February 2019

Back Pain Helped by Chiropractic After Failed Low Back Surgery

A case study published on January 17, 2019, in the Annals of Vertebral Subluxation Research documented the improvement with chiropractic of a patient with scoliosis and lower back pain who previously had failed lower back surgery. 

The study begins by explaining that "Scoliosis is a structural three-dimensional deformity of the spine defined by a lateral curvature of more than 10 degrees." In people above the age of 50, the prevalence of scoliosis is somewhere between 6 and 32% of that population. In adults with scoliosis, it is not uncommon to see back pain, muscle fatigue, degenerative changes, and spinal stenosis.

The study points out that spinal problems in the aging population is of increasing concern and has become more of a financial burden. "Chronic low back pain due to degenerative spine disease is an increasing concern in the aging US population and imposes a large economic burden on society. In the last decade, the Medicare costs of treating adult spinal deformity (ASD), including scoliosis, have increased more than 16-fold, from $56 million to more than $958 million."

In this case, a 62-year-old woman presented herself to the chiropractor after being referred by her massage therapist. The woman was suffering with chronic lower back pain for the past 20 years. At the time of her chiropractic consultation, she was severe to the point of being antalgic and leaning to the right.

The womanís history included two prior spinal surgeries. The first spinal surgery was 20 years prior where her L5 disc was removed. Her second surgery was 13 years prior for an L5-S1 fusion in which titanium screws were put in through the entire L5-S1 joint space. Both surgeries were unsuccessful as the woman continued to suffer from her issues.

The woman described her pain as being across her lower back and going down into her left leg and foot. She rated the pain as a 7 out of 10, with 10 being the worst. She reported that her pain increased upon standing, sitting, walking or lying down longer than 20 minutes.  Her health history also included current and past symptoms of fatigue, migraine headaches, poor posture, arthritis, sciatica, sleep problems, swelling of the ankles, and loss of short-term memory. She was currently taking 13 different medications for her various issues.

A chiropractic examination was performed which included a postural analysis, static and motion spinal palpation, thermographic paraspinal heat studies, and spinal x-rays. In addition to the many individual conditions that the woman had been diagnosed with and medically treated for, the chiropractor determined that subluxations were present and could be addressed with specific forms of chiropractic care. 

During her chiropractic care, several follow-up examinations were performed to objectively evaluate her progress. In each of these examinations, the tests showed that she was improving when compared to the initial testing. The woman reported improvement in her ability to sleep and a reduction in low back pain. She also reported improvement in her overall quality of life.  A follow-up on her condition three years later showed that she continued to show an improvement in her quality of life and she was able to modify and discontinue her medications.

In the study discussion, the authors summed up the benefits of chiropractic by explaining, "Chiropractic is a health care profession that focuses on the musculoskeletal and nervous system, and the disorders that affects these systems whether they are internal or external. Chiropractors optimizes the nervous system function by removing interference to the nervous system via adjustments of vertebral subluxations. The removal of these interferences allow the brain and the body to communicate effectively allowing for an increase in health and well-being including increased movement and overall improved quality of life this is essential in all age groups but particularly in those over the age of 60 as they are more susceptible to impaired functions."  


Infant with Chronic Bilateral Ear Infections Helped with Chiropractic

On January 14, 2019, the Journal of Pediatric, Maternal & Family Health published a case study documenting the resolution of chronic bilateral ear infections in a toddler through chiropractic care. The technical name for ear infections is otitis media.

The study begins by reporting on how common otitis media is. It is estimated that by three years of age, 80% of children will have experienced at least one episode of otitis media. By the age of five years, it is estimated that 40% of children will have had multiple episodes of the condition.

Some of the more common symptoms of otitis media include ear pain, fever, headache, irritability, and listlessness. If left unaddressed, the problem could lead to hearing impairment, a loss of sleep, and a decrease in the overall quality of life not only for the child but also the parents.

Although antibiotic treatment has been a medical main-stay of treatment. Recent concerns for overuse of antibiotics resulting in resistant strain of bacteria have led to more physicians taking a "wait and see" approach to ear infections. All of these factors have driven many parents to seek alternative care approaches for their children, of which chiropractic is the most popular practitioner-based approach.

In this case, a one-year-old girl was brought to the chiropractor by her parents for an evaluation and possible care. The infantís primary problem was she was suffering from reoccurring ear infections. It was reported that over the previous five months, the girl had suffered from 4 bouts of bilateral ear infections. Each time, she had been diagnosed with otitis media and placed on antibiotics. Each time, the ear infection would seem to subside and her symptoms reduce, only to return again a month later after the antibiotic treatment was concluded.

The girlís ear infections were affecting her ability to sleep and causing her to be agitated. In addition to the ear infections, it was noted that the infant girl also suffered from frequent colds, sinus congestion, and food allergies.

A chiropractic examination of the infant led to the conclusion that subluxations were present in the childís spine, especially in the upper neck area. With agreement from the parents, specific age-appropriate chiropractic adjustments were started to address the infantís subluxations. The girl received a total of 9 adjustments over the initial 6-week period. After the initial care, the child was seen on a less frequent basis.

