Dr Merri's Blog

A research study published on January 21, 2022, published by Oxford University Press on behalf of the American Academy of Pain Medicine, found that the outcomes were better when chiropractic care was added to usual medical care for lower back pain in U.S. servicemen. The title of the study is, "Health-related quality of life among United States service members with low back pain receiving usual care plus chiropractic care plus usual care vs usual care alone: Secondary outcomes of a pragmatic clinical trial."

The study begins by explaining just how large a problem lower back pain is. "Low back pain (LBP) is the primary cause of years lived with disability worldwide for the past 3 decades across 126 of 195 countries." The study continues, "As a result, 5 back and neck pain currently account for the highest healthcare expenditures in the United States 6 (U.S.), estimated at $134.5 billion in 2016." The authors also note that standard medical care may not an effective treatment. "The current literature shows that commonly used therapies, ranging from opioids to spinal fusions, can lead to serious side effects with little impact on the pain experience."

The study reports that over half of the adults in the U.S. have received care from a chiropractor. Also, members of the military have a high rate of lower back pain.

This study was designed to look at the impact of adding chiropractic care to usual medical care for members of the military suffering with back pain. Researchers also looked at the overall health-related quality of life of those service members to see what other effects the chiropractic care had on their lives.

The study was conducted at 3 military treatment facilities with a total of 750 active-duty military personnel with low back pain. The care reviewed was over a 6-week period. The patients and their clinicians determined if care was to include standard medical care only, or the addition of chiropractic care. Those in the medical-only group were asked to refrain from receiving any chiropractic care during the time of the study.

Numerous questions about daily life and the effect their lower back was having on their life was recorded initially, during care, and at the completion of the 6-week period. The results were then compared between the two groups to see if the addition of chiropractic care to the standard medical care had a positive effect on the lower back pain and the overall quality of life of the servicemember.

The results showed that at the 6-week point, those participants who also got chiropractic care in addition to the standard medical care got "significantly better" results as compared to those that just received the medical care. This improvement was not only seen with the lower back pain, but also in most all measures of quality of life that the researchers tested for.

In their conclusion, the researchers report on the wide range of health improvement by noting, "Findings from this pre-planned secondary analysis demonstrate that chiropractic care impacts health-related quality of life beyond pain and pain-related disability."

Above is the title of a study published on December 6, 2021, in the journal Annals of Vertebral Subluxation Research documenting the improvements in balance and coordination of an elderly patient receiving chiropractic care. This study begins by explaining the importance of balance and coordination in the elderly population. "Gait and balance deficits in geriatric patients are common presentations in clinical settings and are a major source of morbidity in the elderly."

The study author goes on to point out how dangerous a loss of balance or coordination can be for an elderly person. "Senior patients with gait imbalances are at a higher risk of falling, which can lead to injury, physical disability, and a decreased quality of life. In the United States alone, 30% of adults 50 and older experience falls that impact both the personal and social life of the patient and financial burden upon society."

In addition to the health problems for individuals who fall, the costs for the individual and society in general are extremely high. The study reports that the costs of fall-related injuries in 2011 were estimated to be $3.1 billion. That number grew to about $32 billion by 2020.

In this case, a 65-year-old man presented himself for chiropractic care because he was concerned that he was experiencing unsteadiness on his feet. The man did not recall any specific incidence that started his unsteadiness and commented that it seemed to gradually come on over the past year.

The man had been an avid ballroom dancer. He was engaged in this activity up to five nights per week. One evening, his dance instructor pulled him aside to tell him that she noticed problems with his balance that she had not previously seen. After that episode, the man began to realize that he was also having balance problems with walking in general. The problem continued to get worse affecting all parts of his life. Eventually the man had to give up dancing, and even had to hold onto a shopping cart to go grocery shopping.

A full chiropractic examination was performed including spinal x-rays. From his examination, it was determined that the man had multiple vertebral subluxations that were affecting nerve system function. With this information, and with the man’s consent, chiropractic care was started initially at the rate of two visits per week. As care progressed, the patient was routinely tested for balance and showed steady improvement both in the tests and in his daily activity.

In the study conclusion, the author points out that chiropractic does not directly treat balance or coordination problems, but rather nerve systems problems from subluxations that can create balance issues. "The purpose of this paper is not to conclude that chiropractic adjustments are intended to treat gait disorders but to make a connection between the abnormal physiological and biomechanical functioning of the patient to the presence of subluxation.

