November 2018

• Resolution of Hot Flashes with Chiropractic
• Study Documents Postural Improvements with Chiropractic Care
• Resolution of Breech Pregnancy with Chiropractic
• Pain Reduced, Sleep Improved and Quality of Life Improved in Renal Cancer Patient After Chiropractic
• Sensory Processing Disorder, Speech Delay and Sleeping Disorders Resolved with Chiropractic
• Vaginal Birth of Twins After Prior Caesarean with Chiropractic Care

The Journal of Upper Cervical Chiropractic Research published the results of a case study on October 29, 2018, documenting the resolution of a woman's hot flashes under chiropractic care. Hot flashes are the most common condition of women who are entering menopause.

According to the Mayo Clinic's website, "Hot flashes are sudden feelings of warmth, which are usually most intense over the face, neck and chest. Your skin might redden, as if you're blushing. Hot flashes can also cause sweating, and if you lose too much body heat, you might feel chilled afterward. Although other medical conditions can cause them, hot flashes most commonly are due to menopause — the time when menstrual periods become irregular and eventually stop."

Hot flashes are not a life-threatening condition, but they are an annoyance and can be severe enough to disturb a woman's daily life. The authors explain, "Hot flashes do not typically cause any health concerns, but may interrupt sleep, and can impact the general health and well-being of some women, but the risks are minimal. The most concerning impact of hot flashes is the discomfort they bring to women and the sudden onset at inconvenient times and places. Hot flashes usually cause a heated or warm sensation throughout the core, chest, face, neck, and head along with sweating and possibly chills directly afterwards and can last anywhere from a half minute up to 10 or sometimes 15 minutes."

In this case, a 57-year-old woman presented herself for chiropractic care. Her primary reason for seeking chiropractic was several weeks of right-sided sciatic pain, along with low back pain and pain between her shoulders. Ten years earlier, she had been involved in an automobile accident in which her car was rear-ended resulting in temporary neck pain. In addition to her pain symptoms that brought her to the chiropractor, it was reported that she was also suffering with hot flashes.

A chiropractic examination involving palpation, range of motion, posture analysis and x-rays was performed. From the examination, it was determined that subluxation was present and specific forms of chiropractic care were started.

The results of the study only reported on the first six weeks of her care, which is when a re-evaluation was performed. Results beyond the first six weeks were not included in this study. At the time of her re-evaluation, the woman made three specific comments regarding her progress. She reported that her "leg numbness improved", her "leg muscle spasms improved" and she had "no hot flashes for the last 2 weeks." At that point, she rated herself at about 50% improvement for the symptoms that brought her to the chiropractor.

The authors of the study summed up the case by stating, "This was a case where the patient had been experiencing approximately 10 hot flashes per day while simultaneously suffering from sciatic pain and low back pain. The hot flashes this patient was experiencing completely resolved after four weeks of care and the sciatic pain improved 50% in six weeks."

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The Journal of Upper Cervical Chiropractic Research published the results of a study on October 15, 2018, that showed postural improvements in subjects who had undergone chiropractic care specifically designed to align the top bone in the neck. The postural improvements were measures using Computer Dynamic Posturography (CDP) testing.

The study begins with a definition of posture. "Human posture is defined as the set of angles expressed at each joint that determine the relative disposition among the segments of the body and the maintenance of the body mass over the base of support." They further explain that standing upright requires a complex combination of neurological and biomechanical responses to the position of the human body while standing. The ongoing feedback from the parts of the body back to the central nervous system allow the body to make the continual tiny adjustments needed to stand erect, walk, or perform any basic movement.

The study notes that even when you are standing still, the body is actually in motion making continual changes to allow you to stand. The authors explain, "Gravity causes a forward fall of the body and thus the body is constantly fine-tuning human posture by applying a counter-torque that results in a swaying motion to counteract the forces of gravity. These postural adjustments are called equilibrium reactions. Because of the necessity to counteract gravity, postural sway is constant, even when attempting to stand still."

