June 2018

Neck Pain and Numbness Resolved Under Chiropractic Care

On May 3, 2018, the Journal of Upper Cervical Chiropractic Research published a case study documenting the resolution of neck pain and hand numbness in a patient undergoing chiropractic care. According to the study authors, neck pain is one of the more common pain conditions in the general population.

Estimates show that at any given time, nearly 13% of the population suffers with some form of neck pain. Overall, nearly 50% of the population will suffer with neck pain at some point in their lives. Neck pain is one of the more common condition that people seek chiropractors for. About 25% of all patients that see chiropractors did so because of neck pain.

According to the study, neck pain is more common in people whose work requires performing repetitive static tasks, or physically demanding work. Neck pain is also more common in people who have had previous neck trauma, and those suffering from other conditions such as depression, low back pain, or headaches.

In this case, a 28-year-old man suffering with neck pain and tingling in his hands sought chiropractic care. The man reported that his neck pain started about five months earlier, though he could not recall any particular incident that brought on the problem. He also reported that he did not remember when his hands started tingling. He had not seen any other type of doctor, and was not taking any medications for these conditions.

The man described the neck pain as a dull achy kind of pain in his lower neck that he rated as only a 2 out of 10 in severity. He noted that his hands felt like pins and needles with the feeling be more prevalent in his right hand. Although he felt that these annoying conditions did not prevent him from performing normal daily activities, he did state that these issues prevented him from working out as hard as he used to.

An examination was performed at the chiropractic office which included checking his vital signs, orthopedic and neurological exams, cervical static and motion palpation, along with range of motion tests in both the cervical and lumbar region. A postural analysis did reveal some abnormal positioning as well as limitations is specific motions of some neck vertebrae. Cervical thermographic scans showed irregularities. X-rays of the neck showed malpositioning of cervical vertebrae in addition to moderate disc degeneration and spurring in the neck.

Based upon the finding of the examination and x-rays, it was determined that subluxations were present and specific forms of chiropractic adjustments were started. After the first adjustment, at his subsequent visit the patient did not report any improvement. Care was continued based upon specific findings that indicated the need for a chiropractic adjustment.

On the sixth visit, the man reported that his neck pain was gone and he only had some minor neck stiffness. He also stated that his hand tingling had reduced to only occasional tingling in his fingers. By the seventh visit, the man reported no neck pain or stiffness, and his hand tingling was completely gone. He elected to continue chiropractic care for correction of subluxations.


Improvement in Behavior, Communication & Sociability in a Child with Autism Following Chiropractic

The Journal of Pediatric, Maternal & Family Health published the results of a case study on May 16, 2018, documenting the improvement in many autism related symptoms following chiropractic care. The study begins by noting, "Autism and Autism Spectrum Disorder (ASD) is a developmental disability that has the potential to cause significant social, communication and behavioral challenges."

There is no specific blood test, no x-ray, or any type of verifiable scientific test for ASD. The diagnosis of ASD is based on observable behavior that fits the criteria agreed upon by experts that has been published in the book, "The Diagnostic and Statistical Manual of Mental Disorders."  Because of this lack of an absolute test, there is a subjective nature of interpretation to the diagnosis process of ASD. Some cases are very obvious while some could just be interpretations of abnormal behavior which could lead to over diagnosis and medical treatment.

Over the past 10 years, the diagnosis of ASD in the U.S. has doubled, going from 1 in 150 children  in the years 2000-2002, to 1 in 68 children by 2010-2012.  Other western nations have also seen an increase in the diagnosis of ASD with Canada reporting a diagnosis rate of 1 in 94 children, New Zealand and the United Kingdom both having the rate of 1 in 100 people, and a rate of ASD diagnosis of 1 in 150 people in Australia.

These high rates of ASD diagnosis are accompanied by a high financial burden. In the U.S. alone, ASD is estimated to cost between $11.5 billion – $60.9 billion each year. This comes out to an average increase in medical costs of $4,110 to $6,200 per year per child.