The Annals of Vertebral Subluxation Research released the results of a case study on October 25, 2021, documenting the improvement of vestibular vertigo in a woman who had previously was diagnosed as having had a stroke two years ago. Vertigo is a symptom of the feeling of dizziness, off-balance, lightheadedness, disorientation, disequilibrium, or a spinning sensation.

The study reports that vertigo occurs in approximately 1.8% of the general population, up to as high as 30% in the elderly. Vertigo is often triggered by a change in the position of the head. Typical symptoms that people report with vertigo include a spinning feeling, tilting to one side, swaying, feeling unbalanced, or being pulled to on direction.

In this case, a 44-year-old woman went to the chiropractor because she had heard chiropractic might be able to help with her vertigo. Two years before seeking chiropractic help, the woman reported her problems to her MD. At that time, her MD gave her the diagnosis of a history of stroke, vertigo, and high blood pressure. The woman’s family did have a history of stroke and high blood pressure, so the woman was given blood pressure medication by her MD and scheduled to be monitored. Eventually, the stroke was ruled out as a cause of the vertigo, and she was referred to an ear nose and throat specialist.

The chiropractor performed an examination which included a history, observation, range of motion, postural analysis, and spinal palpation. From her examination, it was determined that subluxations were present.

Specific forms of chiropractic adjustments were performed over an initial three-month period. As the care progressed, the woman reported a decrease in her symptoms after each chiropractic visit. She reported that she was able to get back to a more normal routine which included driving, which she was unable to do with the severe vertigo. The woman was very pleased with the results especially since her medical physicians told her she might not ever get better and may have to learn to live with her situation.

In summing up this case, and the difference between a medical approach and a chiropractic approach to vertigo patients, the authors of the study related that the woman "…no longer has to worry about being dizzy while driving or typing at her desk, allowing her to relieve her stress of not accomplishing her daily tasks that require these two activities. While most patients with vertigo undergo vestibular neurectomy surgery or vestibular rehabilitation exercises to help with vertigo, this patient no longer has to do either and is enjoying her life free of vertigo."

This is the headline of an article in Medical News Today that appeared on September 21, 2021. The author, Mary West, suggests that the research and information available points to chiropractic helping with this debilitating condition.

The Migraine Research Foundation lists the following facts about migraines on their website. "Migraine is the 3rd most prevalent illness in the world. Nearly 1 in 4 U.S. households includes someone with migraine." They also note that 12% of the U.S. population suffers from migraines at some time, and women are twice as likely to suffer with migraines than men. Migraines are such a debilitating condition that 90% of those suffering a migraine are unable to work or function normally.

The article suggests that the research on chiropractic helping migraines is limited. However, there are many case study research papers that document chiropractic care having a positive outcome with people who suffer with the condition. Aside from the volume of case studies documenting chiropractic helping migraine sufferers in the chiropractic research literature, the National Center for Biotechnology Information, U.S. National Library of Medicine published a case study of a patient who was completely free of migraines after chiropractic care.

The Medical News Today article notes that many people who go to a chiropractor with migraines also suffer from other related musculoskeletal conditions. Up to 75% of those with migraines also have neck pain and stiffness. "People may seek a chiropractor for migraine because they often have associated symptoms, such as neck pain and stiffness, which chiropractors commonly treat."

The common medical treatment for migraines is nonsteroidal anti-inflammatory drugs and muscle relaxants. These drugs may help to temporarily alleviate the symptoms, but they do nothing to get to the underlying physiology that may be at the source of migraines. Also, all drugs come with additional side effects that in some cases could be serious.

"Chiropractors commonly see patients with migraine headaches," states Dr. Braile, a chiropractor in Georgia and former president of the International Chiropractors Association. He explains, "Chiropractors actually do not treat migraine headaches. What we do is correct nerve interference and structural distortions at the spine, called subluxations, that then lead to migraines. Most chiropractors can report that they have had patients who were long-time migraine sufferers who no longer had the condition after chiropractic care."

The Medical News Today article seems to support Braile's claim when they state, "A 2017 survey questioned 1,869 chiropractors to determine the prevalence of migraine treatment and management. The results showed 53% had a caseload that was high in individuals with migraine headaches."

