CHIROPRACTIC CASE REPORTS
 
   

Welcome to Case Reports @ Chiro.Org   This section contains studies which describe the impact of chiropractic care on a wide variety of conditions.   Publish your own report here.

 
   
Case Reports

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org


Alternative Care Chiropractic

If there are terms in these articles you don't understand, you can get a definition from the Merriam Webster Medical Dictionary. If you want information about a specific disease, you can access the Merck Manual. You can also search Pub Med for more abstracts on this, or any other health topic.


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Case Reports From Journals
 
   

Hold your horses! Before you wade into the Case Study Section, please read Dr. Nansel & Szlazak's fascinating JMPT article (see below), as it clarifies WHY chiropractic gets such dramatic results with a spectrum of purported diseases and disorders. You'll be glad you did!

  
Somatic Dysfunction and the Phenomenon of Visceral Disease Simulation:   A Probable Explanation for the Apparent Effectiveness of Somatic Therapy in Patients Presumed to be Suffering from True Visceral Disease
J Manipulative Physiol Ther 1995 (Jul);   18 (6):   379–397

The proper differential diagnosis of somatic vs. visceral dysfunction represents a challenge for both the medical and chiropractic physician. The afferent convergence mechanisms, which can create signs and symptoms that are virtually indistinguishable with respect to their somatic vs. visceral etiologies, need to be appreciated by all portal-of-entry health care providers, to insure timely referral of patients to the health specialist appropriate to their condition. Furthermore, it is not unreasonable that this somatic visceral-disease mimicry could very well account for the “cures” of presumed organ disease that have been observed over the years in response to various somatic therapies (e.g., spinal manipulation, acupuncture, Rolfing, Qi Gong, etc.) and may represent a common phenomenon that has led to “holistic” health care claims on the part of such clinical disciplines.

      You may also want to review our:
     Conditions That Respond Well to Chiropractic Page


  
Early Adolescent Lumbar Intervertebral Disc Injury:
A Case Study

Chiropractic & Manual Therapies 2013 (Apr 26);   21:   13

This article describes and discusses the case of an adolescent male with lumbar intervertebral disc injury characterized by chronic low back pain (LBP) and antalgia. A 13-year-old boy presented for care with a complaint of chronic LBP and subsequent loss of quality of life. The patient was examined and diagnosed by means of history, clinical testing and use of imaging. He had showed failure in natural history and conservative management relief in both symptomatic and functional improvement, due to injury to the intervertebral joints of his lower lumbar spine. Discogenic LBP in the young adolescent population must be considered, particularly in cases involving even trivial minor trauma, and in those in which LBP becomes chronic. More research is needed regarding long-term implications of such disc injuries in young people, and how to best conservatively manage these patients. A discussion of discogenic LBP pertaining to adolescent disc injury is included.


  
Low-Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain
Treated with Chiropractic Care

J Altern Complement Med. 2012 (Apr);   18 (4):   420-422

A 36-year-old male patient had low-back pain, right leg pain, and testicular pain that was worsening. All had been present for 5 years. The patient was treated with Cox Technic (flexion-distraction) of the lumbar spine, receiving a total of 19 treatments over an 8-week time period. After 4 weeks, the patient's low-back pain was decreased and his leg pain was gone. The testicular pain was improved after the first treatment and gone after 3 weeks of care.


  
Neuromusculoskeletal Disorders Following SARS:
A Case Series

J Can Chiropr Assoc. 2011 (Mar);   55 (1):   32-39 ~ FULL TEXT

In this case series, three patients with varied neuromuscular complaints reported short-term subjective improvements in their pain experience and quality of life, and two were able to return to work. Future research should investigate the role of conservative care and manual therapies for this type of patient population using subjective outcome measures.


  
Upper Cervical Manipulation Combined with Mobilization for the Treatment
of Atlantoaxial Osteoarthritis: A Report of 10 Cases

J Manipulative Physiol Ther. 2011 (Feb);   34 (2):   131-137

A retrospective case review of 10 patients who were diagnosed with either degenerative or posttraumatic atlantoaxial arthritis based on histories, clinical symptoms, physical examination, and radiographic presentations was conducted at a multidisciplinary integrated clinic that used both chiropractic and orthopedic services. All 10 patients selected for this series were treated with a combination of upper cervical manipulation and mechanical mobilization device therapy. Outcome measures were collected at baseline and at the end of the treatment period. Assessments were measured using patients' self-report of pain using a numeric pain scale (NPS), physical examination, and radiologic changes. Average premanipulative NPS was 8.6 (range, 7-10), which was improved to a mean NPS of 2.6 (range, 0-7) at posttreatment follow-up. Mean rotation of C1-C2 at the end of treatment was improved from 28° (±3.1) to 52° (±4.5). Restoration of joint space was observed in 6 patients.


  
Chiropractic Management of the Kinetic Chain for the Treatment of Hip
Osteoarthritis: An Australian Case Series

J Manipulative Physiol Ther. 2010 (Jul);   33 (6):   474-479

Four patients diagnosed with hip osteoarthritis had decreases in WOMAC scores and increases in hip range of motion after chiropractic management. Further research in the form of large scale randomized controlled trials is needed to investigate the effectiveness and clinical significance of chiropractic management for hip osteoarthritis.