In describing the reason for this study the authors stated, "This project was designed as a feasibility study to investigate if a precise chiropractic adjustment to the atlas vertebrae could improve postural stability and serve as a preliminary study to answer the question of whether or not this type of chiropractic care can reduce the risk of falls in patients with various balance impairments." Their stated hypotheses for this study was that, "Chiropractic works on the theory that misalignments and/or fixations of the spine can cause neurological interference through various neurophysiological mechanisms. This interference, when caused by a spinal misalignment/fixation is termed a subluxation."

In this study, there were nine participants who met all the requirements and were able to follow through completely with the study. Computerized dynamic posturography (CDP) was used initially, and twice during the study to determine postural results to the chiropractic care. Dynamic posturography involves measuring the subject's posture specifically while disrupting their posture using a foam cushion or a moving/tilting platform. All participants in the study received specific forms of chiropractic adjustments to only the upper cervical spine.

The results documented that all nine subjects showed improvement from their first CPD scan to their last scan. The CPD test issues a stability index score. The higher the score the better. The results reported, "The average stability index score for all 9 subjects as measured by a percent was 75.1% for the 1st scan, a 78.0% for the 2nd scan and 80.6% during the 3rd scan resulting in a 7% increase among all subjects between the 1st and 3rd scans."

The conclusion from this study was that the top bone in the neck, known as the atlas, has a profound effect on how the body handles its own posture. The researchers stated, "The results supported the hypothesis that a misalignment of the atlas vertebrae can cause neurological change in regards to sensorimotor integration and that correcting the misalignment will result in improved postural control."

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The Journal of Pediatric, Maternal & Family Health published a case study on October 18, 2018, documenting the resolution of a breech pregnancy after chiropractic care. In a normal pregnancy, the baby's head will be pointed downward prior to delivery. This is known as a cephalic or vertex position. A breech pregnancy is when the head is not pointed downward and either the buttocks or feet are downward instead.

The study begins by noting that, in the United States, there are approximately six million pregnancies yearly, of which about 875,000 will experience one or more complications. Breech pregnancy is one of the more common complications of pregnancy occurring in approximately 3-4% of pregnancies at full term.

Common medical practice for breech presentation is to schedule a cesarean delivery instead of allowing the baby to be born breech. The study notes that breech presentations will rarely spontaneously reposition to cephalic presentation beyond 34 weeks of pregnancy. Because of this, 80-100% of breech presentations are delivered by caesarean section. On occasion, a medical procedure known as an external cephalic version (ECV) is used to attempt to physically turn the baby by pushing from the exterior.

In this case, a 33-year-old woman who was 29 weeks pregnant with a breech pregnancy presented herself to the chiropractor for an evaluation and possible care. The breech presentation was confirmed by an ultra sound performed by her obstetrician. This was the woman's first pregnancy.

A chiropractic examination was performed which consisted of static and motion palpation, postural analysis, a surface EMG study, thermographic heat readings along the woman's spine and a Webster protocol analysis. The conclusion of the examination was that subluxations were present, and the Webster technique was indicated.

The Webster technique was developed by Dr. Larry Webster, a chiropractor whose practice specialized in pregnancy and pediatric cases. 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." Specific chiropractic adjustments and the Webster technique were utilized in this woman's case.

The study reports that, at the time of the woman's ninth chiropractic visit, the fetus had turned to the normal cephalic vertex position as confirmed by a second ultrasound done by her obstetrician. The study further noted that the woman was able to have a normal vaginal delivery under the guidance and supervision of her midwife. There were no reported complications with the birthing process.

In the conclusion of this study the authors summed up this case by saying, "The patient presented with frank breech presentation. Utilizing Webster Technique during her pregnancy helped to reestablish normal sacral biomechanics of the female through sacral adjustments and trigger point therapy. After nine chiropractic adjustments, the fetus was confirmed to be in vertex position and the patient went on to have a natural vaginal birth with no complications. This single case study of one woman's experience with Webster Technique will contribute to the current research available on Webster Technique."