A study in the Journal of Pediatric, Maternal & Family Health, published on March 1, 2021, documented the case of an infant with plagiocephaly who could not tolerate tummy-time being helped with chiropractic.

The study begins by stating, "Plagiocephaly refers to a deformation of the skull, resulting in flattening of the cranial bones and asymmetry within the cranial vault." Although some serious neurological issues can occur, plagiocephaly is normally regarded as only cosmetic and should self-correct over time.

The American Academy of Pediatrics has been promoting having children sleep on their back in an attempt to reduce the incidence of Sudden Infant Death (SIDs). However, this study noted that infants sleeping on their backs could give rise to flattening of the skull. Since the push to have infants sleep on their backs, there has been a 40% reduction in the incidence of SIDs, but a 600% increase in plagiocephaly.

In this case, a 4-month-old infant girl was brought by her mother to the chiropractor. It was noted that the infant girl's head showed a flattening on one side. The infant had a limited range of neck motion and had tight neck muscles. The infant was fussy during the examination process. Using chiropractic procedures and palpation, it was determined that the infant had multiple subluxations present in her spine.

Age-appropriate specific chiropractic adjustments were performed to address the subluxations that were determined to be present. The day after the first adjustment, the infant girl’s mother reported that her daughter had a better range of movement of her neck and an increase in tolerance for tummy-time. She could also prop herself up and hold her head upward, which she was unable to do before chiropractic. Additionally, the girl was now able to roll from her belly to her back. The infant’s head was also measured routinely, and it was noted that the shape of her head had visibly improved.

In the conclusion of this study, it was explained how subluxations in the neck could cause a reduction of neck motion leading to the infant keeping her head in one position which resulted in a head deformity know as plagiocephaly. "Vertebral subluxation can lead to a sequela of comorbidities, in this case restriction of cervical extension compounded by continuous supine positioning, resulting in deformational plagiocephaly. Chiropractic adjustments are safe and effective in correcting subluxation."

A recent study published in BioMed Central Geriatrics on April 23, 2021, looked at how and why older people utilize chiropractic services. In the background of the study the authors state, "…the purpose of this study was to describe the demographic characteristics of older adults seeking chiropractic care, and to report problems diagnosed by chiropractors and the treatment provided to older adults who seek chiropractic care."

The study begins by pointing out that most older adults seek primary medical care for a variety of musculoskeletal conditions. Older adults are the highest consumers of health care services overall. This study specifically looked at chiropractic care for the older population.

Although there would be some debate defining the profession of chiropractic, the authors of the study describe chiropractic by saying, "Chiropractic is a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health."

The study reported on patient encounters from 94 chiropractors from both Australia and Canada who agreed to participate in the study. The chiropractors were asked to manually record patient encounters on 100 consecutive patient encounters in their facilities. The information was recorded on forms by either fill-in information or check box. Demographic information regarding date, age, sex, height, and weight were recorded, along with up to three reasons the patient came to see the chiropractor on that particular visit.

The chiropractors also provided information as to how the patient was referred for chiropractic, and the patient diagnosis as well as the types of care rendered. The average age of the chiropractor in the study was 43 years, with an average of 16 years in practice. A total of 6781 chiropractic patient encounters were recorded for this study.

The results showed that from all the patient encounters, 16% were patients over the age of 65 years. Of those seniors, 56% went to the chiropractor for back problems, while 10% went for neck problems. It should be noted that the understanding of chiropractic could vary by nation as prior studies in the United States have shown a higher percentage of patients seeking chiropractic care for neck problems than was reported in this study in Canada and Australia.

In the conclusion of the study, the authors gave a summary of the results. "From 6781 chiropractor–adult patient encounters across two countries, one in six chiropractic patients were aged ≥65 years. Among older adult patients, back pain was the most common problem diagnosed by chiropractors (accounting for 82 in every 100 encounters). Neck pain and lower limb problems were the next most common presentation to chiropractors."

A dissertation by Genevieve M. Keating and released by Fielding Graduate University in 2021 has the title "Do Children in Australia Benefit from Chiropractic Care?" This paper is an exhaustive look over a ten year period at the responses of parents whose children underwent chiropractic care in Australia. The author of this paper looked at data from the Review of Chiropractic Spinal Care for Children that was conducted in 2019 by Safer Care Victoria on children under 12 years of age.

