August 2019

• Chronic Migraines and Neck Pain Helped with Chiropractic
• Gastroesophageal Reflux Disease and Colic Helped with Chiropractic
• Chiropractic Availability World-Wide
• Opioid Usage and Deaths Decrease with Chiropractic Care
• Infant with Torticollis and Breastfeeding Difficulties Helped by Chiropractic
• Resolution of Sleep Disorder in an Infant Undergoing Chiropractic Care

A study published on July 1, 2019, in the research journal the Annals of Vertebral Subluxation Research documented the case of a woman who was suffering with migraines and was helped by chiropractic. The study is titled "Resolution of Chronic Migraines & Neck Pain in a 23-Year-Old Female Following Chiropractic Care for Vertebral Subluxations."

The study begins by reporting that headaches are the third most common reason that people seek chiropractic services behind only back and neck pain. Studies vary as to the prevalence of migraine headaches. This study estimates that 12% of the population suffers with this condition. The National Library of Medicine's Medline offers a summary of migraines by saying, "Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound."

In this case, a 23-year-old woman went to a chiropractic teaching facility for a consultation and possible care. The woman's chief complaint was chronic migraine headaches for the past ten years. At that time, she had been diagnosed with migraines by a neurologist, who said the cause of her condition was unknown. In addition to the migraines, the woman also suffered with chronic neck pain and low back pain.

The woman's history noted that the migraines became worse two years ago after a car accident. Her history also reported issues with hypothyroidism and depression. She was having migraines at the rate of 2-3 times per week. She rated the pain between a 5 and 10, with 10 being the worst. She had been given a variety of medications for her various health issues. She reported little or no relief with her migraines from the medications. The woman reported that her neck pain was constant all day and rated it as a 7 out of 10. She rated her back pain as 5 out of 10, and reported that it was there most of the day. She stated that trying chiropractic was her "last hope."

A chiropractic examination was performed which included a postural inspection, spinal palpation, range of motion, physical nerve tests, and specific spinal x-rays. From these tests, it was determined that subluxations were present in the woman's spine. With this conclusion, specific forms of chiropractic adjustments were initiated. After the woman received her first neck adjustment, she was excited to report that she had not experienced any migraines since the prior visit. She also noted that there was improvement in both her neck and back pain.

After a month of chiropractic, the woman reported that she had not suffered any migraines and had only had minimal headaches on occasion.  After 10 weeks of chiropractic care, the woman reported that all of her initial complaints of chronic migraines, neck pain and low back pain had completely been resolved. She was also able to discontinue all medications for her migraines.

In their conclusion, the authors of the study plainly state, "The case report provides supporting evidence that individuals suffering from headaches may benefit from chiropractic care."

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The Journal of Upper Cervical Chiropractic Research published a case study on July 15, 2019, reporting on the care of an infant who was suffering from gastroesophageal reflux disease (GERD) with colic who was helped by chiropractic care.

The study reports that GERD has a world-wide prevalence of 30% of all infants making it the most common gastrointestinal disorder in infants. The second most common is colic which as a 20% prevalence.

In this study, a 3-month-old baby girl was brought to the chiropractor by her mother because she was suffering with infantile colic, gastroesophageal reflux disease (GERD), and failure to thrive (FTT). The infant’s parents noticed the symptoms of colic and GERD almost immediately after taking their baby home from the neonatal intensive care unit, where the baby girl was exclusively tube feeding. From that point, it was noticed by her parents that their baby’s symptoms got progressively worse. The parents noted that their baby was unable to hold down more than 3 ounces of formula per feeding without spitting up and/or crying.

The history of the mother’s pregnancy revealed that in-utero, ultrasound imaging determined that the child’s umbilical cord was wrapped around her neck twice. The infant was delivered premature by Cesarean Section at 34 weeks into the pregnancy.

Several weeks after the birth, the baby was taken to a pediatrician and a variety of medications were unsuccessfully tried to help the infant. The study noted that the girl’s father was reluctant to have the baby brought to a chiropractor because he did not see any possible benefit and he "didn’t believe" that chiropractic was appropriate for babies. After there was no improvement in the baby’s situation under medical care, it was the mother who finally brought the baby to see a chiropractor.

A chiropractic examination was performed on the infant using age-appropriate procedures and testing, including inspection, palpation and thermal scans. Based on the findings and the seriousness of the issues, specific spinal x-rays were taken. From these procedures, it was determined that subluxations were present in the upper cervical (neck) of the infant. The top bone in the neck is the atlas.

A specific and age appropriate adjustment was delivered to the top bone of the baby’s neck. After the adjustment, follow-up thermal scans were performed to verify that the adjustment had been effective.

Following the infant’s first spinal adjustment, her mother reported that when they returned home, her infant daughter went immediately to sleep and took a long nap. This was very unusual for the baby. It was recorded that by the second visit five days later, the infant’s improved sleep was continuing with her mother noting an overall improvement in her baby’s symptoms. Her mother also noted that her baby was able to ingest and hold down larger amounts of food. The baby’s sleep continued to improve and on a subsequent visit to the MD, it was recorded that the baby was gaining weight.