  
Intractable Migraine Headaches During Pregnancy
Under Chiropractic Care

Complementary Therapies in Clinical Practice 2009 (Nov);   15 (4):   192–7

The absence of hormone fluctuations and/or the analgesic effects of increased beta-endorphins are thought to confer improvements in headache symptoms during pregnancy. However, for a number of pregnant patients, they continue to suffer or have worsening headache symptoms. The use of pharmacotherapy for palliative care is a concern for both the mother and the developing fetus and alternative/complementary care options are sought. We present a 24-year-old gravid female with chronic migraine headaches since age 12years. Previous unsuccessful care included osteopathy, physical therapy, massage and medication. Non-steroidal anti-inflammatory medication with codeine provided minor and temporary relief. Chiropractic care involving spinal manipulative therapy (SMT) and adjunctive therapies resulted in symptom improvement and independence from medication. This document provides supporting evidence on the safety and possible effectiveness of chiropractic care for patients with headaches during pregnancy. You can review many other articles on Chiropractic and Headache at our LINKS Headache Page.


  
A Mind-body Treatment for Hypothyroid Dysfunction:
A Report of Two Cases

Complementary Therapies in Clinical Practice 2009 (May);   15 (2):   67-71

This paper describes the management of a new conservative approach to management in two individuals who sought treatment from a practitioner specialising in a new integrative mind-body based treatment. The purpose of this study is to present two case studies of the management of hypothyroid dysfunction using the mind-body neuro-emotional technique (NET). (After care) In both cases, there were improvements in TSH and T(4) levels, both returning to normal levels.


  
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
J Canadian Chiropractic Association 2008 (Dec);   52(4):   248–255 ~ FULL TEXT

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.


  
Rehabilitation Program for Traumatic Chronic Cervical Pain Associated With Unsteadiness: A Single Case Study
Chiropractic & Osteopathy 2008 (Nov 17);   16 (1):   15 ~ FULL TEXT

Neck problems are often recurring or chronic. After pain, unsteadiness and balance problems are among the most frequent symptoms reported by chronic neck pain (CNP) patients. Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients. 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. You can review many other articles on Chiropractic and Chronic Neck Pain in our RESEARCH Section.


  
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
Clinical Chiropractic 2008 (Sep);   11 (3):   122–129

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. You can review many other articles on Chiropractic and Colic in our RESEARCH Section.


  
Chiropractic Care of a Patient with Erb's Palsy
with a Review of the Literature

Clinical Chiropractic 2008 (Jun);   11 (2):   70–76

The patient was an 8-year-old female with medically diagnosed Erb's Palsy. She presented with the typical ‘waiter's tip’ deformity in the right arm. Since birth, the patient had restricted range of motion in the right upper extremity at all involved joints along with muscle rigidity despite long-term medical care. Following 3 months of care, the patient's range of motion was bilaterally symmetrical and muscle tonicity had normalized. The patient was able to fully participate in social and sporting activities, including rock climbing.


  
Predictors For Immediate and Global Responses to Chiropractic
Manipulation of the Cervical Spine

J Manipulative Physiol Ther 2008 (Mar);   31 (3):   172–183

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.


  
Prospective Case Series on the Effects of
Lumbosacral Manipulation on Dysmenorrhea

J Manipulative Physiol Ther 2008 (Mar);   31 (3):   237–246

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. You can review many other articles on Chiropractic and Female Issues in our RESEARCH Section.


  
Short and Long-Term Results of Connective Tissue Manipulation and Combined Ultrasound Therapy in Patients with Fibromyalgia
J Manipulative Physiol Ther 2006 (Sep);   29 (7):   524—528

This is an observational prospective cohort study of 20 female patients with Fibromyalgia (FM). Intensity of pain, complaint of nonrestorative sleep, and impact of FM on functional activities were evaluated by visual analogue scales. All evaluations were performed before and after 20 sessions of treatment, which included connective tissue manipulation of the back daily, for a total of 20 sessions, and combined US therapy of the upper back region every other session. One-year follow-up evaluations were performed on 14 subjects. Statistical analyses revealed that pain intensity, impact of FM on functional activities, and complaints of nonrestorative sleep improved after the treatment program. CONCLUSION: The methods used in this study seemed to be helpful in improving the pain intensity, complaints of nonrestorative sleep, and impact on functional activities in patients with FM. You can review many other articles on Chiropractic and Fibromyalgia in our LINKS Section.


  
Improvement of Lower Extremity Electrodiagnostic Findings Following a Trial of Spinal Manipulation and Motion-based Therapy
Chiropractic & Osteopathy 2006 (Sep 12);   14:   20 ~ FULL TEXT

An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function.   You can review many other articles on Disc Herniation and Chiropractic in our LINKS Section.