After six months of care, a follow-up assessment was performed to monitor the progress. At that time, the parents reported that their baby girl had not had an ear infection or symptoms of an ear infection since she began chiropractic care.

In their discussion and conclusion, the authors of this study stress the importance that chiropractic care could play in this health issue. "Acute OM is such a common condition that it is considered one of the leading causes of visits to medical clinics and for prescription antibiotics. Despite differences in research design and disease definitions, the World Health Organization (WHO) estimated that 28 thousand deaths yearly is attributable to complications (i.e., death through meningitis and brain abscess) of OM." They concluded, "This case report adds to the growing literature on the effectiveness of subluxation-based chiropractic care in children presenting with a history of medically diagnosed OM."


Resolution of Vertigo, Neck Pain and Headaches Following Chiropractic Care

Above is the title of a case study published on January 10, 2019, in the Annals of Vertebral Subluxation Research. In this case, a patient who had been involved in a whiplash-type automobile accident and was suffering with dizziness, neck pain, and headaches, was helped by chiropractic.

This study begins by explaining that whiplash injuries fall under the umbrella of traumatic brain injuries. The authors point out that 1.7 million people in the United States currently suffer from a traumatic brain injury (TBI). They also report that 35.4% of U.S. adults over the age of 40 suffer with vestibular dysfunction, of which vertigo can be a result. They explain that people who suffer whiplash often then develop vertigo.

In their description of whiplash, the Mayo Clinic website states, "Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash most often occurs during a rear-end auto accident, but the injury can also result from a sports accident, physical abuse or other trauma.  Common signs and symptoms of whiplash include neck pain, stiffness and headaches." Additional symptoms that can occur from whiplash include tingling or numbness in the arms, dizziness, ringing in the ears, blurred vision, irritability, and depression.   

In this case, a 44-year-old woman with the complaints of vertigo, neck pain, and headaches, presented herself to the chiropractor. She had been suffering with these issues for three years which began immediately after being involved in a car accident. It was reported that the woman was stopped at a red light and was hit from behind by another vehicle which totaled her car. Immediately after the accident, the woman felt dizzy and had an elevated blood pressure. Shortly thereafter, she developed vertigo, neck pain, and daily headaches, all of which she had never experienced prior to the accident.

An examination was performed by the chiropractor which included vital signs, a postural analysis, thermographic heat readings, both static and motion spinal palpation, range of motion examinations, and several orthopedic and neurological examination procedures. Prior spinal x-rays taken a year earlier did not reveal any medically diagnosable issues, but assisted in the chiropractic analysis. From the findings, specific forms of chiropractic care were started.

It was noted that when care initially began, the woman was unable to stand up straight with her feet together and eyes closed without immediately losing balance. After 9 chiropractic visits, the woman was able to perform this activity for 93 seconds before losing her balance. As her care continued, the woman continued to improve with all her symptoms including her neck pain and headaches.

The authors of the study summed up the results the woman got from her chiropractic care by saying, "Overall, the patient demonstrated improvements in virtually all aspects of care. The frequency and severity of her symptoms improved to their best status since the initial onset of her complaints. Not only were her symptoms markedly improved, but also her general affect was much more positive and cheery."


Americans More Likely to Die of Opioid Overdose Than Car Crash

The headline above comes from a January 14, 2019, article in USA Today. The article is reporting on a study published by Injury Facts on the same day with the title "For the First Time, We're More Likely to Die From Accidental Opioid Overdose Than Motor Vehicle Crash."

Everyone should have heard by now that the U.S. in in the grips of an opioid crisis. As more studies are done, the evidence continues to mount that this problem is only getting worse. Now a new study shows that more people in the U.S. are dying from accidental opioid overdoses than from motor vehicle crashes. This makes accidental opioid overdose the most common form of preventable injury death in this country.

According to the study, in 2016, there were 37,814 deaths from accidental opioid overdose. This number grew alarmingly to 43,036 deaths for the year 2017. In comparison, there were 40,327 deaths due to motor vehicle accidents in 2016. But in 2017, that number decreased slightly to 40,231 deaths. Currently the odds of a person dying from an opioid overdose have risen to 1 out of every 96 people in the U.S.

Maureen Vogel, a spokeswoman for the National Safety Council, commented in a email to CNN by stating, "Too many people still believe the opioid crisis is abstract and will not impact them. Many still do not see it as a major threat to them or their family. These data show the gravity of the crisis. We have known for some time that opioid overdose is an everyday killer, and these odds illustrate that in a very jarring way."

Ken Kolosh,  the National Safety Council's manager of statistics and who has been working at the NSC for nearly 20 years added, "I look at a lot of data, particularly I look at a lot of historic trends. This advent of opioid overdoses and the quickness of its rise, I believe, is unprecedented." He continued, "This was something that was not on our radar at all, and now for it to be a leading cause of death is truly startling."

"There are many proposed attempts at a solution to the growing opioid epidemic." States Robert Braile, a chiropractor, author and past president of the International Chiropractors Association. What needs to be addressed first is the culture of taking medications to treat pain instead of looking at ways to correct the cause." Dr. Braile continued by explaining, "All to often health care professionals to not consider non-drug approaches for chronic pain patients because it falls outside their area of expertise or training."

