This prospective case series suggests the possibility that menstrual pain associated with primary dysmenorrhea may be alleviated by treating motion segment restrictions of the lumbosacral spine with a drop table technique. The research team needs to conduct a well-designed feasibility trial to further evaluate the effectiveness of this specific spinal manipulative technique for primary dysmenorrhea.
This study is the first attempt to identify variables that can predict immediate outcomes in terms of improvement and worsening of presenting symptoms, and global improvement, after cervical spine manipulation. From the findings, it was possible to identify some predictors of immediate improvement in presenting symptoms after cervical spine manipulation.
Patients presenting with symptoms of “reduced neck, shoulder, arm movement, stiffness,” “neck pain,” “upper, mid back pain,” “headache,” “shoulder, arm pain,” and/or “none or one presenting symptom only” are likely to report immediate improvement in these symptoms after treatment. Patients presenting with any 4 of these symptoms were shown to have the highest probability of immediate improvement. This finding may enhance clinical decision making for selecting cervical manipulation in the treatment of patients with one or more of these complaints. Although it was possible to identify a number of predictor variables for immediate worsening in presenting symptoms and global improvement after cervical spine manipulation, these failed to provide a robust predictive model for clinical application.
Comparison of the Short-term Effects of Chiropractic Spinal Manipulation and Occipito-sacral Decompression in the Treatment of Infant Colic: A Single-blinded, Randomised, Comparison Trial
Both treatments appear to offer significant benefits to infants with colic. Infants treated by SMT or OSD cried less and slept more after 2 weeks of treatment. There were no differences in outcomes between the two treatment approaches. Although the participants completed the trial of therapy prior to the usual age of remission for infant colic, the natural course cannot be ruled out. Therefore, the treatment approaches as a cause of the observed benefits in this study must be appropriately interpreted.
Rehabilitation Program for Traumatic Chronic Cervical Pain Associated With Unsteadiness: A Single Case Study
This case report indicates that an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy may have had an effect on improvement of postural control in a trauma CNP patient with unsteadiness. These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.
Chiropractic Care of a Pediatric Patient with Symptoms Associated with Gastroesophageal Reflux Disease, Fuss-cry-irritability with Sleep Disorder Syndrome and Irritable Infant Syndrome of Musculoskeletal Origin
The mother of a 3-month old girl presented her daughter for chiropractic care with a medical diagnosis of gastroesophageal reflux disease. Her complaints included frequently interrupted sleep, excessive intestinal gas, frequent vomiting, excessive crying, difficulty breastfeeding, plagiocephaly and torticollis. Previous medical care consisted of Prilosec prescription medication. Notable improvement in the patient’s symptoms was observed within four visits and total resolution of symptoms within three months of care. This case study suggests that patients with complaints associated with both musculoskeletal and nonmusculoskeletal origin may benefit from chiropractic care.
Thyroid dysfunction has been effectively treated by conventional medicine for many years. Changes in thyroid dysfunction after a course of NET have been described. As the standard medical model is associated with some adverse effects such as long-term medication use and potential side effects, all natural, non-invasive approaches to management should be reviewed. Further research into this mind-body therapy is recommended to evaluate its potential effectiveness for this common condition.
This case study provides supporting evidence on the safety and effectiveness of chiropractic care during pregnancy with a chief complaint of migraine headaches.
Chiropractic Management of the Kinetic Chain for the Treatment of Hip Osteoarthritis: An Australian Case Series A Report of 10 Cases
This case series presents 4 participants diagnosed with hip osteoarthritis who had increases in hip range of motion and reductions in pain and disability scores (WOMAC scores) of approximately 69% after 9 sessions of chiropractic management of the lower limb kinetic chain. This case series provides the observations of assessing and treating the entire lower limb kinetic chain (through hip and full kinetic chain manipulative therapy combined with passive and active-assisted stretching) for HOA. However, further research in the form of large scale randomized controlled trials is needed to investigate the effectiveness and clinical significance of chiropractic management of the lower limb for hip osteoarthritis.
Upper Cervical Manipulation Combined with Mobilization for the Treatment of Atlantoaxial Osteoarthritis: A Report of 10 Cases
This case series suggests that some of the signs and symptoms of atlantoaxial facet osteoarthritis, which can occur in the elderly because of degenerative disorder and younger patients because of trauma, may be improved by upper cervical spinal manipulation combined with mobilization with a mechanical device.
This case was one of chronic idiopathic testicular pain. The patient was treated with the Cox Technic, and his low-back pain improved with complete remission of his leg and testicular pain. The testicular pain had not returned 6 months following his discharge from care.