In explaining the purpose for this paper and study, the author noted, "Infant and early childhood development have significant impacts on long term health and wellbeing. This early development sets the scene for life-long health, wellbeing, and competence, and early preventative intervention in the health and educational fields can be very valuable." She goes on to explain that "Chiropractors work with infants and children who have postural and musculoskeletal issues. It is important to address these issues early because they may impact breastfeeding, settling, sleeping, and development."

The goal of this study was to answer a number of general questions concerning chiropractic care for children. The questions included, "Why do parents seek chiropractic care for their children?", "Who else do they consult for these concerns?", and "How satisfied were parents (or their children) with the care they received?". The data was from the results obtained from 22,043 parents whose children under 12 had received chiropractic care in the last ten years.

The results of the study showed that 48% of those parents who sought chiropractic for their children did so for musculoskeletal complains. In most of those instances, the parents were concerned about their child's development. Of these children, 77.5% of them were also under care of another health professional for the same issue.

Almost universally, 99.16% of the parents felt well-informed and involved in their decision about chiropractic care for their child. However, being well-informed at such a high rate was not the study's most surprising statistic. The study also showed that 98.4% of the parents stated that their child showed improvement from their chiropractic care, and 99.6% of parents said chiropractic care benefited their child. These high levels of satisfaction and report of benefit is unprecedented anywhere else in healthcare.

The Asia-Pacific Chiropractic Journal published the result of a case study which was released on March 17, 2021, documenting the improvement of a young boy who was suffering with the symptoms of Asperger's syndrome.

According to the National Institute of Neurological Disorders and Stroke, "Asperger syndrome (AS) is a developmental disorder. It is an autism spectrum disorder (ASD), one of a distinct group of neurological conditions characterized by a greater or lesser degree of impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behavior."

The authors of this study note that AS is different from what is commonly known as autism because it is considered a high-functioning form of autism where the person with the syndrome still maintains a fair command of language skills and cognitive abilities. People with the condition have more trouble with social skills and tend to exhibit an almost obsessive focus on one topic or perform the same behaviors over and over again.

In this case, a 6-year-old boy was brought to the chiropractor for help with several medical conditions that had not responded to medical care. He had been diagnosed with Asperger's syndrome with symptoms of jumping and flapping of his hands. In addition, the boy also suffered from asthma, and allergies that were made worse by his Asperger's syndrome.

A chiropractic examination was performed which resulted in the determination that there were multiple areas of subluxation and joint dysfunction. From this information, specific forms of chiropractic adjustments and procedures were started to address the issues.

The study records that the boy's parents reported improvement in the AS symptoms within the first week of the chiropractic care. The boy's health continued to improve, and he was eventually taken off asthma and allergy medications that were needed before chiropractic care. A year after starting chiropractic, the boy was much improved and experienced only two exacerbations which were quickly helped with chiropractic.

A follow-up of the boy at age 15 documented that he was off all medications, was not experiencing problems with allergies or asthma, and had not had a return of any of the symptoms associated with Asperger's syndrome.

The authors of the study note that this is just a single care study. However, they also recommend that chiropractic may well be a safer alternative than the harsh drugs used to treat Asperger's. "With the risk benefit ratios associated with the reduced risk of chiropractic care with increased risk of the typical medications used for this condition, a trial of chiropractic care for children or adults with this condition may yield important information."

On August 5, 2021, the Journal of Contemporary Chiropractic published the results of a case study documenting the benefits of chiropractic on a patient suffering with muscular dystrophy and a variety of debilitating symptoms associated with that condition.

According to the U.S. Centers for Disease Control and Prevention, "Muscular dystrophies are a group of muscle diseases caused by mutations in a person’s genes. Over time, muscle weakness decreases mobility, making everyday tasks difficult. There are many kinds of muscular dystrophy, each affecting specific muscle groups, with signs and symptoms appearing at different ages, and varying in severity."

In this case, a 23-year-old man sought chiropractic care for complaints of low back pain, immobility of lower limbs and neck pain, and arm and neck numbness. The man first noticed problems when he was 13 years old as he was having trouble walking, bending, and sitting due to pain and stiffness.

