March 2022

• Resolution of Otitis Media After Chiropractic Care

• Chiropractic Care More Affordable Than Multidisciplinary Care
• Recovery from Severe Headaches and Neck Pain with Chiropractic
• Study Shows Opioid Prescriptions Greatly Reduced Due to Chiropractic Care

The Journal of Pediatric, Maternal & Family Health published the results of a case study on February 28, 2022, documenting the complete resolution of otitis media in a child receiving chiropractic care. Otitis media is an infection of the middle ear, and is more common in children.

The study begins by pointing out how common otitis media by saying, "...approximately 80% of children will experience at least one episode of acute otitis media, AOM, before school age." They report that globally there are 10.8 new episodes of otitis media per 100 people each year.

In this case, an 8-year-old girl suffering with right ear pain, sinus problems, and upper neck pain was brought  to a chiropractor by her mother. The girl had been previously diagnosed with otitis media which she seemed to get with colds. In three previous occasions of ear aches, antibiotics were use to alleviate the situation.

A chiropractic examination was performed which focused on checking the girl's spine for subluxations. The examination revealed the presence of subluxations in multiple areas of her spine. Based upon these findings, chiropractic care was started to address the subluxations.

The girl was seen for chiropractic care on four consecutive days. By the third day, it was reported that her ear infection was completely gone. The study also reports that the girl's neck pain decreased, and neck range of motion had improved.

This study also reviewed a number of previous studies on chiropractic care and otitis media issues. In each of these cases, the results were consistent with the results of this study in that the patient recovered from the episode of otitis media. In one, hearing loss was restored, and in most cases, there were no further incidences of ear infections.

In the study conclusion the authors wrote, "There is some evidence that suggests chiropractic care is an effective technique for reducing the frequency and severity of recurrent otitis media in children as this case described the successful management and resolution in a young child undergoing chiropractic care."

A study in the journal Chiropractic & Manual Therapies showed that chiropractic care alone was more affordable and similarly as effective as multidisciplinary which included chiropractic for the treatment of patients suffering with low back pain. The study, published on March 1, 2022, was titled, "Multidisciplinary integrative care versus chiropractic care for low back pain: a randomized clinical trial."

This study attempted to see if there was a difference in outcomes between chiropractic care alone verses a multidisciplinary approach, which included chiropractic, in the care for patients suffering with lower back pain. This study looked at two groups of people suffering with either sub-acute or chronic lower back pain. The care for each of these groups was only rendered for a 12-week period, but the results of that care were tracked for a year after care began.

The primary outcome that the study was examining was pain intensity. However, the study also looked at secondary outcomes including disability, improvement, medication use, quality of life, patient satisfaction, frequency of symptoms, and missed days of work or reduced activities day. Participant’s results were reported on weeks 4, 12, 26 and 52 after the beginning of care.

A total of 201 participants were enrolled in the study and randomly divided into two groups. One group received only chiropractic care, while the other group received several different types of care which included exercise therapy, self-care education, traditional Chinese medicine, massage therapy, chiropractic care, cognitive behavioral therapy, and medication.

The results of the study showed that both groups experienced considerable improvements in all measured outcomes. The group that received the multiple types of care got marginally better results as far as pain relief and disability. On average, the multidisciplinary group showed a few percentage points better relief of their symptoms throughout this study.

One of the drawbacks that the researchers pointed out was that the cost of the multidisciplinary care was considerably higher than the chiropractic care alone. They also noted that the group that received multidisciplinary care had more doctor visits and was less convenient for the patients, as well as on average each visit lasting much longer. They also noted that the multidisciplinary care was logistically difficult to coordinate the various types of care from a provider standpoint.

It should also be noted that the multidisciplinary care included the continual use of medications, which carries its own inherent risk from side effects. Ongoing use of medication is opposite the goal of most pain care which is to have the patient no longer need pain medication.

The authors sum up the results of the study and their conclusions by stating, "Low back pain patients who received integrative care by a multidisciplinary integrative care team tended to have better outcomes than those who received chiropractic care. However, given the relatively small magnitude of between group differences and the extensive resources required to successfully manage and implement, the team based integrative care might not be worthwhile."

The Chiropractic Journal of Australia published the results of a case study released on February 11, 2022, documenting the improvement of headaches and neck pain on a patient who was also diagnosed with neurofibromatosis.