  
Return to Work After Two Years of Total Disability:
A Case Report

J Occup Rehabil 2006 (Jun 3)

This paper describes the conservative management of a patient who was disabled from work for 2 years, using an integrated approach including chiropractic manipulation, pain education, restricted duty and clear communications among all parties involved. After 15 weeks, the patient returned to her previous occupation as a nurse, first part time, and subsequently full time.   You can review many other articles on Chiropractic and Chronic Spinal Pain in our LINKS Section.


  
Improvement in Hearing After Chiropractic Care:
A Case Series

Chiropractic & Osteopathy 2006 (Jan 19);   14 (1):   2 ~ FULL TEXT

A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system. You can review many other articles on Chiropractic and Deafness in our RESEARCH Section.


  
Congestive Heart Failure: A Review and Case Report
From a Chiropractic Teaching Clinic

J Manipulative Physiol Ther 2005 (Jun);   28 (5):   356–364

Patients with known and undiagnosed Congestive Heart Failure (CHF) may visit the chiropractic physician; thus, knowledge of comprehensive care, differential diagnosis, and continuity of care are important. Chiropractic management may be helpful in alleviating patient discomfort. Further clinical investigations may help to clarify the role of complementary and alternative care in the diagnosis and treatment of CHF.


  
Spinal Manipulation May Benefit Asthma Patients ~ FULL TEXT
         Foundation for Chiropractic Education and Research (FCER)

         Patients afflicted with asthma may benefit from spinal manipulation in terms of symptoms, immunological capacity, and endocrine effects, an audience was told on October 5 at the 9th International Conference on Spinal Manipulation in Toronto. The investigative team, headed by Ray Hayek, Ph.D., has been conducting a trial at 16 treatment centers in Australia involving 420 patients with an average age of 46 in an effort to find out what effects spinal manipulation has on symptoms, depression and anxiety, general health status, and the levels of immunity as reflected by the concentrations of both an immunoglobulin (IgA) and an immunosuppressant (cortisol). You can review many other articles on Chiropractic and Asthma in our RESEARCH Section.


  
Rotator Cuff Impingement
          J Manipulative Physiol Ther 2004 (Nov);   27 (9):   580–590

          Outcomes included pain measurement; range of motion of the shoulder, and return to normal daily, work, and sporting activities. At the end of the treatment protocol the patient was symptom free with all outcome measures normal. The patient was followed up at 4 and 12 weeks and continued to be symptom free with full range of motion and complete return to normal daily and pre-treatment activities. You can review many other articles on Chiropractic and the Shoulder in our LINKS Section.


  
Chiropractic High-Velocity Low-Amplitude Spinal Manipulation in the Treatment of a Case of Postsurgical Chronic Cauda Equina Syndrome
J Manipulative Physiol Ther 2004 (Nov);   27 (9):   574–578

A 35-year-old woman presented with complaints of midback pain, low-back pain, buttock pain, saddle anesthesia, and bladder and bowel incontinence, all of 6 months duration. The patient was 6 months post emergency surgery for acute cauda equina syndrome due to lumbar disc herniation. She had been released from neurosurgical care with the current symptoms considered to be residual and nonprogressive. The patient was treated with high-velocity low-amplitude spinal manipulation and ancillary myofascial release. After 4 treatments, the patient reported full resolution of midback, low back, and buttock pain. The patient was seen another 4 times with no improvement in her neurologic symptoms. No adverse effects were noted. You can review many other articles on Disc Herniation and Chiropractic in our LINKS Section.


  
Reduction of Cervical Dystonia After an Extended Course
of Chiropractic Manipulation: A Case Report

J Manipulative Physiol Ther 2004 (Jul);   27 (6):   421–426

A 38-year-old man had gross anterior-lateral torticollis, focal dystonia of the head and neck, and radicularlike pains which failed to respond to physical therapy, medication, and injection. Two specific spinal manipulative technique systems unique to the chiropractic profession (Applied Biostructural Therapy [ABT] and Atlas Coccygeal Technique [ACT]) were applied to the patient. The patient's grading on a modified cervical dystonia scale dropped from a grade 16 to a grade 5 after an extended course of these specific chiropractic manipulative techniques.


  
Neck-tongue Syndrome
         J Manipulative Physiol Ther 2004 (Jun);   27 (5):   E 8

         A 24-year-old female dancer/skater sought treatment for recurrent episodes of right-sided upper neck pain with associated ipsilateral numbness of her tongue following brisk active rotation. The patient had sought chiropractic treatment for this condition several times since she was 8 years old. Diversified chiropractic adjustments were applied to restrictions throughout the cervical spine as determined by the clinician. No other interventions were employed. The patient experienced significant improvement in frequency and intensity of the neck and tongue symptoms following spinal manipulative therapy applied to her cervical spine.