The prevalence of childhood and adolescent LBP is more common than once thought. Discogenic pain from annular tears, herniation and vertebral endplate injury, must be considered particularly in cases involving chronic LBP, and lack of response to conservative manual therapy. MRI can be useful in appropriately connecting patient history, physical examination, and imaging findings to correlate the most likely cause of a patient’s LBP. It should be used particularly when conservative management and/or natural history fails to resolve the LBP disorder. Specialist referral is warranted when pain levels are intractable or when continuous pain and disability occurs after a course of conservative management. Speedy resolution of lumbopelvic function is considered important to help limit any long term deleterious effects on spinal growth and therefore improve quality of life in young persons. More research is needed regarding long-term implications of IVD injuries in people of such young age, and how best to conservatively manage them.
This case report describes the responses of a patient with PD who was treated with blue-lensed glasses, vibration stimulation therapy, spinal manipulation, and eye-movement exercises. No definitive conclusions can be drawn from this case; however, it does suggest that the use of chiropractic care may benefit a patient with PD.
Elongated Styloid Processes and Calcified Stylohyoid Ligaments in a Patient With Neck Pain: Implications for Manual Therapy Practice
This study describes a patient with neck pain and other symptoms in the presence of ESPs and CSLs that initially suggested Eagle syndrome as a diagnosis. This diagnosis was later ruled out by an otolaryngologist, however the patient’s clinical findings and anatomic features prompted the use of precautions pertaining to the use of cervical spine manipulation. This case highlights proper diagnostic workup for this condition and presents potential contraindications to consider with regard to cervical spine manipulation in such patients. We therefore propose that because of the proximity of ESPs to sensitive neurovascular structures, this anatomic anomaly may pose a relative contraindication for thrust manipulation of the cervical spine.
This case report demonstrates successful management of symptoms either caused by or complicated by central canal stenosis. The flexion-distraction technique might provide an effective method of improving spinal biomechanics, allowing for the normal dynamic increase in canal size and subsequent symptomatic relief. Further study of this method is warranted to determine whether it can regularly provide relief for afflicted patients seeking nonsurgical management.
This case demonstrates how an athlete with recurrent shoulder instability had a successful outcome after receiving multimodal treatment of soft tissue mobilization, manipulation, proprioceptive training and taping, nutritional counseling, and conditioning exercises. It further demonstrates that achieving functional and sport-specific activities after musculoskeletal trauma can be enhanced significantly if proprioception is addressed in the treatment program. The decreased frequency of instability occurrences in this case combined with the perceived improvement on the shoulder instability index suggest a gradual stabilization of the proprioceptive function of the shoulder. This would suggest that rehabilitation exercises should focus on the importance of incorporating joint position sensibility and reflexive-type contractions into the therapy program. Future directions for proprioception research should consider the effects of upper extremity training on proprioception in both normal and unstable shoulders. Future studies should also examine the effectiveness of proprioceptive training in nonoperative treatment of shoulder instability. Further research to better understand and use chiropractic management strategies and interventions for athletes with shoulder instability appears warranted.
Chiropractic Care of a Patient with Vertebral Subluxations and Unsuccessful Surgery of the Cervical Spine
We presented the chiropractic care of a patient with neck pain and cervical radiculopathy after an unsuccessful surgical diskectomy. This unusual case may challenge the conventional allopathic clinical care pathways, as well as opinions within some chiropractic circles about the appropriateness of chiropractic care of patients with cervical radiculopathy or unsuccessful cervical surgery.
We have discussed the chiropractic care of a patient with vertebral subluxation and complaints associated with a disorder of the TMJ. We have examined the possibility that subluxations of the cervical spine may result in a TMJ disorder and that removal of subluxations through adjustments may alleviate the extravertebral complaint. Because the incidence of these disorders is on the rise, it becomes increasingly important for today’s chiropractor to not only understand the pathology behind TMDs but also the myriad of care options available. The possibility that some of these disorders may be effects of subluxations through referred pain or dysfunction in the craniovertebral kinematic chain should be considered in the care of patients.
The PulStar computer-assisted mechanical adjusting device set to the lowest force setting appears to have been well tolerated by both a 6-week-old female infant and a 9-week-old male infant with colic. Significant improvement in colicky behavior was observed, including apparent remissions within 10 days and 5 to 8 treatment sessions. These gains continued for a 30-day follow-up period in both cases. Although no claims can be made on the basis of individual cases, these findings are supportive of chiropractic intervention for infantile colic. Further research is warranted and necessary to determine whether computer-assisted devices can enhance the effectiveness and safety of chiropractic treatment of infants with colic.