In the study discussion the authors wrote, "In the case presented, upper cervical care of atlas subluxation resulted in improvements in an infant’s ability to hold down food and improved sleep as well as abatement of GERD and infantile colic, failure to thrive." They continued in their conclusion by saying, "This case report provides supporting evidence on the successful chiropractic care of an infant suffering from GERD, infantile colic and failure to thrive.

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In the journal Chiropractic & Manual Therapies, a study was published on July 24, 2019, that reviewed the availability of chiropractic world-wide. The study titled; "The chiropractic workforce: a global review", also looked at the number of chiropractors, and the legality in various countries.

The authors of the report start by noting that there is a global shortage of health care workers. "Health workers are the engine of our health care systems. Yet, the world is faced with a chronic shortage of health workers. In 2013, the World Health Organization (WHO) estimated a global shortage of 7.2 million health workers, with 83 countries facing a health worker crisis."

This study points out that there is a growing number of "careseeking elderly people." This increase in the elderly population leads to an increase of disability, particularly as it relates to musculoskeletal conditions. They estimate that the rate of disability ranges from the average of 11.8% in high income countries to 18.0% in lower income countries. This translates to about one billion people world-wide.

To help meet the challenge of a population in need, this study looked at the number of chiropractors and distribution in 193 United Nations countries. The research looked at factors such as the total number of chiropractors in each region or country, the level of education needed to practice, licensing and legality of practice, and the scope of practice for chiropractic.

The data for this study was collected from a number of sources including chiropractic organizations that were members of the World Federation of Chiropractic, as well as government websites and online data searches.

The study found that there was at least one practicing chiropractor in 90 out of 193 countries. Worldwide, the total number of chiropractors according to this study was 103,469. Not surprisingly, since chiropractic began in the U.S., 77,000 of the total number are in the United States. This translates into 23.7 chiropractors for every 100,000 people, which is the highest density in the world. 

There 48 chiropractic educational programs currently in 19 countries, predominantly located in English-speaking and/or high-income countries. Again, the U.S. leads in the number of chiropractic schools having 18 of the total number. Australia has the second highest number of schools with four.

There are 81 countries where their populations have direct access to chiropractic care. In two countries, the Bahamas and Saudi Arabia, a medical referral is needed to see a chiropractor. In 46 countries, just slightly over half of the countries that have chiropractic, the care was partially or fully covered by governmental health programs or private health insurance.

Chiropractic is legally recognized in 68 (75.6%) of the 90 countries. In 12 countries, chiropractic is illegal. Those countries include Egypt, Argentina, Columbia, Austria, Estonia, Greece, Hungary, Lebanon, Republic of Korea, Taiwan, Turkey, and Ukraine. In 10 countries, chiropractic does not fall under the law, leaving chiropractic neither legal or illegal.

In their conclusion, the authors note that chiropractic services are not evenly distributed throughout the world. "The profession is represented in 90 countries, but the distribution, chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited."

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A study published in the Journal of Manipulative and Physiological Therapeutics in May 2019 reported on the results of a broad study in Canada to see how chiropractic care could affect the usage of opioids in patients suffering from chronic pain.  The study titled; "System Dynamics to Investigate Opioid Use and Chiropractic Care for Chronic Musculoskeletal Pain" looked at health care records from 2000 to 2015 to see what effect the usage of chiropractic would have on chronic pain patients who were, or would be using opioids to treat their pain.

This study was put together using a large volume of data from other studies and information from governmental sources. The authors of the study noted that people suffering with musculoskeletal pain, particularly chronic lower back pain, were one of the main groups who would most likely be using opioids for the pain and therefore be most at risk for opioid addiction. The researchers then used currently available data in Canada and the U.S. to forecast what effect an increase in chiropractic would have on opioid usage and addiction.

The study created three categories of population study. The first was people who had chronic pain and were first seeking care from either an MD or a chiropractor. The second group were those under medical care with opioids who then added chiropractic to their care for pain. The third group were those who were already opioid dependant or addicted, and then were adding chiropractic care.

Using data currently available, the researchers were able to project the effect adding chiropractic would have on each of the three groups. The results of this projection would be used to create a model for a large-scale clinical trial which could be used on actual patient populations. Short of actually having such a study, this study gives as close a view of results of chiropractic care affecting opioid usage as is available from current data.

The results of their study showed that in each of the three groups, the introduction of chiropractic for patients with chronic pain had not only a benefit for the patient's pain issues, but also had a statistical positive reduction on the usage and dependency of opioid for those patients.