  
The Amelioration of Symptoms in Cervical Spinal Stenosis with Spinal Cord Deformation Through Specific Chiropractic Manipulation: A Case Report with Long-term Follow-up
J Manipulative Physiol Ther 2004 (Jun);   27 (5):   e7 ~ FULL TEXT

A 70-year-old special education teacher had neck pain, headaches, and burning paresthesia on the entire left side of her body. These symptoms developed within hours of being injured in a side-impact motor vehicle accident. Prior to her visit, she had been misdiagnosed with a cerebrovascular accident. Additional diagnostic studies revealed that the patient was suffering from cervical spinal stenosis with spinal cord deformation. Two manipulative technique systems (Advanced Biostructural Therapy and Atlas Coccygeal Technique) unique to the chiropractic profession and based on the theory of relief of adverse mechanical neural tension were administered to the patient. This intervention provided complete relief of the patient's complaints. The patient remained symptom-free at long-term follow-up, 1 year postaccident.


  
Treatment of Bipolar, Seizure, and Sleep Disorders and Migraine Headaches
Utilizing a Chiropractic Technique

J Manipulative Physiol Ther 2004 (Mar);   27 (3):   E5

At initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermography and radiography. Chiropractic care using an upper cervical technique was administered to correct and stabilize the patient's upper neck injury. Assessments at baseline, 2 months, and 4 months were conducted by the patient's neurologist. After 1 month of care, the patient reported an absence of seizures and manic episodes and improved sleep patterns. After 4 months of care, seizures and manic episodes remained absent and migraine headaches were reduced from 3 per week to 2 per month. After 7 months of care, the patient reported the complete absence of symptoms. Eighteen months later, the patient remains asymptomatic.


  
Successful Pregnancy Following Diagnosis of Infertility
and Miscarriage: A Chiropractic Case Report

Journal of Vertebral Subluxation Research 2003 (Dec 2):   1–7

A 27 year old female presented for chiropactic care to improve her overall health, in the hope that she may ultimately be able to have a child. In the previous year she had suffered 2 miscarriages, and had been anovulatory for 9 months. She was under medical treatment for infertility and ulcerative colitis, and followed a restrictive diet. Prior to attempting to become pregnant, she had been on the birth control pill for 7 years. After 60 days of care, a normal ovulatory cycle occurred, and she became pregnant after her second normal cycle. You can review many other articles on Chiropractic and Infertility in our RESEARCH Section.


  
A Suspected Case of Ulnar Tunnel Syndrome Relieved by
Chiropractic Extremity Adjustment Methods

J Manipulative Physiol Ther 2003 (Nov);   26 (9):   602–607

Care for this patient consisted of adjustment procedures directed to the wrist, primarily the hamate and pisiform articulations with the triquetrum. Her symptoms were resolved in 4 office visits, with corresponding improvement in examination findings.


  
Chiropractic Management of Ehlers-Danlos Syndrome:
A Report of Two Cases

J Manipulative Physiol Ther 2003 (Sep);   26 (7):   448–459

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.


  
Vectored Upper Cervical Manipulation for Chronic Sleep Bruxism,
Headache, and Cervical Spine Pain in a Child

J Manipulative Physiol Ther 2003 (Jul);   26 (6):   E16

Bilateral rotary cervical stretching/mobilization and a vectored high-velocity, low-amplitude adjustment were performed in the upper cervical spine, using the atlas transverse process as the contact point. There was complete relief of the chronic subjective symptoms concomitant with remission of the objective signs of joint dysfunction.


  
Chiropractic Care of a Pediatric Patient with Myasthenia Gravis
         J Manipulative Physiol Ther 2003 (Jul);   26 (6):   390–394

         The patient was cared for with contact-specific, high-velocity, low-amplitude adjustments to sites of vertebral subluxation complexes in the upper cervical and sacral spine. The patient's response to care was positive and after 5 months of regular chiropractic treatment her symptoms abated completely. There are indications that patients suffering from disorders “beyond low back pain” as presented in this case report may derive benefits from chiropractic intervention/management.


  
Chiropractic Care of a Patient With Vertebral Subluxation and Bell’s Palsy
         J Manipulative Physiol Ther 2003 (May);   26 (4):   253 ~ FULL TEXT

         The patient was cared for with full spine contact-specific, high-velocity, low-amplitude adjustments (Gonstead Technique) to sites of vertebral and occipital subluxations. The patient’s left TMJ was also adjusted. The initial symptomatic response to care was positive, and the patient made continued improvements during the 6 months of care. You can review many other articles on Chiropractic and Bell's Palsy in our RESEARCH Section.


  
Long Term Remission and Alleviation of Symptoms in Allergy and Crohn's Disease Patients Following Spinal Adjustment for Reduction of Vertebral Subluxations
J Vertebral Subluxation Research 2003 (Mar);   4 (4):

Of the 17 patients who received spinal adjustments, 12 showed long-term and stable remission of their symptoms and of these, 9 experienced an alleviation effect. We found that vertebral subluxation is a common and characteristic finding in patients with allergies and Crohn's disease. You can review many other articles on Chiropractic and Crohn's Disease in our RESEARCH Section.