Current emergency department/urgent care facility procedures mandate performing radiography on patients sustaining cervical spine trauma, but the number of x-ray films or the need for additional imaging, such as CT, is left up to the attending emergency physician. This case shows that cervical spine fracture-dislocations can be missed, and chiropractors are cautioned to perform a comprehensive evaluation of patients suffering from cervical trauma even if they have prior x-ray films reported as normal. Although CT is extremely reliable for detection of cervical spine fracture-dislocation, mandatory use of CT for all patients with cervical spine trauma is most likely cost-prohibitive. This case clearly demonstrates the importance of careful clinical assessment and imaging procedures on patients after cervical trauma. The x-ray films taken at the emergency facility did appear negative for fracture, but there were radiographic signs and clinical findings that were not ruled out. A comprehensive assessment addressing all significant radiographic and physical examination findings would have justified further imaging, such as CT or MRI and revealed the fracture-dislocation that was not detectable on plain film.
The unique approach of chiropractic care in which vertebral and extravertebral disorders are managed in concomitant with nervous system afflictions such as Bell’s palsy is not well described in the literature. This descriptive case report of Gonstead Technique procedures adds to the paucity of knowledge currently available regarding chiropractic in patients with Bell’s palsy.
Chiropractic care may be of benefit to some patients with connective tissue disorders, including Ehlers-Danlos syndrome. Low-force chiropractic adjusting techniques may be a preferred technique of choice in patients with tissue fragility, offering clinicians a viable alternative to traditional chiropractic care in attempting to minimize risks and/or side effects associated with spinal manipulation. Psychosocial issues, including patient desire to return to work, were important factors in work disability status and perceived outcome.
While no definitive conclusions can be drawn from a case report, the results observed in these cases are encouraging, given that close to 70% of EDS patients complain of neck and back pain that is usually resistive to pharmacological intervention and is independent of any EDS-associated spinal deformity. Any relief that chiropractic care could offer this group of patients would be significant and make a favorable impact on improving their quality of life. Further study, organized in an academic research venue, will help to clarify the role that chiropractic treatment may be able to provide for sufferers of EDS.
The above case is probably not unique, nor even unusual, for a chiropractic practice. There are many anecdotal reports of patients coming in with similar symptoms for which the Doctor of Chiropractic in general practice may not have had the expertise to make a specific diagnosis. The effects of chiropractic adjustments seem, in many cases, to be general enough that many symptoms will clear up with care—or perhaps on their own, with time—despite the lack of a specific approach, fortunately for both parties involved. Of course, in a more persistent or severe case, the doctor should make a referral to a specialist. For practical considerations, however, it is important to note that additional diagnostic studies or referral to a neurologist would also mean significant additional expense. For the above patient, who paid cash and had no insurance coverage for chiropractic care, the examination and care rendered involved 4 office visits and a total cost of only $168 (USD).
There certainly are unanswered questions in this case. How valid were the examination findings? No attempt was made to quantify the degree of tenderness in the hand using any sort of measurement device, such as a pressure algometer; the assessment was subjective but based on experience. No measurement device, such as a dynamometer, was used to evaluate muscle weakness. However, Brandsma et al  studied manual muscle strength testing of the hand with patients who had neuropathy involving the ulnar and median nerves, and intraobserver reliability was found to be good to very good.
An assumption was made that the location of the problem was the ulnar tunnel; further examination could include radiographs or MRI of this area to evaluate for fractures, osteophytes, scar tissue, tumors, masses, and inflammation. As it is, although the patient’s symptoms seem to have improved from the carpal manipulation, it is still not clear exactly what the cause of the symptoms was or what exactly the adjustments accomplished. The lack of positive findings of the cervical and thoracic outlet tests does not necessarily rule out involvement in either of these areas, since the orthopedic tests used have a limited degree of sensitivity. There are many anecdotal reports from chiropractors who claim to be able to help carpal tunnel syndrome using cervical manipulation alone. Since at least some of these are probably cases of cervical radiculopathy misdiagnosed as CTS, we should be reminded of the significance of understanding the syndromes we work with and the importance of a good examination.
Most practitioners would find it reasonable, in cases such as the one above, to proceed with a trial of care based on the findings. However, without confirmation by nerve conduction velocity (NCV), this case remains a diagnostic impression of UTS, thus suspected ulnar tunnel syndrome, rather than a true diagnosis. No method of measurement of the suspected nerve dysfunction was made; NCV, electromyography (EMG), or somatosensory evoked potential (SSEP) studies could be appropriate in such a case. NCV is considered to be the “gold standard” for confirmatory diagnosis of CTS and would be for UTS as well.