In this case, a 3-year-old boy who was diagnosed with autism was brought to the chiropractor by his parents. The boy's primary symptoms reported by his parents were chronic constipation, fussy eating, easily gagging and vomiting, poor sleeping habits, poor weight gain and hyper-sensitivity to touch. His parents also reported that their son had sleeping problems described as waking at night with anxiety and being hard to wake in the morning. The boy had suffered with chronic ear and sinus infections since infancy, and the parents reported that their son often fell for no apparent reason as if he temporarily lost consciousness.

A chiropractic examination was performed using inspection, palpation, and thermography to determine the presence of subluxation. From this examination, it was determined that multiple areas of subluxations were present in the boy's spine. Specific forms of chiropractic adjustments were then given on a weekly basis for correction of the subluxations.

In the first few visits, the boy's parents reported several improvements to his behavior, communication ability, social ability, a decrease in the frequency of falls, and an improvement in their son's sleeping patterns. By the fourth visit and beyond, the boy's parents reported that their son was no longer falling. By the sixth visit, it was reported that the boy's vocabulary had increased significantly and he was speaking in sentences more frequently. By the eighth visit, it was reported he was sleeping well and not waking with anxiety any longer.

In their discussion the authors reported, "This case documents the improvement in behavior, communication and social ability in a 3-year-old male with autism receiving chiropractic care for vertebral subluxation. The reported results are consistent with similar presentations described in the literature."

In the review of additional literature on this subject, the authors of the study note, "There is a growing body of evidence reporting the positive impact of chiropractic care on patients presenting with Autism and ASD, with steep growth in the evidence over the past 5 years according to two recent systematic reviews of the literature available specific to the topic."


Urinary Incontinence Resolved with Chiropractic

The Journal of Pediatric, Maternal & Family Health released the results of a study on May 21, 2018, documenting the case of a pregnant woman who was unable to control her bladder being helped by chiropractic.

Urinary incontinence (UI) is defined by most authorities as a leakage of urine. The Mayo Clinic internal medicine concise textbook lists four types of UI. They are: urge incontinence - due to an overactive bladder, stress incontinence - due to poor closure of the bladder, overflow incontinence - due to either poor bladder contraction or blockage of the urethra, and functional incontinence - due to medications or health problems making it difficult to reach the bathroom

UI is a common complaint among women after pregnancy and delivery. Some sources estimate rates as high as 31% among women who delivered vaginally.  According to the Urology Care Foundation, somewhere between one-quarter and one-third of adults suffer with some form of UI. Pregnancy in women, prostate problems in men, and aging in the general population seem to be related to an increase in incidence of UI. 

In this case, a woman presented herself for chiropractic care. The woman was in her second trimester of her second pregnancy. She was suffering with urinary incontinence and low back pain, as well as generalized diffuse body pain.  The woman reported that the UI first started immediately after the traumatic delivery of her first child. She had suffered with UI since that point for the past three years. She noted that a cough or sneeze would result in urinary leakage.

A chiropractic examination was performed involving a static and motion observation of posture as well as palpation of her spine and supporting structures.  The presence of vertebral subluxations was confirmed and chiropractic care was started at the rate of two visits per week. Additionally, the woman was given some home exercises to perform daily.

On the fourth visit to the chiropractor's office, the woman reported that she had sneezed one time, but had not had any urinary leakage as a result. By the sixth visit, the woman was able to report that she was no longer having any signs of UI and her problems have been resolved.

In the conclusion of this case study the author wrote, "This case demonstrates the effectiveness of chiropractic care in addressing pelvic floor dysfunction resulting in urinary incontinence and the safety of this care during pregnancy."


Study Showed Dizziness and Neck Pain Helped by Chiropractic

The results of a randomized controlled study, which included sham procedures, was published in the May 2018 edition of the journal Chiropractic & Manual Therapies. The study showed that subjects with non-specific dizziness and neck pain were helped by chiropractic.

The study begins by pointing out that neck pain and dizziness are common ailments in older adults. While neck pain carries with it the discomfort and limitation of daily activity, dizziness adds the risk of fall which can lead to serious problems, disability, or even death. For this reason, any form of care that can assist in the reduction of dizziness is of value to an aging population.