In the group that sought chiropractic early, the researchers were able to show that there would be a decrease in people ever using opioids and therefore a decrease in both addiction and deaths. In the group that was already using opioids but was not yet dependant, the researchers also showed a decrease usage of the opioids with an accompanied decrease in addictions and deaths. In the group that was already addicted to opioids, there was less of statistical reduction in opioid related problems, but the number was still significant enough to show benefits for those individuals.

Even though the results of this study were projections of possible effects, the data showed that the number of people who would become addicted is reduced when chiropractic care is either introduced early or during patient care for pain. This also would cause a decrease in the related deaths from opioids.

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A case study published in the June 27, 2019, issue of the Journal of Pediatric, Maternal & Family Health documented the improvement through chiropractic care of an infant who was one of a set of twins, and who was suffering from torticollis and breastfeeding problems.

The study begins by reporting that twin pregnancies and births have a much higher incidence of issues as compared to singular births. They report that twins have a 4-fold higher risk of death in pregnancy and a 7-fold higher risk of death shortly after birth. Additionally, twins have a 10-fold higher need for neonatal special care unit admission and have a 6-fold higher risk for cerebral palsy. There is also an increased risk of birth trauma which can lead to several additional problems.

In this case, a 13-days-old male infant who was one of twins was brought to the chiropractor with his twin sister for evaluation and possible care. The parents reported that during the pregnancy the boy was in the head down position for most of his time in utero with the weight of his sister on top of him. The birth was induced at 37 weeks and the boy was born vaginally 4 hours after his sister.

Since his birth, the infant boy had been struggling with breastfeeding due to a failure to latch. His parents reported that he was very gassy and seemed uncomfortable daily. Consultation with a lactation consultant and a pediatrician provided initial help to a degree, but the breastfeeding problem was still constant.

During the chiropractic examination, it was noted that the boy had a significant right head tilt with left rotation. Most of the testing of the infant was within normal, except for the head tilt, a visible cranial asymmetry, and some specific chiropractic testing that indicated spinal issues. Thermography was used to determine heat variations along the spine along with spinal palpation.

From the findings, it was determined that areas of subluxations were present. With the consent of the parents, chiropractic care was started at the rate of 2 visits per week for the first 4 to 6 weeks. Specific infant appropriate forms of chiropractic adjustments were used to address the subluxations that were present.

By the third visit, it was reported that the infant was able to able to latch on both breasts, and his symptoms of gassiness had also decreased. After 6 weeks of care, the parents reported that his head alignment was improved and positioned more in a neutral position, without the torticollis posture that was previously noticeable. A follow-up examination also documented a reduction in the cranial asymmetry that was initially found on the first examination.

In their conclusion the authors of the study wrote, "This case report provides supporting evidence that infants born with muscular torticollis, cranial distortion and difficulty breastfeeding may benefit from chiropractic care."

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The Journal of Pediatric, Maternal & Family Health published the results of a case study on July 22, 2019, documenting the chiropractic resolution of sleeping issues in a baby who developed sleeping problems after previously having been able to sleep through the night.

This study begins with the authors noting the importance of the proper amount of sleep in children. "It’s acknowledged that when children are lacking sleep, their physical, emotional, cognitive and social development are negatively affected and can impair both the parent and child’s daytime functioning." They also report that "…longer sleep duration was generally associated with better body composition, emotional regulation, and growth in children aged 0 to 4 years."

In this case, a 7-month-old baby girl was brought to the chiropractor by her mother. The girl’s mother stated that her daughter was previously sleeping 9-10 hours throughout the night but recently was currently only sleeping a maximum of 2-3 hours at a time throughout the day. It was also noticed that the girl had difficulties turning her head to the right.

During the examination, it was noticed that the girl was mostly calm throughout the process except when the chiropractor was examining the girl’s neck. Upon touching the neck, the girl became agitated, started fussing, and was grabbing at the doctor’s hands. It was obvious from the palpation examination that the neck area was sensitive and tender to the baby girl, particularly in her upper neck. The motion in this upper neck area was also restricted. No other part of the baby’s spine was sensitive or restricted. A determination was made that subluxations were present.

With consent, specific forms of chiropractic adjustments were given to the baby girl’s spine to address the subluxations. The documented results of the care showed that after the first visit, the girl was immediately able to sleep 9-10 hours through the night without issues. After the second visit, her mother reported that the girl had more energy and a better disposition. Her mother also noticed better range of motion in her neck and reported that her baby girl was less fussy.

In the discussion in the study, the authors note that chiropractic for children is generally thought of as being for musculoskeletal issues. "Of the practitioner-based complementary and alternative medicine (CAM) therapies, chiropractic has been found to be highly utilized by parents for their children. Use of chiropractic services have been to address physical complaints of mainly neuromusculoskeletal origin, the co-morbidities of childhood and wellness care." They also note that more parents are bringing children to the chiropractor for issues outside of the musculoskeletal types. "This case report provides supporting evidence on the effectiveness of chiropractic care in infants with disordered sleep as a primary or secondary presenting complaint."

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