Peripheral nerve compression syndromes represent a category of problems that chiropractors sometimes claim to be able to help but for which there is only scant documentation. The case above lacks many of the controlled conditions of a research study, so it is difficult to draw hard conclusions. While a clinical trial of a number of patients would provide better information, it also may be difficult to accomplish, since this is not a particularly common syndrome. I hope that this initial report will contribute to further understanding of similar conditions and the use of conservative manipulative approaches in their resolution.
Treatment of Bipolar, Seizure, Sleep Disorders and Migraine Headaches Utilizing a Chiropractic Technique
This case report details the history of a 23-year-old man suffering from bipolar disorder, sleep disorder, seizures, migraine headaches, and neck and back pain following a headfirst fall; the 18-month intervention of chiropractic care utilizing an upper cervical technique; and the patient’s response. Evidence of an upper cervical subluxation was found using paraspinal digital infrared imaging and upper cervical radiographs. It was corrected by performing a specific adjustment to the first cervical vertebra according to radiographic findings. The upper neck subluxation could have been caused by an accident in which the patient fell headfirst into the ground while pole vaulting. All of the patient’s conditions were absent by the seventh month of care and remained absent at the conclusion of care. Further investigation into upper cervical injury and resulting neuropathophysiology as a possible etiology or contributing factor to bipolar disorder, sleep disorder, seizures, and headaches should be pursued.
The Amelioration of Symptoms in Cervical Spinal Stenosis with Spinal Cord Deformation Through Specific Chiropractic Manipulation: A Case Report with Long-term Follow-up
Resolution of the signs and symptoms of cervical stenosis with MRI-documented spinal cord compression through chiropractic techniques is reported. This case suggests the need for more research into the less traditional chiropractic techniques. More research is needed to identify the exact mechanisms of neurological insult seen in cervical spinal stenosis. Better understanding of the pathophysiology of this condition may lead to novel conservative approaches to treatment.
Based on the information presented in this article, we suggest that the majority of cases of NTS are uncomplicated and the onset is usually idiopathic or secondary to trauma. Although upper cervical instability secondary to inflammatory disease, myelopathy, or severe degenerative joint disease (DJD) is unlikely in athletes, it remains a possibility. Intuitively, NTS in athletes is more likely caused by a spasm of the inferior oblique muscle, and once upper cervical instability is ruled out, it should be categorized as uncomplicated. In conclusion, SMT appears to be beneficial and should be considered in all cases of uncomplicated NTS, once upper cervical instability has been ruled out. Use of a cervical collar and postural training exercises in conjunction with patient education may be beneficial in all cases of NTS.
Chiropractic High-Velocity Low-Amplitude Spinal Manipulationin the Treatment of a Case of Postsurgical Chronic Cauda Equina Syndrome
This appears to be the first published case of chiropractic treatment of a patient with chronic CES. It seems that chiropractic HVLA spinal manipulation was safe and effective for relieving back pain in this patient and treatment seems to have had no positive or negative effect on the neurologic deficits present.
This article highlights a successful outcome for a patient with shoulder impingement syndrome after receiving a multimodal treatment approach combining soft tissue techniques (ischemic compression, friction), electromodalites (ultrasound), manipulation, and rehabilitation (exercises). In managing the shoulder and shoulder pain syndromes, a detailed knowledge of the anatomy of the shoulder and associated structures including the scapulohumeral, scapulothoracic articulations, the cervical, and the thoracic spine is important to develop an appropriate treatment plan. The practitioner is therefore well placed to manage both shoulder and spinal pain syndromes. Recent evidence suggests that this may be the future direction in managing pain of musculoskeletal origin,  particularly of the shoulder.  To determine the true effectiveness of a multimodal chiropractic treatment approach, further research should be initiated.
Comprehensive care, differential diagnosis, and continuity of care are important aspects of primary care. These principles are emphasized in the chiropractic clinical curricula and delivered through chiropractic patient management. This case report also typifies the application of primary care principles in a chiropractic teaching clinic. Holistic care delivered with compassion but guided by rigorous science is in the best interest of the patient. A clinical trial using a multidisciplinary team could further clarify the role of complementary and alternative care in the diagnosis and treatment of CHF. It is our hope that this report stimulates research in this critically important area of patient care.