This study was conducted in Australia, so the statistic related to population occurrences may be different from other countries such as the United States. It is inferred that most industrialized advanced nations would share similar statistics concerning dizziness. One such statistic noted that among Australians over the age of 50, about 36% have reported dizziness in the past three months. Women seem to be affected by the problem at a slightly higher rate than are men.  The medical treatment for dizziness is usually drugs. However, these medications carry a variety of risks including an increase incidence of falling in the elderly population. 

Neck pain also carries an increased statistical risk of falls, although not as great as dizziness. The medical treatment of neck pain through medications carries its own risk of side effects. It has been well documented that pain medication usage has become a major health issue in most societies.

Neck pain accompanied by dizziness is referred to as "cervicogenic dizziness" or "cervical dizziness." The diagnosis of cervicogenic dizziness is usually made by ruling out all other possible factors that could be causing the dizziness independent of the neck pain.

This study was unique in several ways. First, the researchers used social media and advertising to recruit a large number of people for the study. From the respondents, the numbers were reduced by only accepting people who would fit into a specifically narrow criteria. Participants had to be between the ages of 65 and 85, and have both neck pain and dizziness for a period of at least three months.

A number of factors led to participants not being included in the study. Such factors that would exclude participants from the study were pathologies relating to the dizziness, a diagnosis of Meniere’s disease, a history of stroke or heart disease, psychiatric diseases, or a history of inflammatory joint diseases such as rheumatoid arthritis. Because of the narrow parameters of acceptance, the number of acceptable participants in the study was drastically reduced.

The remaining participants were randomly divided into two groups. The participants did not know which group they were in, or what the difference was. One group got chiropractic adjustments using an instrument set to the proper level to deliver an adjustment, the other group received a sham adjustment with the same type of instrument set to the zero level. This would allow the instrument to activate and make the same noise and sensation as a real adjustment without any impulse as in a real adjustment. Care was rendered for the same period of 4 weeks to both groups, after which a re-evaluation of the level of dizziness and neck pain was performed. 

Data related to the severity of the neck pain and the dizziness were done one week prior to any chiropractic or sham intervention and then again one week after the four-week four-visit trial. The dizziness was measured using a dizziness handicap inventory (DHI) score, and the neck pain was measured using a neck disability index (NDI) score. The results of this study showed that the group that received the real adjustment was statistically improved for both the neck pain over the group that got the sham adjustments when measured using the standardized DHI and NDI scoring.


Study of Active Military Personnel Showed Addition of Chiropractic to Standard Medical Care Superior to Just Medical Care for Lower Back Pain

A large study published on May 18, 2018, in the JAMA Network Open under Physical Medicine and Rehabilitation showed that adding chiropractic to standard medical care gave superior results for lower back pain than just standard medical care among active U.S. military personnel.

The study begins by noting the prevalence of lower back pain in the general population and the U.S. military population.  Lower back pain (LBP) is the second leading cause of disability world-wide. In the U.S. it is estimated that 20% of the adult population suffers with this problem. LBP carries a hefty price tag with direct costs for this condition in the U.S. in 2010 being estimated at $34 billion, and additional indirect costs including lost workplace productivity losses estimated at $200 billion.

In the military, LBP is one of the most common reasons military personnel seek medical care as well as one of the most common conditions that cause a soldier to interrupt combat duty. Common medical care includes medications such as nonsteroidal anti-inflammatory drugs, or opioids,  and surgical procedures such as spinal fusions, as well as procedures such as epidural steroid injections. Unfortunately, all these procedures carry significant risks and have been demonstrated to have a limited effectiveness.

This study involved a large number of active military personnel at three locations. The three locations were Walter Reed National Military Medical Center in Bethesda, Maryland; Naval Medical Center San Diego in San Diego, California; and the Naval Hospital Pensacola in Pensacola, Florida. Each of the three facilities had 250 participants in the study for a total of 750 active military personnel being involved. All participants were suffering from lower back pain not caused by disease or fracture.