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A study published in the October 25, 2018, issue of the Annals of Vertebral Subluxation Research documented the improvement in sleep, pain, and overall quality of life in a woman suffering with renal carcinoma.

The study begins by pointing out that renal cell carcinoma is one of the most common malignancy of the kidney and is one of the top 20 malignancies in the world. For the past 65 years, the prevalence of renal cell carcinoma has increased 2% every year. The costs of this condition in the U.S. is estimated to be up to $5 billion per year with each individual suffering with the condition expected to cost $43,805 annually.

In addition to the financial considerations, the condition itself, as well as the treatment to address it, has been shown to have substantial effects of the patient's quality of life, and specifically the ability to get proper sleep. The study reports that sleep disturbances and sleep disorders are a common problem for those diagnosed with cancer as well as cancer survivors. Even without a diagnosis of cancer, sleep disorders themselves are a significant health issue affecting between 50 and 70 million Americans.

In this case, a 24-year-old woman presented herself to a chiropractic clinic. Her chief complaints included low back pain, neck pain and difficulty sleeping. She had recently been diagnosed with Stage IV renal cell carcinoma (RCC). The woman stated that she was also suffering with mild anxiety, tension and stress, as this was her second diagnosis with RCC after being told three years earlier by her oncologist that she had been cured of the disease. The woman was on multiple cancer medications and was on a list for a kidney transplant.

A chiropractic examination was performed which included palpation, range of motion, inspection, thermographic heat studies, some orthopedic tests, and a limited set of spinal x-rays. Based upon the results of the examinations procedures, vertebral subluxations were determined to be present and specific chiropractic adjustments were started.

The patient was initially seen twice per week and a record of her progress was made on each visit for inclusion into this case study. After the woman's first chiropractic adjustment visit, she reported a complete resolution of her low back pain and reduction in her neck pain. After her second adjustment, the woman reported that both her neck and back pain had completely resolved. These complaints did not re-occur again throughout the remainder of her care.

A reassessment was performed after five visits, at which time the woman reported that she was not only free of any lower back or neck pain, but she reported that she was sleeping for a full eight hours through the night for the first time since being re-diagnosed with renal cell carcinoma. By her ninth visit, she was no longer having any sleep disturbances. As an additional quality of life benefit the study also recorded that "…she was no longer getting sick from taking the cancer medications and that she could go on a vacation with her friends without being extremely ill from her medications."

In the study conclusions, the authors make the case for chiropractic inclusion into the care of patients with serious health issues such as in this case. "In the case of a 24-year old female with multiple diagnoses of Stage IV renal cell carcinoma, severe neck and back pain with severe sleep disturbances there was a complete resolution of symptomatology and more importantly reports of increased quality of life. Evidence in this case supports subluxation based chiropractic care in the co-management of patients with renal cell carcinoma and associated decreased quality of life."

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On September 27, 2018, the Journal of Pediatric, Maternal & Family Health published a case study featuring the care of a child suffering with sensory processing disorder, sleep challenges, and speech delay, who was helped by chiropractic.

According to the STAR Institute for Sensory Processing Disorder, "Sensory processing (originally called "sensory integration dysfunction" or SID) refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses." They explain that any action that a person performs depends on the sensory input they receive in order to properly perform any function. "Sensory Processing Disorder (SPD), exists when sensory signals are either not detected or don't get organized into appropriate responses."

Although there is no clear study showing the number of children that suffer with SPD, surveys of parents put estimates of children entering kindergarten with SPD to be as high as 13.7%. Some studies and authorities estimate that just over 5% of children have some form of SPD.

This study reports that "The prevalence of speech and language delays is reported to range from 1.35% to 8% for children from 2-12 years old." Also known as specific language impairment, this problem is defined as "…a form of developmental language impairment in which children demonstrate unexpected difficulties with the acquisition of spoken language."