  
Clinical Efficacy of Upper Cervical Versus Full Spine
Adjustment on Children with Autism

WFC'S 7th Biennial Congress Conference Proceeding May 1-3, 2003:   328–329

Children with autism are presented with multiple categories of clinical pictures that affect their social, sensory, speech, and physical development. In addition to chiropractic care, parents of autistic children seek all possible therapies available. In this study, the clinical outcome of chiropractic care showed higher efficacy of upper cervical adjustment when compared to full spine adjustment in autistic children. You can review many other articles on Chiropractic and Autism in our RESEARCH Section.


  
Hearing Loss, Otalgia and Neck Pain: A Case Report on Long-Term Chiropractic Care That Helped to Improve Quality of Life
Chiropractic Journal of Australia 2002 (Dec); 32 (4):   119–130

Observation over an extended period assists in understanding the progression of chronic disorders. This patient experienced substantially reduced symptoms with chiropractic care during the 7-year observation period. Of note is the repeated exacerbation of neck pain that often precedes exacerbation in ear symptoms, along with the relief of both following adjustment and an association between improved hearing and improved cervical alignment. You can review many other articles on Chiropractic and Deafness in our RESEARCH Section.


  
Chiropractic Spinal Manipulation for Cervicogenic Headache in an 8-Year-Old
         J Neuromusculoskeletal System 2002 (Fall); 10 (3): 98–103

         A case of cervicogenic headache (CEH) in an 8-year-old boy that improved after chiropractic spinal manipulation is reported. An 8-year-old boy presented with a complaint of daily headache. The duration of symptoms was over 3 years. The patient met the diagnostic criteria for CEH. Awkward head position reproduced head pain, as did palpation of the upper cervical region. Decreased range of motion of the neck was evident, as well as abnormal tenderness and primarily of the right upper cervical region. A significant decrease in headache frequency as reported by the patient and parent was seen after the first treatment. After four treatments the headache frequency decreased to approximately one per month. You can review many other articles on Chiropractic and Headache at our LINKS Headache Page.


  
Missed Cervical Spine Fracture-dislocations:
The Importance of Clinical and Radiographic Assessment

J Manipulative Physiol Ther 2002 (May);   25 (4):   263–269

Cervical spine fracture-dislocations are often missed during standard radiographic examinations in emergency department settings. Chiropractors are encouraged to perform a comprehensive evaluation of patients presenting with cervical trauma even if they have had prior x-ray films reported as normal. Standard x-ray films taken at emergency department facilities are not entirely reliable for detecting or revealing cervical spine fracture-dislocations. This case stresses the importance of careful clinical assessment and imaging procedures on patients who have encountered cervical spine trauma.


  
Vertebrogenic Hearing Deficit, the Spine, and Spinal Manipulation Therapy: A Search to Validate the D.D. Palmer/Harvey Lillard Experience
Chiropr J Aust 2002 (Mar);   32 (1):   14–26

The claim that hearing can be improved following SMT has been scoffed at as physiologically impossible, but a review of the medical and chiropractic literature suggests that hearing deficits may be associated with spinal joint motion restriction, spondyloarthrosis, irritation of the sympathetic nervous system, decreased cervico-cerebral circulation and/or decrease in tinnitus. You can review many other articles on Chiropractic and Deafness in our RESEARCH Section.


  
Differential Compliance Instrument in the Treatment of Infantile Colic:
A Report of Two Cases

J Manipulative Physiol Ther 2002 (Jan);   25 (1):   58–62

The PulStar mechanical adjusting device appears to have been well tolerated and beneficial in 2 cases of infantile colic. Further research is necessary to determine whether this device can enhance the safety and effectiveness of chiropractic treatment in infants with colic. You can review many other articles on Chiropractic and Colic in our RESEARCH Section.


  
Chiropractic Care of a Patient with Temporomandibular
Disorder and Atlas Subluxation

J Manipulative Physiol Ther 2002 (Jan);   25 (1):   63–70

High-velocity, low-amplitude adjustments (ie, Gonstead technique) were applied to findings of atlas subluxation. The patient's symptoms improved and eventually resolved after 9 visits.


  
Chiropractic Care of a Patient with Vertebral Subluxations and
Unsuccessful Surgery of the Cervical Spine

J Manipulative Physiol Ther 2001 (Sep);   24 (7):   477–482

The chiropractic care of a patient with neck pain and left upper extremity radiculopathy after cervical diskectomy is presented. Marked resolution of the patient's symptoms was obtained concomitant with a reduction in subluxation findings at multiple levels despite the complicating history of an unsuccessful cervical spine surgery. This is the first report in the indexed literature of chiropractic care after an unsuccessful cervical spine surgery.


  
Chiropractic Management of a Professional Hockey Player
with Recurrent Shoulder Instability

J Manipulative Physiol Ther 2001 (Jul);   24 (6):   425–430

The patient had undergone strength training for rehabilitation after each of the previous two shoulder operations and had very strong rotator cuff and scapular musculature. Proprioceptive testing revealed a poor response in the left shoulder compared with the right shoulder. Two subjective outcome measures were used to determine the effectiveness of the treatment protocol in reducing the symptoms of recurrent shoulder instability. Much of the treatment focused on proprioceptive training, soft tissue mobilization, and improving joint function.


