Dr Merri's Blog

Teenage Boy's Neck pain and Curvature Helped with Chiropractic Care

Posted: May 22, 2019
By: Dr. Meredith Oudt

After Auto Accident Teenage Boy's Neck Pain and Neck Curvature Helped by Chiropractic

The Journal of Pediatric, Maternal & Family Health published a case study on September 10, 2018, documenting chiropractic helping a teenage boy with neck pain following a car accident. The study was also able to show improvement in the boy's neck curvature.

The study authors begin by noting that the most common diagnosis from U.S. hospital emergency departments given to people involved in a motor vehicle accident (MVA) is neck sprain/strain. These types of injuries are often painful, progressive and permanent if not corrected. One common finding in lateral x-rays of patients involved in MVA is a loss or reversal of the normal forward neck curvature. Neck curvature may not be directly from the MVA, but having an abnormal curve seems to be associated with a poor outcome. The study also reported that there is a higher incidence of forward head position in patients who have had a MVA as compared to those who have not.

Typical medical care of either medications or a "wait and see" approach have been shown to help in acute situations, but do not do as well for chronic pain, and do nothing to address the aberrant neck curvature or forward head position.

In this case, a 14-year-old boy who was involved in a MVA a year earlier was brought to a chiropractor by his parents. The boy was suffering with chronic headaches and neck pain that he and his parents related to the MVA a year earlier. The boy had no history of his neck pain or headaches prior to the accident. The accident occurred when the boy was riding in the front passenger seat of a minivan which was then rear-ended by a full sized pickup truck.

Within the first three months after the accident, the boy did receive some chiropractic care which had given him some relief. However, care was not continued until a year after the MVA when specific forms of chiropractic were utilized after an examination and additional x-rays. The neck x-rays specifically showed a loss of the neck curvature and a forward head position.

Prior to the specific chiropractic care, the boy's pain level was reported to be 7 out of 10, with 10 being the worst. After 11 weeks of specific chiropractic care, his pain had been reduced to 0 out of 10. Additionally, the reversal of the neck curve that was seen on the initial x-rays had began to show a curvature in the proper direction according to the follow-up neck x-rays.

Resolution of Bedwetting and Constipation Following Chiropractic Care

Posted: April 7, 2019
By: Dr. Meredith Oudt
Resolution of Bedwetting and Constipation Following Chiropractic Care

On June 25, 2018, the Journal of Pediatric, Maternal & Family Health published the results of a case study showing the resolution of bedwetting and constipation after chiropractic care. The clinical name for bedwetting is enuresis.

There are two types of enuresis. Nocturnal enuresis is bed-wetting at night and is the more common type of elimination disorder. Daytime wetting is called diurnal enuresis, and can occur by itself or in conjunction with nighttime bedwetting. Clinically, both nocturnal enuresis and diurnal enuresis are only considered to be a diagnosis if there is no other underlying organic disease, and after a child is five years of age.

The study points out that enuresis and constipation are very common conditions for children. Nocturnal enuresis is thought to affect up to 20% of children up to the age of seven. About 15% of the cases seem to correct themselves each year. Daytime, or diurnal enuresis is less common but commonly seen with the nighttime condition as well.

Constipation is defined as two or fewer bowel movements per week. It is the most common digestive symptom of the general population. Approximately 3 to 5% of all pediatric office visits are for child for constipation problems. The study notes that about 28% of adults in the United States suffer from constipation. Children are also commonly affected, with around 9-13% of pediatric cases that suffer from constipation being also associated with bladder symptoms, such as enuresis.

In this case, a 9-year-old girl was brought to a chiropractor for an evaluation and possible care. She was suffering with diurnal enuresis, nocturnal enuresis and chronic constipation. The history revealed that the girl was intolerant to red dye and suffered from digestive issues. She regularly experienced infrequent bowel movements that were difficult to pass.