A percentage of patients seeking chiropractic care have a mild to moderate hearing loss, identified by audiometry. In accordance with other reports, the clinical progress documented here suggests chiropractic care may benefit hearing loss and that chiropractic adjustments to various areas of the spinal column and locomotor system may have an effect on central auditory processing, though alternative explanations can not be disregarded. There is a difference in the unilateral aspect of the hearing deficit noted in the right ear of patients in this current study as reported in others. The observations documented in this case series provide limited support to previous works indicating that, when hearing is tested immediately after a single chiropractic adjusting visit, hearing may be improved in both ears. Further research in this area is required, in the form of a well designed randomised controlled trial. Competing interests
This report is provided to illustrate a systematic approach diagnosis and treatment to assist this injured workers return to work. This case illustrates that even after 2 years successful return to work can be achieved.
Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. The magnitude and objectivity of the data presented warrants further study in using a comprehensive active rehabilitation approach to improve clinical symptoms of lumbar disc disease in individuals refusing surgical intervention. Electrodiagnostic testing provided useful clinical information in this case, and should be further investigated in chiropractic cases.
Short and Long-Term Results of Connective Tissue Manipulation and Combined Ultrasound Therapy in Patients with Fibromyalgia
CTM, HVPGS, and US seemed to be helpful in improving pain intensity, complaints of nonrestorative sleep, and impact on functional activities in patients with FM. Effectiveness of these methods is thought to be worthy of investigation in further studies, including comparisons with other methods or sham/controlled protocols.
A case is presented that exhibited substantial improvement of cervical dystonia following specific chiropractic manipulation. Possible explanations for this observed therapeutic response are offered, and the need for future research of less traditional chiropractic techniques in general and in cases of cervical dystonia is suggested.
The Dental-chiropractic Cotreatment of Structural Disorders of the Jaw and Temporomandibular Joint Dysfunction
The position of the jaw and head and neck are intricately linked. The acute symptoms experienced during the initial dental treatment phase were caused by the inability of the head and neck to adapt to maxillary and mandibular changes. Chiropractic treatments enabled the body to respond positively to the dental changes. As the mandibular position improved, further improvements were indicated by physical testing and X-rays.
The use of computerized static perimetry to measure the cerebral effects of spinal manipulation has increased knowledge of how chiropractic works. The further recovery of vision with each spinal adjustment suggests that more treatment may be better than less treatment in the chiropractic management of such cases.
The use of computerized static perimetry changes to measure the cerebral effects of spinal manipulation is recommended for future chiropractic research.
Muscle Tension Dysphonia and Spasmodic Dysphonia: The Role of Manual Laryngeal Tension Reduction in Diagnosis and Management
Excessive activity of the extralaryngeal muscles affects laryngeal function and contributes to a spectrum of interrelated symptoms and syndromes including muscle tension dysphonia and spasmodic dysphonia. Recognition of the role of extralaryngeal tension is helpful in ensuring proper diagnosis and selection of appropriate treatment. This report demonstrates the application of manual laryngeal musculoskeletal tension reduction techniques in the diagnosis and management of laryngeal hyperfunction syndromes. The manual technique consists of focal palpation to determine 1) extent of laryngeal elevation, 2) focal tenderness, 3) voice effect of applying downward pressure over the superior border of the thyroid lamina, and 4) extent of sustained voice improvement following circum-laryngeal massage. The clinical utility of this innovative approach is discussed.
In the presented case, the sensitivity of MRI to stress-induced BME identified the cause of this patient’s symptoms and, more importantly, directed management. Because of its ability to demonstrate anatomic and physiologic information, MRI is the ideal imaging modality for assessing suspected injury to the osseous tissues. In patients who relay historical information that suggests chronic or acute osseous injury but demonstrate no radiographic changes to support the clinical suspicion of bony abnormality, an MRI may be indicated to exclude occult injury.
Appropriate intervention of chiropractic examination procedures and imaging techniques culminated in successful resolution of this case. When such cases are recognized, appropriate management may occur conservatively with judicious application of joint manipulation and adjunctive procedures.
Chiropractors demonstrated the personalized nature of their care by the specificity of their responses to each patient. The importance of explaining the adjustment and the sensations that patients are likely to experience, particularly in new patients, is confirmed. The desirability of scrutinizing the patient for evidence of stress and of using diverse strategies for minimizing the stress response are discussed. Although the chiropractic consultation is not generally regarded as a stress-provoking experience, chiropractors should actively screen their patients for evidence of stress and take steps to enhance their patients’ perceptions of the chiropractic consultation as a stress-free experience.
