May 2020

• Study Shows Reduction in Anxiety Under Chiropractic Care
• Neck Pain, Curvature, Spinal Canal Diameter Improved in Accident Cases Under Chiropractic
• Resolution of Meniere’s Disease with Chiropractic
• Proper Sleep is Important for Your Health

The Annals of Vertebral Subluxation Research published the results of a case series on April 17, 2020, documenting the reduction of anxiety in five adults in a case series undergoing chiropractic care. Anxiety disorder is considered a form of mental illness that affects an estimated 31.1% of adults in the United States.

According to the NIH’s National Institute of Mental Health, "…anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships."

The study reports that anxiety disorders are the ninth leading cause of nonfatal burden in years of living with a disability. They also note that the estimated economic burden is $46.6 billion yearly.

The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is considered the main resource document for classification of mental disorders. According to the DSM-5, the criteria for anxiety disorder is "excessive anxiety and worry (apprehensive expectation) occurring on more days than not for at least 6 months, about a number of events or activities (such as work or school performance)".

This case series reviewed five patients (2 female and 3 male) presenting for chiropractic care with a complaint of anxiety. The patients ranged in age from 24 to 53. All of the patients came to the chiropractor because of musculoskeletal complaints such as headache, neck pain, and/or back pain, with one seeking chiropractic for help with hypertension. All patients expressed a desire to decrease stress and their anxiety.

The Hamilton Anxiety Rating Scale (HAM-A), a widely accepted means of rating anxiety, was used to rate and document the severity of the patient’s anxiety prior to, and after chiropractic care.

The results of the study showed that all HAM-A scores of the patients undergoing chiropractic care indicated a reduction in severity of anxiety symptoms. Three of the patients' scores improved from initially being moderate/severe, reducing in severity to mild anxiety symptoms. The other two patients went from initially being moderate/severe to reducing down to the lowest level of mild/moderate severity of anxiety symptoms.

In their discussion and conclusion, the study authors noted, "This case series chronicles the reduction in severity of anxiety and improvement in autonomic nervous system function in 5 patients receiving chiropractic care. Considering the burden mental health issues, such as anxiety, have on society globally, further clinical research investigating the role of chiropractic care and its effects on anxiety is warranted."

A case series study was published in the April 2020 issue of the Journal of Radiology Case Reports documenting patients’ improvement in eight separate auto accident cases with neck pain, loss of cervical curve, and spinal canal diameter with chiropractic care.

The study begins by pointing out "Spondylolisthesis refers to the slippage of one vertebral body on the vertebra below. It is considered uncommon in the cervical spine when compared to the lumbar spine and is now being recognized as an under-studied condition." When this condition occurs due to a trauma, such as an automobile accident, it is referred to as acquired spondylolisthesis. When the condition is due to degenerative changes in the spine, it is referred to as degenerative cervical spondylolisthesis (DCS).

Acquired spondylolisthesis is often accompanied with spinal degeneration, pain numbness, and a narrowing of the spinal canal at that level. The medical approach has often involved surgery with removal of disc and fusion. This study followed the result of eight patients with cervical spondylolisthesis who underwent chiropractic care.

In this study, all eight patients were females ranging in age from 44 to 62 years. All the women were suffering with neck pain, bilateral upper back pain, neck stiffness, restricted neck motion, and radiating pain into their shoulders and/or arms. They reported that their problems created limitations on their daily activities. All eight women had sought medical care and/or physical therapy at least 6 months prior to seeking chiropractic care. Additionally, all the women had a history of being involved in a motor vehicle accident.

A chiropractic examination and evaluation including x-rays was conducted on all the patients. This was followed by 30 visits involving specific chiropractic procedures and followed by post-care spinal x-rays.

Upon re-examination, all the women reported improvements in their conditions and symptoms. Tests showed that they had improved from moderate neck disability to a level of minimal neck disability. Follow-up x-rays confirmed positive changes in the positioning of the cervical vertebrae of the patients.

In their conclusion, the authors note that medical care for degenerative cervical spondylolisthesis (DCS) is typically a wait-and-watch condition that results in surgery if the disability becomes severe enough. In contrast, the chiropractic approach focuses on restoring healthy alignment and biomechanics of the spine and posture.

They also concluded that, "Motor vehicle collision may cause instability and abnormal alignment of the cervical spine leading to cervical spondylolisthesis. Improving spinal alignment may be an effective treatment to reduce vertebral subluxation and cervical spondylolistheses and improve neck disability as a result of improved spinal alignment."

On April 27, 2020, the Journal of Upper Cervical Chiropractic Research published the results of a case study documenting the improvement of Meniere’s disease with chiropractic. Meniere’s disease was discovered in 1861 by Prosper Meniere and still remains loosely studied and not fully understood today.