  
Chiropractic Management of a Patient with Lumbar Spinal Stenosis
         J Manipulative Physiol Ther 2001 (May);   24 (4):   300–304

         Flexion-distraction manipulation of the lumbar spine was performed. Incremental increases in traction forces were applied as the patient responded positively to care. He experienced a decrease in the frequency and intensity of his leg symptoms and a resolution of his low back pain. These improvements were maintained at a 5-month follow-up visit.


  
Epilepsy and Seizure Disorders: A Review of Literature
Relative to Chiropractic Care of Children

J Manipulative Physiol Ther 2001 (Mar);   24 (3):   199–205

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.


  
Consequences of Neck Manipulation Performed by a Non-professional
         Spinal Cord 2001 (Feb);   39 (2):   112–113

         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.


  
The Chiropractor's Role in Pain Management for Oncology Patients
         J Manipulative Physiol Ther 2001 (Jan);   24 (1):   52–57

         Although it is an oncologist who institutes the necessary treatment for a cancer patient's primary disease process, a chiropractor can help provide noninvasive and non-pharmacologic options for decreasing pain and improving function. As part of a cancer rehabilitation team, the chiropractor can provide treatment that may significantly enhance a cancer patient's quality of life at any stage in the disease process. Treatment may benefit those patients experiencing pain from the side effects of treatment or from the disease process itself. The chiropractor's treatment may include manipulation, soft tissue techniques, physiotherapeutic modalities, exercise, and ergonomic counseling. You can review many other articles on Chiropractic and Cancer in our RESEARCH Section.


  
Resolution of Suckling Intolerance in a 6-month-old Chiropractic Patient
         J Manipulative Physiol Ther 2000 (Nov);   23 (9):   615–618

         The patient was treated 5 times through use of cranial adjusting; 4 of these visits included atlas (C1) adjustment. The suckling intolerance resolved immediately after the first office visit and did not return.


  
Upper Cervical Chiropractic Management of a Patient with Parkinson's
Disease: A Case Report

J Manipulative Physiol Ther 2000 (Oct);   23 (8):   573–577 ~ FULL TEXT

Upper cervical chiropractic care aided by cervical radiographs and thermal imaging had a successful outcome for a patient with Parkinson's disease. Further investigation into upper cervical injury as a contributing factor to Parkinson's disease should be considered. You can review many other articles on Chiropractic and Parkinson's Disease in our RESEARCH Section.


  
Treatment of Severe Glaucomatous Visual Field Deficit by Chiropractic Spinal Manipulative Therapy: A Prospective Case Study and Discussion
J Manipulative Physiol Ther 2000 (Jul);   23 (6):   428–434

Recovery of vision in this patient was an unexpected and remarkable outcome, raising the question of whether chiropractic spinal manipulative therapy may be of value in the management of glaucomatous visual field loss. More intensive research is required. You can review many other articles on Chiropractic and Blindness at our RESEARCH Section.


  
Vertigo, Tinnitus, and Hearing Loss in the Geriatric Patient
         J Manipulative Physiol Ther 2000 (Jun);   23 (5):   352–362

         The clinical progress documented in this report suggests that upper cervical manipulation may benefit patients who have tinnitus and hearing loss. You can review many other articles on Chiropractic and Hearing Loss in our RESEARCH Section.


  
Bilateral Simultaneous Optic Nerve Dysfunction After Periorbital Trauma: Recovery of Vision in Association with Chiropractic Spinal Manipulation Therapy
J Manipulative Physiol Ther 1999 (Nov);   22 (9):   615–621

Chiropractic spinal manipulation was used to aid recovery of vision to normal over a course of 20 treatment sessions. At times, significant improvement in vision occurred immediately after spinal manipulation. Progressive recovery of vision was monitored by serial visual field tests and by electrophysiologic studies. Unfortunately, the patient refused a further single photon emission tomographic study when visual recovery was complete. You can review many other articles on Chiropractic and Blindness in our RESEARCH Section.


  
The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer
J Manipulative Physiol Ther 1999 (Oct);   22 (8):   517–522

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. You can review many other articles on Chiropractic and Colic in our RESEARCH Section.


  
Chiropractic Management of a Patient with Myasthenia Gravis
and Vertebral Subluxations

J Manipulative Physiol Ther 1999 (Jun);   22 (5):   333–340

Contact specific, high-velocity, low-amplitude adjustments were applied to sites of patient subluxation. Myasthenia gravis is no longer debilitating to the patient; he is medication free and has resumed a “normal life”. The clinical aspects of the disease, including the possible role of chiropractic intervention in the treatment of patients suffering from myasthenia gravis, are also discussed. This case study encourages further investigation into the holistic approach to patient management by chiropractors vis-a-vis specific adjustments of vertebral subluxation.


  
Chiropractic Management of a Patient with Subluxations,
Low Back Pain and Epileptic Seizures

J Manipulative Physiol Ther 1998 (Jul);   21 (6):   410–418

Chiropractic adjustments using a specific-contact, short-lever arm, high-velocity, low-amplitude maneuver (i.e., Gonstead) were applied to the subluxations at the cervical, thoracic and lumbopelvic region. The patient's reported low back pain and neck complaints improved and her seizure frequency decreased. At 1.5-yr follow-up, the patient reported her low back complaints had resolved and her seizures had decreased (period between seizures as great as 2 months).