Thermal Asymmetry of the Upper Extremity in Scalenus Anticus Syndrome, Leg-length Inequality and Response to Chiropractic Adjustment
Scalenus anticus syndrome and upper extremity thermal asymmetry may result from altered cervical biomechanics caused by atlas vertebral subluxation complex. Furthermore, the supine leg check may be of value in determining the necessity of atlas adjustment.
Manual adjusting procedures and soft tissue therapy were applied initially. Procedures were modified later to include an intrarectal technique. The quantity of urine loss decreased slowly with the initial treatment approach but never resolved completely. The flank pain also decreased somewhat but never ceased altogether. After the introduction of the intrarectal technique, additional progress was reported and both the flank pain and urinary incontinence resolved completely. A 4-yr follow-up confirmed complete resolution.
Results encourage further investigation of possible neurological sequalae, such as epileptic seizures, from spinal dysfunction identified as vertebral subluxation complexes by chiropractors and treated by specific spinal adjustments.
In the management of myasthenia gravis, no standard measure of disease severity and no medical treatment approach has been proven efficacious by rigorous, prospective, controlled studies. The preponderance of evidence certainly links a “connection” between the immune system and the central nervous system beyond a reasonable doubt. The exact mechanisms involved and the role of chiropractic care and its putative effects largely remain unexplored. Although a specific myasthenia gravis osseous structure does not exist per se, chiropractic approaches to case management use signs (ie, biomechanical and postural assessment), palpatory findings, specific range of motion findings, x-ray studies, and symptoms (ie, pain) to determine the spinal level to be adjusted. Patient outcomes are also determined as above. If the patient’s condition does not improve, then subluxation findings are reevaluated, and the patient’s treatments are varied accordingly. Whether such a treatment process or approach brings about healing as a result of specific or nonspecific effects of the treatment or the treatment is merely “riding on the wave” of remission remains to be fully elucidated.
The exact mechanisms leading toward disease and the role of spinal adjusting continue to be some of the greatest challenges for our profession. We hope that this case study encourages further investigation into the holistic approach to patient management by chiropractors vis-à-vis specific adjustments of vertebral subluxation.
The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer
By trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group (P = .04). On days 8 through 11, crying was reduced by 1 hour for the dimethicone group, whereas crying in the manipulation group was reduced by 2.7 hours (P = .004). From trial day 5 onward the manipulation group did significantly better that the dimethicone group. The authors then conclude: Spinal manipulation is effective in relieving infantile colic.
Bilateral Simultaneous Optic Nerve Dysfunction After Periorbital Trauma: Recovery of Vision in Association with Chiropractic Spinal Manipulation Therapy
In this account, we report rapid recovery from monocular visual field loss in association with spinal manipulation therapy, adding to previous demonstrations of the same phenomenon. The significance to the chiropractic profession of recovery of monocular visual field loss with spinal manipulation should not be underestimated; it suggests that spinal derangement can be linked to sundry cerebral pathologic conditions, as was postulated by Palmer  more than a century ago.
The now well-authenticated recovery of concentric narrowing of the visual fields with spinal manipulation is detracted by the fact that the vision abnormality is generally considered a form of psychoneurosis. In this patient’s case, it would be unreasonable to assign a psychologic pathogenesis to her condition in light of the clearly defined electro-physiologic abnormalities and the positive SPECT scan.
If spinal manipulation does influence the function of the nervous system anywhere in the brain, as the improvement in optic nerve function attests, then logically spinal manipulation therapy might have wide application in diseases of the nervous system.  Considering that the appropriate control of bodily functions depends on sound cerebration, the ultimate place of spinal manipulation therapy in health care needs urgent definition by further research.
This case details changes before and after treatment with long-term follow-up care in a clinical setting. Daily notes, bilateral skin temperature readings, and clinical impressions were included to illustrate the day-to-day clinical thinking process in this case. A case study is limited in its ability to provide conclusions; one single case should not be taken out of context. It is possible that the patient described here recovered through spontaneous remission or because she believed her problem had been discovered and improved, creating a placebo effect. The spinal structural changes recorded in this case along with neurophysiologic recuperation weigh against the placebo affect. The time span in which the patient had the original symptoms before the instigation of chiropractic care makes spontaneous remission less likely.
