June 2022

• Chiropractic Resolution of Breech Presentation Confirmed by Ultrasound
• Essential Tremors Reduced in Elderly Man Under Chiropractic
• Study Links Chiropractic Care to Lower Costs, Faster Return to Work
• Blocking Inflammation May Lead To Chronic Pain

The Journal of Pediatric, Maternal & Family Health published the results of a case study on June 3, 2022, documenting the successful resolution of a breech pregnancy with chiropractic care. The correction was documented using before and after ultrasound studies.

The American Pregnancy Association describes a breech presentation by explaining, "In the last weeks of pregnancy, a baby usually moves so his or her head is positioned to come out of the vagina first during birth. This is called a vertex presentation. A breech presentation occurs when the baby’s buttocks, feet, or both are positioned to come out first during birth. This happens in 3–4% of full-term births."

In this case, a 30-year-old woman who was in her 39th week of pregnancy with her fifth child, went to a chiropractor. Her OB/GYN had confirmed via ultrasound that her baby was breech. Although she had never been to a chiropractor before, she decided to seek chiropractic care because of the positive results other patients have had, and because she had learned about the positive results from the Webster Technique.

According to the International Chiropractic Pediatric Association, "The Webster Technique is a specific chiropractic sacral analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of sacral subluxation/ SI joint dysfunction. In doing so, neuro-biomechanical function in the pelvis is facilitated." The process is gentle and painless and causes the baby to move into a proper position on its own.

The woman’s OB/GYN has suggested an external cephalic version, (ECV). An ECV is where the MD presses the woman’s pregnant belly in an attempt to externally move the baby into a proper position. After learning of the risk of this procedure, the woman decided not to go this route and instead went to the chiropractor.

The woman received a chiropractic examination followed by a chiropractic adjustment which included the Webster Technique. Following her second chiropractic adjustment, the woman reported that she noticed a lot of movement of the baby. Shortly after this, she scheduled another visit with her OB/GYN who performed an ultrasound and confirmed that the baby had moved into the correct vertex position. Within 48 hours, the woman went into labor and delivered a baby girl through a normal vaginal birth.

In the study conclusion, the authors summed up the case by stating, "In this case the baby’s position was confirmed to be breech via ultrasound before Webster Technique was administered and ultrasound then confirmed the baby to have moved into the vertex position after the technique was applied. The changes took place in a short amount of time once the patient started under chiropractic care and was otherwise not doing anything differently in her daily life."

The Annals of Vertebral Subluxation Research published the results of a case showing the reduction in essential tremors for an elderly man receiving chiropractic care. According to the Mayo Clinic website, "Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you do simple tasks, such as drinking from a glass or tying shoelaces. Essential tremor is usually not a dangerous condition, but it typically worsens over time and can be severe in some people."

The study begins by noting that essential tremors are a common condition in the elderly affecting about 5% of that population. Essential tremors are different than the tremors from Parkinson's disease in that essential tremors are in the upper extremities 95% of the time and are present during movement of the upper extremities unlike Parkinson's which are present while resting.

Common medical treatment usually involves medications such as beta blockers, anti-seizure drugs, tranquilizers, or even Botox injections. These treatments have mixed results and often include significant side effects and risks.

In this case, a 75-year-old man suffering with tremors affecting both hands went to the chiropractor to see if he could be helped. The man described his tremors as spasms that were pounding, dull and crawling, and were often accompanied by pain. He explained that his tremors started many years ago but had been getting progressively worse over the past four years.

In describing his tremors using a 0 to 10 scale, with 10 being the worst, he rated his problem as a 5/10 at its best and a 9/10 at the worst. The tremors interfered with his daily activities including eating and writing. He was on several medications that had little effect. He reported that the only thing that could relieve his tremors was alcohol consumption.

A chiropractic examination was performed which included a comprehensive neurological assessment, postural analysis, orthopedic evaluation, active range of motion, palpation, and spinal x-rays. The conclusion of the examination was the presence of multiple areas of vertebral subluxations present in the man’s spine. From this, the man was started on a regime of regular specific chiropractic adjustments to address the subluxations.

After 12 chiropractic visits, the man underwent a re-evaluation to determine the progress made. In addition to improvements noted in the results of the exam procedures, the man reported that he could notice a 50% reduction in his tremors. Because of this improvement, he was able to write more efficiently and was able to eat breakfast cereal with a spoon more easily. The authors concluded, "Chiropractic care resulted in significant decrease of essential tremors for this patient."