According to the Mayo Clinic's website, "Neurofibromatoses are a group of genetic disorders that cause tumors to form on nerve tissue. These tumors can develop anywhere in the nervous system, including the brain, spinal cord and nerves." They note that the tumors are usually benign. They also note that there are three types of neurofibromatosis with the type 1 (NF1) being the most common.

This study reports that over 50% of patients with neurofibromatosis develop bode deformities such as scoliosis as well as difficulty in healing any bone fractures. Pain in the spine and head area can also result from NF1. The study authors begin by stating that "The purpose of this case report is to present the results of a five-year conservative management for neck pain, cervicogenic headache and spinal deformity in a patient with NF1. Chiropractic intervention may be a viable option for addressing musculoskeletal pain and cervicogenic headache resulting from NF1."

In this case, a 25-year-old salesman had been medically diagnosed with NF1 ten years before his seeking chiropractic care. In the past six months, the man had developed pain on the right side of his head and neck. His head pain extended around to the front of his head. On a scale of 0 to 10 with 10 being the worst, he rated his neck pain as a 2 out of 10 and his head pain as an 8 out of 10. The man described his head pain as a pulsating squeezing that lasted about an hour occurring about 2-3 times per day. He reported that over the preceding month, the pain disturbed his sleep and daily activities.

Chiropractic care was started on a daily basis for the first week and then reduced in frequency to three days per week for the next 4 weeks. After the first week, the man reported that his pain reduced from an 8 down to a 5 out of 10. The chiropractic care frequency continued to be reduced as the man improved. Follow-up x-rays of the man's neck showed an improvement of his neck curvature which prior to chiropractic care had been almost straight, instead of a normal forward curvature.

Eventually, the man began maintenance chiropractic care with a lower frequency of visits. At a 5 year follow-up,  the man reported that he no longer had the pain symptoms he originally complained about.

In their conclusion, the study authors summed up the results of this case by saying, "This case report details the long-term recovery of a patient with NF1 from severe headaches and neck pain following chiropractic treatment. It provides evidence and highlights the value of chiropractic intervention in improving neuromuscular functions and resolving cervicogenic headache in a patient with NF1, especially when the problems cannot be effectively solved by pharmacological or other conservative means."

Study Shows Opioid Prescriptions Greatly Reduced in Seniors Receiving Chiropractic

A study published on January 31, 2022, in the journal Chiropractic & Manual Therapies shows that older adults are less likely to fill prescriptions for opioids if they are under chiropractic care.  The title of the study is "Association between chiropractic care and use of prescription opioids among older Medicare beneficiaries with spinal pain: a retrospective observational study."

The study begins by pointing out that there have been several large studies that showed that patients who sought out chiropractic care for spine-related pain were less than half as likely to receive a prescription for or utilize opioids as a method of treatment. Considering the opioid epidemic situation our society is currently facing, any alternatives to opioids is preferable.

This study looks specifically at older adults who are on Medicare and suffer from spinal pain. Prior studies looked at the opioid usage in the general population and not specifically among seniors who are more likely to be on multiple medications in addition to any opioid use. The interactions of multiple medications with opioids, coupled with other health issues that seniors typically suffer from, add special concern to finding out if chiropractic care could reduce the usage of opioids in seniors.

Researchers reviewed the Medicare claims over several years of 55,949 Medicare beneficiaries who were suffering with spinal pain. Of this total patient number, 9,356 received chiropractic care and 46,593 did not. Those who were received chiropractic were also receiving medical care at that time. The researchers tabulated the number of people in each group who filled a prescription for opioid medications within one year of the initial diagnosis for spinal pain.

The results of the study showed that those who got chiropractic care were 56% less likely to fill an opioid prescription within 365 days of first chiropractic visit. Those who sought chiropractic earlier in their condition were 62% less likely to fill an opioid prescription compared to those who did not receive chiropractic.

In their discussion, the researchers noted that their results were similar to other studies that did not specifically look at seniors. "The results of this study support our hypothesis that among older Medicare beneficiaries diagnosed with spinal pain, recipients of chiropractic care have a lower risk of filling a prescription for an opioid analgesic as compared to non-recipients."

The results of this study add further strength to the argument that chiropractic should be included on senior care especially when related to spinal pain. In the conclusion to the study, the authors summed up the results by saying, "Older Medicare enrollees with spinal pain who saw both a chiropractor and a primary care physician had less than half the risk of filling an opioid prescription, as compared to those who received primary medical care alone. The association was most pronounced among those who saw a chiropractor within the first 30 days of care."