  
A Conservative Approach for a Patient with Traumatically
Induced Urinary Incontinence

J Manipulative Physiol Ther 1998 (Jun);   21 (5):   363–367

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.


  
The Role of the Chiropractic Adjustment in the Care and
Treatment of 332 Children with Otitis Media

Jou Clin Chiro Ped 1997 (Oct);   2 (2)

To our knowledge this is the first time that tympanography has been used as an objectifying tool with respect to the efficacy of the chiropractic adjustment in the treatment of children with otitis media. The results indicate that there is a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study. This pilot study can now serve as a starting point from which the chiropractic profession can begin to examine its role in the treatment of children with otitis media. You can review many other articles on Chiropractic and Otitis Media in our RESEARCH Section.


  
Thermal Asymmetry of the Upper Extremity in Scalenus Anticus Syndrome,
Leg-length Inequality and Response to Chiropractic Adjustment

J Manipulative Physiol Ther 1997 (Sep);   20 (7):   476–481

Treatment was limited to chiropractic, upper cervical, vectored, linear adjustment of the atlas vertebra. Temperature differential between the hands improved significantly after individual atlas adjustment(s) and in the long term. Scalenus anticus syndrome and upper extremity thermal asymmetry may result from altered cervical biomechanics caused by atlas vertebral subluxation complex.


  
The Chiropractic Consultation: A Stressful Experience?
         J Manipulative Physiol Ther 1997 (Jul);   20 (6):   377–381

         A case study of 25 chiropractors and 137 patients found that although the chiropractic consultation was not regarded as stressful by most patients, some patients found adjustment stressful. 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.


  
Manipulative Reduction and Management of Anterior
Sternoclavicular Joint Dislocation

J Manipulative Physiol Ther 1997 (Jun);   20 (5):   338–342

Specific joint manipulation for reduction of the dislocation was performed. Immobilization of the joint after reduction was accomplished by a reverse figure-8 bandage. Follow-up radiographic evaluation demonstrated reduction of the dislocation. Resolution of difficulty in swallowing and pain was dramatic and instantaneous after reduction.


  
Bone Marrow Edema Caused by Altered Pedal Biomechanics
         J Manipulative Physiol Ther 1997 (Jan);   20 (1):   56–59

         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.


  
Muscle Tension Dysphonia and Spasmodic Dysphonia:
The Role of Manual Laryngeal Tension Reduction in Diagnosis and Management

Ann Otol Rhinol Laryngol 1996 (Nov);   105 (11):   851–856

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.


  
Does 'Normal' Vision Improve with Spinal Manipulation?
         J Manipulative Physiol Ther 1996 (Jul);   19 (6):   415–418

         To define a guideline for a proposed investigation into visual field changes with spinal adjustment, his visual fields were tested before and after a normal office spinal manipulation. After this procedure, there was a measurable rise in the visual sensitivity of both eyes. You can review many other articles on Chiropractic and Visual Disorders in out RESEARCH Section.


  
The Dental-chiropractic Cotreatment of Structural Disorders
of the Jaw and Temporomandibular Joint Dysfunction

J Manipulative Physiol Ther 1995 (Sep);   18 (7):   476–481

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. You can review many other articles on Chiropractic and TMJ in our RESEARCH Section.


  
Chiropractic Treatment of Frozen Shoulder Syndrome (Adhesive Capsulitis) Utilizing Mechanical Force, Manually Assisted Short Lever Adjusting Procedures
J Manipulative Physiol Ther 1995 (Feb);   18 (2):   105–115

The patient's shoulder was conservatively managed with chiropractic adjustments to the affected shoulder joint, as well as to the cervicothoracic spine. Treatment consisted of mechanical force, manually assisted short lever chiropractic adjustments, delivered via an Activator Adjusting Instrument. Successful resolution of the presenting symptomatology was achieved. You can review many other articles on Chiropractic and the Shoulder in our LINKS Section.


  
Chiropractic Manipulation in Carpal Tunnel Syndrome
         J Manipulative Physiol Ther 1994 (May);   17 (4):   246–249

         Chiropractic manipulations were rendered 3 times per week for 4 wk, to the subject's cervical spine, right elbow and wrist using a low amplitude, short lever, low force, high velocity thrust. Significant increase in grip strength and normalization of motor and sensory latencies were noted. Orthopedic tests were negative. Symptoms dissipated. In this case study, chiropractic made a demonstrable difference through objective and subjective outcomes. You can review many other articles on Chiropractic and Repetitive Stress Disorders in the LINKS Section. There is also a new Chiropractic And Carpal Tunnel Syndrome in our RESEARCH Section.