On May 18, 2022, the publication Claims Journal published an article with the above title. The article was based on a study by the Workers Compensation Research Institute published on May 17, 2022, with the title, "Chiropractic Care for Workers with Low Back Pain."

In this study, researchers reviewed more than 2 million open and closed workers compensation claims from 28 U.S. states, with injuries that occurred between October 1, 2015, through September 30, 2017. The states that were included were Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

The article in Claims Journal starts by addressing the incorrect notions regarding the costs of chiropractic care for workers compensation cases. "Chiropractors are involved in only a small fraction of workers’ compensation claims for low back pain in states where insurers or employers control the choice of medical provider, but a report released Tuesday suggests that skepticism about runaway costs may be unfounded."

The researchers examined the claims from the over 2 million workers compensation claims and compared the patients who received only chiropractic care to those workers who received no chiropractic care at all, and to workers who received services from both chiropractors and other types of providers.

When comparing the costs of care for injured workers who received only chiropractic care, the cost was much less for those who received only chiropractic. The average cost for those patients who only received chiropractic care was $1,366 as compared to $3,522 for treatment of those who did not receive any chiropractic at all. This shows that chiropractic care was 61% less expensive than other forms of care for injured worked with lower back pain.

When chiropractic care was added to other forms of care, the cost savings was less, but still considerable with the average case costing $3001 per case. This showed that when only chiropractic was delivered the biggest cost savings was realized.

The study also noted that the patients who were exclusively cared for by chiropractors had less diagnostic imaging studies and significantly fewer opioid prescriptions. Only 1% of those under only chiropractic care wound up receiving an opioid prescription compared to 10.3% of claimants receiving an opioid prescription who did not get chiropractic care.

Workers Compensation Research Institute President and Chief Executive Officer John Ruser reacted to the study by stating, "This study will be helpful for policymakers and stakeholders who are interested in re-evaluating the role of chiropractors, especially those who have been adopting evidence-based practices and contributing to cost-effective care."

Above is the headline of an article from Neuroscience News published on May 11, 2022. This article, as well as several more in other publications, reports on a study published in Science Translational Medicine on May 13, 2022. The study showed that using anti-inflammatory medications for acute pain may actually cause the problem to get worse and lead to chronic pain.

The Science Translational Medicine study stated, "...clinical data showed that the use of anti-inflammatory drugs was associated with increased risk of persistent pain, suggesting that anti-inflammatory treatments might have negative effects on pain duration." 

The article in Neuroscience News begins by clearly explaining that "Using anti-inflammatory drugs and steroids to relieve pain could increase the chances of developing chronic pain, according to researchers from McGill University and colleagues in Italy." The article quotes  Jeffrey Mogil, a Professor in the Department of Psychology at McGill University and E. P. Taylor Chair in Pain Studies, "For many decades it’s been standard medical practice to treat pain with anti-inflammatory drugs. But we found that this short-term fix could lead to longer-term problems."

The study suggests that inflammation, a normal response to injury, is needed to create healing. Blocking the inflammation can actually prevent the normal healing and turn a short-term problem into a long-term chronic issue. Professor Mogil explains, "Neutrophils dominate the early stages of inflammation and set the stage for repair of tissue damage. Inflammation occurs for a reason, and it looks like it’s dangerous to interfere with it."

The study found that taking anti-inflammatory drugs block neutrophils which are white blood cells that help the body begin the healing process. The study looked at 98 people who were suffering with lower back pain. The researchers observed that the patients whose back pain eventually went away had significantly more neutrophils in their blood compared to those who continued to suffer with the pain.

In noting how huge a shift this new information is from common medical practice, Dr. Thomas Buchheit, director of the regenerative pain therapies program at Duke, had a different view. "People overuse the term ‘paradigm shift’, but this is absolutely a paradigm shift." He added, "There is this unspoken rule: If it hurts, take an anti-inflammatory, and if it still hurts, put a steroid on it." But based on this new study Dr. Buchheit now suggests "...we have to think of healing and not suppression of inflammation."

Dr. Selina Sigafoose-Jackson, president of the International Chiropractors Association and a practicing chiropractor in York, Pennsylvania responded to the study by stating, "This new study confirms that the body's normal processes should not be interfered with. Healing best occurs when there is a removal of interference to the body's own natural healing processes. The chiropractic approach has always been to remove any nerve system interference caused by subluxations, thus allowing the body to heal itself. This approach has been clinically shown to be more effective and safer than the use of medications."