By age 19, the man required medication just to perform normal activities such as tying his shoes. The man was then referred to a neurologist who diagnosed him with muscular dystrophy. He was given a variety of medications for the next 9 months, but his condition continued to worsen. Eventually he was told that his "condition was still progressing, there was no hope of engaging in physical activity and he would ultimately be wheelchair bound for the rest of his life."

Upon his first chiropractic visit, the man revealed that his pain affected every activity on his life including sleeping. He was on a number of strong medications to attempt to alleviate his suffering. On his intake form, the man indicated that he was suffering from nervousness, allergies, headaches, stiff neck, painful shoulder and elbow, arm numbness, constipation, low back pain, sciatica, leg and hip pain, numbness in legs, poor circulation, and hemorrhoids. He was forced to quit his job as a welder as he was now unable to perform the duties of his employment.

A chiropractic examination and x-rays were performed, and it was determined that multiple areas of spinal subluxation existed in the man's spine. Specific forms of chiropractic care were started to address the findings at the rate of three visits per week. At the time of the man's first re-evaluation, it is reported that the man saw an improvement in a number of his symptoms including a complete alleviation of his headaches. Additionally, the man reported improvement in other activities he was previously unable to do, including driving, concentrating, lifting, sleeping and taking care of himself. His spinal ranges of motion increased, and his pain decreased significantly.

In their conclusion, the study authors summed up this case by stating. "Our patient initially visited us with a medical diagnosis of muscular dystrophy. Despite medical intervention, a series of exacerbations led to intense back pain and loss of function and use of his limbs." After chiropractic care, the patient saw improvements in every area including a significant decrease in pain and the greater ability to move and carry-on normal life activities.

A study published on May 21, 2021, in the journal Brain Science showed that people who had suffered stroke had improved motor function after 4 weeks when chiropractic was added to their regime of physical therapy. The journal Brain Science is one of the scientific journals published by the Multidisciplinary Digital Publishing Institute (MDPI) based in Basel, Switzerland.

The multiple authors of this study begin by noting the impact that stroke can have on an individual's quality of life. "Stroke can result in persistent impairments of structure and function, which can lead to limitations of activity and a negative impact on quality of life. Due to long term disability, many stroke survivors are dependent on their caregivers for assistance with activities of daily life, such as dressing, bathing, and toileting, which imposes an additional burden on society. Regaining lost motor function is critical to post-stroke recovery."

In explaining the reason for studying chiropractic care for stroke victims, the authors explain, "Chiropractic care has the potential to facilitate motor recovery in stroke survivors due to its influence on the central nervous system. Chiropractic care constitutes a holistic approach to health, with a focus on the identification and correction of central segmental motor control (CSMC) problems that chiropractors often call vertebral subluxations."

This study was a randomized controlled trial conducted at the Rehabilitation Center of Railway General Hospital, Rawalpindi, Pakistan. The patients in this study were from the Railway General Hospital database who had experienced a stroke at least 12 weeks prior to participation in this study. All participants had completed a rehabilitative program at the hospital.

Participants were all measured for motor function prior to the study so that subsequent tests could determine if there was a change. The participants were divided into two groups. One group received physical therapy plus chiropractic adjustments, while the other group received physical therapy and sham chiropractic. Sham chiropractic is when a procedure is done that seems like a chiropractic adjustment, but no actual adjustment is given.

These two groups were then compared for motor function after four weeks of the care. The motor function analysis was measured using the Fugl-Meyer Assessment scale, which is a highly reliable and valid performance-based impairment scale that is used to measure recovery after a stroke.

Fifty-five participants completed the 4-week assessment. There were no adverse events or reports of harm to any of the participants during the study.

The results showed that there was a "statistically significant" improvement in motor function as measured by the Fugl-Meyer Assessment scale, in the group that received chiropractic care with physical therapy, compared to the group that got physical therapy and the sham or fake chiropractic adjustments.

The authors of the study wrote in their conclusion, "Improvements in motor function were observed when chiropractic care was added to 4 weeks of physical therapy care in people with subacute or chronic stroke. These improvements were statistically significant and a post-hoc responder analysis suggested they were also likely to be clinically significant. Chiropractic spinal adjustments may therefore be beneficial for people with motor impairments associated with subacute or chronic stroke."