"Chiropractic has created zero opiod addictions and is responsible for zero opioid deaths," Braile pointed out. "Additionally, chiropractic has helped millions of people find a way out of chronic pain without the use of drugs of any kind. Think of how many lives can be saved by turning people toward a non-drug approach like chiropractic."


Child with Bowel Problems Helped by Chiropractic

The Journal of Pediatric, Maternal & Family Health published a case study on January 24, 2019, documenting the improvement with chiropractic of a young girl who had been suffering with irregular bowel movements. 

If a child is 4-years-old or older, and has already been potty trained but still soils his or her pants with stools, the term for this condition is encopresis. By the age of four, children should be able to control themselves enough to not have this issue occur except under rare or extreme circumstances. Medical treatment for encopresis typically involves medications, some behavioral modifications, and dietary changes.

It is estimated that approximately 1-2% of children under the age of ten suffer from encopresis. Boys are much more commonly affected by this condition with 80-90% of all cases being in males.

In this case, a 9-year-old girl was brought to the chiropractor for an evaluation of an issue not related to encopresis. It seems the girl's gymnastics coach had observed that her hips were uneven. The girl's health history included having asthma, for which she had received allergy shots. She also had suffered for elbow dislocations before she was 4-years-old. Additionally, her history did record that she was suffering with irregular bowel movements. She was taking 4 Colace pills per day to regulate her bowels. It was later revealed that she  was having accidents where she would soil herself and her clothing.

A chiropractic examination with spinal x-rays was performed. From the examination, it was determined that there were multiple areas of vertebral subluxation in the girl's spine, affecting her nervous system. Based upon the findings of the examination and x-rays, specific age-appropriate chiropractic adjustments were used to address the subluxations.

During the course of chiropractic care, gradual improvements were seen with the girl's regularity of bowel movements and with the incontinence she was experiencing. After one month of care, it was reported that the girl was virtually "accident free." Beyond the one-month point of her care, the girl was no longer having accidents and was able to sleep in normal panties for the first time ever. After a two month follow-up, there was no longer any reports of the problem and the girl was leading the life of a normal 9-year-old.

In their discussion about the mechanism of how chiropractic could help this girl's case the authors wrote, "Chiropractic adjustments act as a physical means to correct vertebral subluxations and reduce dysfunction in the body." They continued, "When this dysfunction is removed and musculoskeletal stresses are reduced, afferent input to the central nervous system is regulated, decreasing the sympathetic hyperactivity. This mechanism may be attributed to how chiropractic adjustments help alleviate fecal incontinence in this case study."


70% Infants With Bronchiolitis Prescribed Antibiotics Inappropriately

Above is the title of an article which appeared in the January 30, 2019, issue of Specialty Medical Dialogs. The report was based upon a study published in the Journal of the Pediatric Infectious Diseases Society on January 17, 2019.

The Mayo Clinic website describes bronchiolitis by saying, "Bronchiolitis is a common lung infection in young children and infants. It causes inflammation and congestion in the small airways (bronchioles) of the lung. Bronchiolitis is almost always caused by a virus." Recommended medical treatment does not involve antibiotics unless there is a secondary bacterial infection. Medical care is focused primarily to help if breathing is significantly hampered by the condition.

Antibiotics are used to treat bacterial infections and have no effect on viruses. In fact, they may be harmful to the child. An article in Medical News Today from 2011 stated the threat by saying, "Did you know that taking antibiotics when you or your child has a virus may do more harm than good? According to the US Centers for Disease Control and Prevention, where children are concerned, antibiotics are the most common cause of emergency department visits for adverse drug events."

The inappropriate use of antibiotics has been well documented over the years. However, this most recent study suggests that the warnings have still gone unheeded. An article in Healio Pediatrics on this new study gave an overview of the findings by saying, "A quarter of children aged younger than 2 years with bronchiolitis who visited U.S. EDs between 2007 and 2015 received antibiotics, even though 70% of those patients had no bacterial coinfection."

In the Healio article, Brett Burstein, MD, PhD, MPH, FRCPC, FAAP, and one of the study coauthors, commented on the study in Infectious Diseases in Children: "Bronchiolitis is a viral infection that does not respond to or require antibiotic treatment, and guidelines of the AAP (American Academy of Pediatrics), first published in 2006 and reiterated in 2014, recommend against the use of antibiotics for this illness. He continued, "Also, since 2013, reducing antibiotic prescribing for viral respiratory illness, including bronchiolitis, has become the top priority of the AAPís Choosing Wisely national campaign. Despite these recommendations, we found that rates of antibiotic use did not decrease significantly in the decade following the guidelines."

The Healio article concluded with, "So, in addition to overprescribing, inappropriate antibiotic selection must be addressed," Burstein said. "Targeted interventions are necessary to translate these guidelines into practice, particularly among nonacademic hospitals, where most infants with bronchiolitis are evaluated and where the use of antibiotics was found to be higher."