Treatment of Severe Glaucomatous Visual Field Deficit by Chiropractic Spinal Manipulative Therapy: A Prospective Case Study and Discussion
The improvement of this patient’s vision after chiropractic SMT suggests a cause-effect relation. We have hypothesized that the presence of chiropractic subluxation in the cervical spine was responsible for irritating the cervical sympathetic nerves, thereby causing the cephalic episodic vascular irritability (ie, migraine) against a background of vascular spasticity (ie, interictal migraine). The resulting compromise of blood supply is thought to produce reduced nervous activity caused by a neural hibernation effect, further reducing visual fields already severely restricted by glaucomatous optic atrophy. Chiropractic SMT was thought to be effective in relieving sympathetic irritation.
It is not known whether this hypothesized vascular phenomenon was of the vertebro-basilar arterial system, thereby affecting vision through reducing neuronal activity of the visual cortex, or of the carotid arterial system, thereby reducing activity of the ocular neural tissue. Should the latter be the case, we postulate that an ischemic penumbra surrounding necrotic optic neural tissue was reversed. This vascular phenomenon may have been present in both arterial systems.
Regardless of the mechanism of the visual improvement, the results of this case study remain remarkable and unexpected, prompting the question whether chiropractic spinal manipulation may be of value in the treatment of glaucomatous field of vision loss.
A need exists for further research, such as blinded, controlled trials of chiropractic SMT in the treatment of visual field loss caused by glaucoma and single photon emission computerized tomography imaging to determine levels of blood flow to the brain and optic structures before and after chiropractic spinal manipulation.
If the results of this case study are reproducible, there are wide implications for the management of glaucomatous visual field loss, especially in normal tension glaucomatous optic atrophy for which no satisfactory treatment is currently available. Other forms of visual field loss may also be amenable to treatment by chiropractic SMT.
This case report described a successful outcome for a patient with PD who was treated with upper cervical chiropractic care. To my knowledge, this is the first case reported on this topic since Palmer’s research 70 years ago.2 No firm conclusion can be obtained from the results of one case, although these results do suggest that upper cervical chiropractic care may provide benefit for patients with PD when an upper cervical injury is found. Further investigation into upper cervical injury and resulting neuropathophysiology as a possible cause or contributing factor to PD should be considered.
Chiropractic care of the infant is a topic that is in need of exploration in the scientific literature. Future case series and randomized comparative group clinical trials, as well as research comparing the outcomes of upper cervical and cranial adjusting, could shed valuable light on the appropriate role(s) of the chiropractor in managing certain neonatal feeding dysfunction cases.
In this case, a 6-month-old male infant had reportedly experienced significant discomfort while attempting to drink from a bottle over a period of 2 months. He drank freely and without fussing after the first of 5 chiropractic visits, which consisted of C1 and cranial adjusting.
A new era in the treatment of patients with cancer has begun. Helping such patients now includes not only traditional treatment of the disease process itself but also incorporation of the contributions of other providers to assist the patient in living a richer, fuller life. This approach attempts to view the patient as a “whole person” with needs reaching beyond the management of the disease entity. The chiropractic profession has, ever since its inception, embraced this “holistic” approach toward patient care. Having chiropractic available to the rehabilitation team adds new opportunities in the treatment of the cancer patient. Within this team, the chiropractor’s primary role is to serve as an ancillary provider by assisting the patient with pain management and increasing mobility. Especially for the ambulatory patient, the chiropractic provider widens the scope of treatment options to include high-velocity and/or low-force manipulation, soft tissue techniques, physical modalities, exercise instruction, and recommendations pertaining to ergonomics and ADL.
The literature most strongly supports the use of chiropractic treatment for patients with low back pain, which is a common entity among patients with cancer. Clinically, many musculoskeletal complaints respond favorably to chiropractic treatment. Symptoms related to radiation fibrosis, chemotherapy-induced neuropathy, or postsurgical trauma to connective tissues and joints may respond favorably to chiropractic methods.
The clinical examples provided in this article are real-world cases in which the practical application of chiropractic treatment benefited patients with cancer. However, as in the examples, it is usually the patient who takes the initiative to seek assistance from a chiropractor. The addition of a chiropractor to the rehabilitation team can improve the physical and emotional well-being of a patient with cancer, which will positively impact the quality of his or her life, and it can provide the team with additional avenues by which to bring comfort to the patient.
Documentation of complication of neck manipulation by an untrained person. Tertiary care referral teaching hospital at Lucknow, India. Clinical evaluation, plain radiography of cervical spine, spinal MRI. A 30-year-old man who fainted after neck manipulation by a barber and developed spinal cord and brainstem dysfunction. His MRI revealed an extramedullary, intradural dumbbell shaped mass on the right side at C1 and C2 level compressing the spinal cord. Public awareness should be increased about the danger of neck manipulation by an untrained person especially in the communities where it is commonly practiced.
Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients.
Vectored Upper Cervical Manipulation for Chronic Sleep Bruxism, Headache, and Cervical Spine Pain in a Child
This case study demonstrated a rapid and complete recovery of chronic sleep bruxism, headache, and cervical spine pain in a child after upper cervical vectored manipulation. The possibility of upper cervical muscle-joint dysfunction as a cause of sleep bruxism should be explored.
The principle aim of this study was to determine the effectiveness of chiropractic manipulative therapy in the treatment of children with hyperactivity. Using blinds between investigators and a single subject research design, the investigators evaluated the effectiveness of the treatment for reducing activity levels of hyperactive children. Data collection included independent evaluations of behavior using a unique wrist–watch type device to mechanically measure activity while the children completed tasks simulating school–work. Further evaluations included electrodermal tests to measure autonomic nervous system activity. Chiropractic clinical evaluations to measure improvement in spinal biomechanics were also completed. Placebo care was given prior to chiropractic intervention. Data were analyzed visually and using nonparametric statistical methods. Five of seven children showed improvement in mean behavioral scores from placebo care to treatment. Four of seven showed improvement in arousal levels, and the improvement in the group as a whole was highly significant (p = 0.009). Agreement between tests was also high in this study. For all seven children, three of the four principal tests used to detect improvement were in agreement either positively or negatively (parent ratings of activity, motion recorder scores, electrodermal measures, and X–rays of spinal distortions). While the behavioral improvement taken alone can only be considered suggestive, the strong interest agreement can be taken as more impressive evidence that the majority of the children in this study did, in fact, improve under specific chiropractic care. The results of this study, then, are not conclusive, however, they do suggest that chiropractic manipulation has the potential to become an important nondrug intervention for children with hyperactivity. Further investigation in this area is certainly warranted.
This time-series case study was designed to determine whether manipulating the spine can be an effective method of relief from dysmenorrhea. A patient suffering from dysmenorrhea monitored her monthly menstrual cramps by using pain diaries. She rated her pain levels during 4 months of a baseline phase and 3 months of treatment. The treatment phase consisted of manual chiropractic adjustments and soft tissue therapy. The patient realized fewer episodes of pain as well as lower pain ratings during the treatment phase. There was no significant change in the duration of the menstrual flow.
Resolution of Spasmodic Dysphonia (Focal Laryngeal Dystonia) via Chiropractic Manipulative Management
This paper discusses the case of a 46-yr-old male suffering from spasmodic dysphonia, a chronic disorder involving hyperadduction of the vocal mechanism and resultant vocal arrest. Attention is paid to the neural innervation of the intrinsic laryngeal musculature and postulated mechanisms of irritation which may be amenable to chiropractic manipulative therapy. The type of spinal adjustment and treatment schedule are discussed.
Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient’s blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient’s medical physician.
Clinical Presentation of a Patient with Multiple Sclerosis and Response to Manual Chiropractic Adjustive Therapies
Manual adjustive therapies appear to be responsible for the dramatic symptomatic relief provided for a patient diagnosed with MS. The relative risk-to-benefit ratio suggests that this approach may be appropriate as an alternative symptom management approach for MS patients, and future research efforts can and should direct the comprehensive management approach to the treatment of this disorder.
Conservative treatment including chiropractic manipulative therapy seems to be a reasonable alternative to surgery, for cervical radiculopathy caused by a herniated cervical disc. Clinical trials should be performed to evaluate long term success rate, risk of permanent disability, rate of recovery and cost effectiveness of this and other forms of treatment for cervical radiculopathy caused by herniated nucleus pulposus.
In this case study, chiropractic made a demonstrable difference through objective and subjective outcomes. Further investigations using double-blind, cross-over designs with larger samples are warranted.
Chiropractic Treatment of Frozen Shoulder Syndrome (Adhesive Capsulitis) Utilizing Mechanical Force, Manually Assisted Short Lever Adjusting Procedures
Chiropractic care may be able to provide an effective mode of therapeutic treatment for certain types of these difficult cases. Low force instrumental adjustments, in particular, may present certain benefits in these cases that the more forceful manipulations and/or mobilizations cannot. As such, further formal investigation of this type of therapeutic intervention for treatment of frozen shoulder may be warranted on a larger scale.
This case study records improvement in optic nerve function when measured before and after spinal manipulation using computerized static perimetry. It contends that spinal manipulation can affect the function of the optic nerve in some patients, presumably by increasing vascular perfusion