This total was subdivided into two groups of 375 participants in each group. One of these groups received usual medical care (UMC) only, while the other group received UMC plus the addition of chiropractic care. The median age of the participants was 30.9 years. the breakdown showed that 175 participants (23.3%) were female, and 243 participants (32.4%) were nonwhite.

The outcomes were measured based on several factors and numbered scales. LBP was measured on a scale of 0 to 10 with 10 being the worst. Disability was measured on a 0-24 scale with 24 being the worst. Additionally, the study measures the participants perceived improvement from 0 (not at all satisfied) to 10 (extremely satisfied). Evaluations of the results were performed at weeks 2, 4, 6, and 12.

The results of the study showed that at each of the intervals, the groups that also received chiropractic in conjunction with UMC outperformed that group that only received medical care in all areas and timeframes tested. This study did not look at any outcomes of chiropractic care alone verses either medical care, or medical care combined with chiropractic. The only determination was that the addition of chiropractic to medical care was more beneficial then just medical care by itself. 

In the authors' conclusion, they wrote, "Chiropractic care, when added to usual medical care, resulted in moderate short-term improvements in low back pain intensity and disability in active-duty military personnel. This trial provides additional support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines."

Dr. Michael McLean, a chiropractor and immediate past president of the International Chiropractors Association stated, “The men and woman of our armed services and their families deserve the best health care our nation can provide. This study adds to the growing body of science confirming that chiropractic care provides meaningful benefit and should become more easily available to those who serve and their families.”


Opioids Are Now Responsible for 1 in 5 Deaths Among Young Adults

Above is the title of a June 2, 2018, article in Time magazine. The article reports on a new study published on June 1st, 2018, by the JAMA Network Open, showing that between 2001 and 2016, the number of opioid-related deaths in the United States increased by 345%.

The Time's article begins with some sobering statistics, "In 2016, one in 65 deaths in the United States involved opioids — and among younger adults, that number skyrocketed to one in five, according to a new study." That study, published in JAMA Network Open, and titled "The Burden of Opioid-Related Mortality in the United States" reviewed information on opioid usage and mortality between the years 2001 and 2016.

The numbers  are extremely concerning. Between the years 2001 and 2016, the number of opioid-related deaths in the United States increased from 9489 to 42,245 deaths, a 345% increase. This translates into 33.3 deaths per million in 2001, to now 130.7 deaths per million people in the U.S. alone.

The death rate for men is higher than women, with men currently accounting for 67.5% of all opioid-related deaths. The average age of a person who dies of opioid usage is only 40 years of age. In the age group of 24 to 35 years, 20.0% of all deaths in the US were attributable to opioids in 2016. The younger groups have not escaped the problem with 12.4% of all deaths in the ages between 15 to 24 years being attributable to opioids in 2016. If you look at this in terms of years of life lost, opioid-related deaths resulted in 1,681,359 years of life lost in the United States.

Dr. Robert Braile, a chiropractor, author and past president of the International Chiropractors Association gave his perspective on the issue. "There are two issues leading up to our present opiod crisis. The first is that much of the public is unaware that there are viable, proven and safer alternative to drugs such as opioids for those suffering from chronic pain. Chiropractic has helped millions to achieve a better quality of life without the use of medications."

"The second issue has do do with the messages being continuously delivered to the public via drug advertising," states Dr Braile. "Almost all drug advertising you see is for continual usage medications. Medications that aim to 'control' the problem without ever seeking to fix the underlying cause. This leads to the hopelessness of a society that believe they just have to live with their problems and their only choice is to control the symptoms. This is simply not true. The human body is a wonderful and amazing self-healing organism. We should be focusing more effort into finding things that interfere with that healing ability, as opposed to just treating the effects of ill health."

In the conclusion of the study the authors wrote, "Premature death from opioid-related causes imposes an enormous and growing public health burden across the United States. The recent increase in the proportion of deaths attributable to opioids among adolescents and young adults and the accompanying estimates of YLL (years of life lost) are alarming, particularly among men. Furthermore, the aging population of people with opioid use disorder requires attention, as the burden of opioid overdose among adults aged 55 to 64 years is growing at a concerning rate."