According to the NIH’s National Institute on Deafness and Other Communication Disorders, "Meniere’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. Meniere’s disease usually affects only one ear." They estimate that approximately 615,000 people in the United States are currently diagnosed with Meniere’s disease and 45,500 new cases are diagnosed each year.

This disorder can happen at any age but is most common between 40 and 60 years of age. This condition is considered a disability by the Social Security Administration and diagnosed people who suffer from this can qualify for disability benefits.

In this case, a 68-year-old woman went to the chiropractor because she was suffering from severe dizziness and vomiting that would occur every 3 weeks for up to 8 hours at a time. She was suffering with this problem for the past 8 years. She also reported a secondary issue of occasional minor neck pain. Two years prior to seeking chiropractic services, her Ear, Nose, and Throat physician (ENT) had diagnosed the woman with Meniere’s disease.

The woman described her episodes by explaining that she would start hearing a continuous "roar" in her left ear that shortly developed into 5 to 8 hours of crippling dizziness and vomiting. For the following 2-3 days after the episode, the woman commented that she felt as if she were intoxicated with alcohol.

A chiropractic examination and x-rays were performed specifically looking to see if there was a subluxation in the woman’s upper neck. The results of the examination and x-rays revealed that the top bone in the neck, the Atlas (C1), was mispositioned leading to the conclusion that a subluxation was present at C1.

With these findings, specific forms of chiropractic adjustments were performed over the following 13 months. The goal of the adjustments was to reduce the subluxation found at the woman’s C1 vertebrae. Follow-up post x-rays were performed during care to access the correction of the atlas from the adjustments.

At the woman’s first reassessment, it was recorded that the woman had not suffered a single episode of Meniere’s disease since she started chiropractic care. After that time, the woman reported only one minor episode of dizziness and three to four short occurrences of feeling intoxicated at times. During the woman’s 2nd reassessment, she claimed that she is doing 95% better since starting chiropractic care.

In their study conclusion, the authors commented, "After the first adjustment, the patient has not had any major MD episodes, with only one short occurrence of dizziness. Her ENT confirmed that the she is no longer showing signs or symptoms of MD (Meniere’s disease)." They added, "The improvement in the patient’s Meniere’s Disease symptomatology while solely undergoing upper cervical care to reduce her atlas subluxation suggests that MD symptomatology may be related to the atlas subluxation."

During times of stress and crisis, proper sleep is more important that ever to help overall health and your ability to cope with difficult times. To help with this effort, the Foundation for Chiropractic Progress (F4CP) published a paper on May 5, 2020, that offers "Tips for Better Sleep to Encourage Overall Health and Well-Being".

The F4CP paper begins by noting, "Staying up late and sleeping in may be a common habit for many Americans, but it could be harmful to our health. A study published this year in the Journal of the American College of Cardiology comprised of nearly 2,000 people whose sleep patterns were tracked over three years found that those with irregular sleep schedules had a greater chance of developing cardiovascular disease."

The NIH's National Heart, Lung, and Blood Institute also stressed the importance of proper sleep on their website. "Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety. The way you feel while you're awake depends in part on what happens while you're sleeping. During sleep, your body is working to support healthy brain function and maintain your physical health. In children and teens, sleep also helps support growth and development. The damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others."

The F4CP wants the public to know that the month of May is Better Sleep Month. Sherry McAllister, DC, executive vice president of F4CP, noted that proper structure is important for proper sleep. "With all of the overwhelming research demonstrating sleep’s health benefits, anyone experiencing disrupted or inadequate sleep for an extended period, for whatever physical or emotional causes, should seek help from a healthcare provider to help them find a solution," Dr. McAllister said. "Not only could correcting the cause of the disturbance improve their rest, but increased sleep quality and quantity will help them feel much better as well.

The International Chiropractors Association (ICA) also stresses the importance of sleep on its website. "Sleep is vital to the normal biological and psychological/emotional functions that humans must engage in to survive. Sleep enables the body and mind to rejuvenate, reenergize, and restore. Sleep allows the brain to perform vital tasks such as organizing long-term memory, integrating new information, and repairing and renewing tissue, nerve cells and other essential biochemical processes."

The ICA offers some practical tips for proper sleeping which include avoiding sleeping on your stomach. But for those with chronic sleep issues, the ICA offered the following advice. "See a doctor of chiropractic if you continue to have trouble sleeping. If you consistently find yourself feeling tired or not well rested during the day despite spending enough time in bed at night, you may have a sleep disorder.
Your family doctor of chiropractic can evaluate your needs and develop a personalized comprehensive care and wellness plan, and, if necessary make an appropriate referral to another professional or professionals."