In this case, a 3 ˝-year-old boy was brought to the chiropractor for evaluation. The boy had been previously diagnosed with SPD and was also suffering from difficulty sleeping and speech delay. His history revealed that he was suffering from repeated respiratory tract infections, as well as 5 to 6 prior ear infections, frequent colds, colic, and night terrors. The boy also had a sensitivity to certain clothing and was insistent on utilizing a pacifier.

The boy's mother noted that her son had been suffering with his problems since birth and had been under the care of multiple professionals including a physical therapist, an occupational therapist, and a speech therapist. The various therapies had been partially effective, but the mother reported that her son was still struggling.

A chiropractic examination was performed which included palpation, an sEMG study, a thermal exam, postural analysis and spinal range of motion. From the findings of the examination, it was determined that multiple subluxations were present. To address the subluxations, age appropriate forms of chiropractic adjustments were started at the rate of three per week.

The study records that, after three months of chiropractic care, the boy's mother reported a dramatic improvement in her son's sensory processing, sleep, and speech. It was observed that the boy was less emotional, and he voluntarily stopped using his pacifier. His mother also reported that her son had three consecutive weeks of 11-12 hours of sleep per night without waking up. She commented about her son saying, "Suddenly everything in his body has ‘clicked' and each system is communicating effectively throughout."

In their conclusion the study authors wrote, "SPD, sleep challenges, and speech delay are common problems seen in pediatric patients. The case of a 3-year-old male presenting at a chiropractic office with these health challenges is described, with resolution or improvement seen after reduction of vertebral subluxation."

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On November 5, 2018, the Journal of Pediatric, Maternal & Family Health published the results of a case study documenting the successful vaginal birth of twins in a woman undergoing chiropractic care, who had previously had a cesarean birth.

When a woman has had a cesarean birth, the two options for subsequent births include a planned second cesarean birth, or a "VBAC", which is a vaginal birth after caesarean. The authors of the study acknowledge that there are risks and benefits for both these directions. Cesarean births are more commonly recommended by medical professionals in this case but there are no clear evidence favoring one procedure over the other. In the case of twin births, cesareans are far more common.

Many women desire to have vaginal births after cesarean due to vaginal birth enhancing the health and well-being of the mother and baby, promotion of maternal infant connection and easing the transition to motherhood.

In this case, a 34-year-old woman presented herself for chiropractic care in her 16th week of a pregnancy of twin girls. Her primary complaint was that she was suffering with intermittent left sacroiliac pain, as well as left posterior hip and left buttock pain which had been present for the past three weeks. Overall, the woman rated her pain as a 6 out of 10, with 10 being the worst. Some activities made the pain more pronounced while rest seemed to improve her pain.

A chiropractic examination was performed and revealed postural imbalance as shown using bilateral weight scales. Additionally, visible postural abnormalities were noted in inspection including head tilt, a high shoulder and an increase in the mid back curvature. Spinal palpation noted multiple areas of restriction and positional concerns throughout the woman's spine. From the examination, it was determined that subluxations were present in her spine.

The patient consented to a course of chiropractic care at the rate of 2 visits per week for an initial period of 8 weeks. This was followed by a weekly visit for the remainder of her pregnancy. After the third visit, the woman reported that she was not having any pain. She commented, "This is the first time in a long while that I haven't felt the pain every day." During the remainder of her care she reported only occasional discomfort which eventually disappeared altogether.

At 35 weeks and 5 days, the woman successfully delivered her twin girls vaginally. The babies were born 20 minutes apart and weighed 4 lbs., 13oz. and 4 lbs., 3oz. After being checked out in the neonatal intensive care they were returned to their mother who was told that her new daughters were healthy babies.

In a review of available literature on the subject, the study authors noted that there was not a lot of prior material available. "Despite the limited number of published cases in the care of patients with successful VBAC and/or twin pregnancies, we are of the opinion that literature does not truly reflect what occurs in chiropractic practice." Submitting this case study for publication was partially to increase the database of cases of vaginal birth after cesarean, (VBAC). The authors concluded, "This case report provides supporting evidence on the benefits of chiropractic care for the pregnant woman with the desire for VBAC."

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