at two-week intervals. At the first two-week assessment, she rated her pain as having been reduced from a 5 out of 10, down to a 3 out of 10. The thermals scans performed at this time showed an improvement as well.

After another two weeks, a second assessment was done. At this time, the woman related a complete resolution of her pain in the neck. This was verified with the thermal scans that also had returned to normal at that time.