  
Chiropractic Treatment of Cervical Radiculopathy
Caused by a Herniated Cervical Disc

J Manipulative Physiol Ther 1994 (Feb);   17 (2):   119–123

Treatment included chiropractic manipulative therapy, longitudinal cervical traction and interferential therapy. The patient began a regular schedule of treatments, which started on a daily basis but were gradually reduced as the patient progressed. By the third week of treatment, neck and shoulder pain was completely resolved. Subjective evaluation indicated the radicular pain to be improved by 60% within 6 wk. The patient's pain, numbness and grip strength returned to normal within 5 months.


  
Clinical Presentation of a Patient with Multiple Sclerosis
and Response to Manual Chiropractic Adjustive Therapies

J Manipulative Physiol Ther 1993 (Nov);   16 (9):   595–600

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. You can review many other articles on Chiropractic and Multiple Sclerosis in our RESEARCH Section.


  
Chiropractic Management of a Hypertensive Patient
         J Manipulative Physiol Ther 1993 (Oct);   16 (8):   544–549

         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. You can review many other articles on Chiropractic and Blood Pressure in our RESEARCH Section.


  
Resolution of Spasmodic Dysphonia (Focal Laryngeal
Dystonia) via Chiropractic Manipulative Management

J Manipulative Physiol Ther 1991 (Jul);   14 (6):   376–378

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.


  
A Chiropractic Approach to the Treatment of Dysmenorrhea
         J Manipulative Physiol Ther 1990;   13 (2):   101–106

         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. You can review many other articles on Chiropractic and Female Issues in our RESEARCH Section.


  
An Evaluation of Chiropractic Manipulation as a Treatment
of Hyperactivity in Children

J Manipulative Physiol Ther 1989 (Oct);   12 (5):   353–363

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. You can review many other articles on Chiropractic and ADD/ADHD in our PEDIATRICS Section.

 
   

Field Submitted Case Reports
 
   


  
Normalization of Autonomous Neurogenic Bladder(ANB)Secondary to Surgically Re-Positioned Myelomeningocele From Spina Bifida Manifesta in a Young Girl Under Chiropractic Management for Functional Scoliosis
By Thomas V. Giordano, D.C.

This case deals with the Chiropractic Management of a 12 year-old girl who showed a marked improvement in a chronic Autonomous Neurogenic Bladder (ANB) secondary to a surgically re-positioned myelomeningocele caused by Spina Bifida Manifesta while being treated for a functional scoliosis. This was one of the most satisfying cases I have handled. I believe it exemplifies what we, as Chiropractors, can accomplish with interprofessional cooperation for the benefit of our patients.


  
Attempted Radiological (ct) and Clinical Correlation in Discopathies Treated by Chiropractic
By Dr. Jean Paul Jolivet, Bologna Italy

The purpose of the study is to assess the anatomical modifications through computerised tomography and the clinical evolution of discopathies before and after a chiropractic treatment. After a critical analysis of the literature, the authors present 13 cases controlled with a rigorous technique. The chiropractic treatment proved always useful and in most cases led to recovery. A favorable clinical evolution can be confirmed by modifications of the CT aspect of the disk. In such cases the advisability of surgical treatment can be questioned.


  
Chiropractic Management of an Adult Male With Lumbosacralgia and Long-Standing Syringomyelia Secondary to an Arnold-Chiari Malformation
By Thomas V. Giordano, D.C.

This case deals with the chiropractic treatment of an anesthesiologist, who was referred to my care by a neurosurgeon for an acute phase lumbosacralgia. An interesting, long-standing cervical syringomyelia was treated concomitantly, with very satisfying results. The patient has had no major complaints in over 6 months from his release from care. A follow-up MRI of the cervical spine is still pending, but deemed superfluous by the neurosurgeon.

 
   

About Writing Case Reports
 
   

   The Evidence-based Case Report: A Resource Pack for Chiropractors
          Clinical Chiropractic 2003 (Jun);   6 (2):   73–84 ~ FULL TEXT

         The chiropractic profession in the United Kingdom has already come a long way by gaining regulation and setting standards for practice through the General Chiropractic Council. The profession overall has greatly benefited from research [33] and has been held up as an example within CAM because of its research and guideline development. [34] The profession is being urged to embrace evidence-based practice. [35-39]


   The Case for Case Reports
          Research Forum 1985 (Summer); 123–124 ~ FULL TEXT

         Enjoy Dr. Mullin's 1985 invitation to our profession to begin to publish Case Studies. This article outlines the “hows” and “whys” and the value of preparing a study.
You may also want a copy of the Outline of the Case Study.


   Writing Patient Case Reports for Peer-Reviewed Journals:
Secrets of the Trade

J Sports Chiropractic and Rehab 2000;   14 (3):   51–59 ~ FULL TEXT

Thanks to the College of Military Chiropractic Physicians website for access to this Adobe Acrobat FULL TEXT article!


   Chiropractic Research Results for a Variety of Conditions
         Our Research Section includes clinical research trials discussing the impact of chiropractic on a wide variety of visceral and musculoskeletal conditions. There are also articles discussing the difficulties of designing an inert placebo for manual care trials.


   The Headache Page
          Review this series of articles demonstrating how chiropractic can help with a variety of headache types.





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Updated 8-12-2013

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