An examination was performed which included a postural analysis and bilateral weight scales. Range of motion of her spine was evaluated. Additionally, palpation of the spine and adjacent musculature was performed. Thermography studies were also conducted to determine heat differences along the spine. Surface Electromyography (sEMG) studies were used as an assessment tool to measure the electrical activity of the girl's paraspinal muscles. From these tests, subluxations were determined to be present and specific forms of chiropractic adjustments were started.

The results of the chiropractic care were almost immediate. It was reported that after the girl's first adjustment, she experienced several bowel movements and remained dry for three consecutive nights. Four weeks after starting chiropractic care, the first re-assessment was performed to evaluate the girl's progress. At that time, she reported having only one wet night in the past week. During the second re-assessment, it was reported that the girl had not had either a daytime or nighttime leakage of urine and was having regular bowel movements about twice per day.

In their discussion, the authors of the study explained how subluxations could have created problems such as enuresis, as well as how correction would allow the body to heal itself. "The nervous system controls and regulates every organ, gland and tissue of the body and controls all bodily functions to maintain a proper bodily homeostasis.31 This regulation is done through direct nerve innervation to all organ systems of the body. When there is malposition of a vertebra in the spinal column there can be negative effects on the neurological signal of the nerve in the involved area, which is called a vertebral subluxation.

Improved thyroid function following Chiropractic Care

Posted: March 26, 2019
By: Dr. Meredith Oudt

The Annals of Vertebral Subluxation Research published a case study on March 19, 2018, documenting the case of a chiropractic patient diagnosed with hypothyroidism having their thyroid function improve due to chiropractic. According to the study authors, "Hypothyroidism is defined as the failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body."

On their website the American Thyroid Association describes the function of the thyroid by saying, "The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should."

In hypothyroidism, the cells of the body are not getting enough thyroid hormone causing them to slow down. This can cause symptoms of feeling colder, becoming tired more easily, the skin can become drier, becoming forgetful and depressed, and constipation. It is estimated that 10 million Americans have this common condition, with about 10% of all women having some signs of hypothyroidism.

In this case, a 49-year-old man complaining of neck, back, and shoulder pain went to the chiropractor. He did not have a specific time of origin for the problems which had been ongoing for a while. His health history revealed that he had been diagnosed with hypothyroidism four years earlier. Five years ago, the man started noticing that he felt low energy, fatigue and started having slurred speech. His medical practitioner ordered bloodwork from which he was diagnosed with hypothyroidism.

The man's medical practitioner prescribed the artificial thyroid hormone replacement Synthroid® at 100 mg per day. While under medication, most of the symptoms from his hypothyroidism were under control.

A chiropractic examination was performed which consisted of health history forms, orthopedic and neurologic testing, static and motion palpation, thermography, and spinal x-rays. Based on the tests, it was determined that subluxations were present. Specific forms of chiropractic care were begun at the rate of three visits per week.

During his chiropractic care, there were no changes in the man's lifestyle, diet, or exercise levels. Several months into chiropractic care, a follow-up blood test was performed showing an improvement in the man's thyroid hormone level resulting in a decrease of his medication. After eight months of chiropractic, his hormone level had returned to normal and he no longer needed the thyroid medication. The study did note that, against recommendation, the man did reduce his chiropractic visits causing a minimal setback and a partial return of symptoms.

In the conclusion of the study, the authors noted that this was not the first study linking improved thyroid function to chiropractic, they stated, "This paper appears to be the fourth to link the decreased need for synthetic thyroid medication while under chiropractic care." They further explained, "Because synthetic thyroid hormone is now the only current treatment for hypothyroidism, it would be beneficial to have an alternative treatment such as chiropractic care. Those currently receiving synthetic thyroid medication risk its side effects, drug interactions, and associated costs."

Neck Pain and Numbness Resolved Under Chiropractic Care

Posted: March 20, 2019
By: Dr. Meredith Oudt
Neck Pain and Numbness Resolved Under Chiropractic Care

On May 3, 2018, the Journal of Upper Cervical Chiropractic Research published a case study documenting the resolution of neck pain and hand numbness in a patient undergoing chiropractic care. According to the study authors, neck pain is one of the more common pain conditions in the general population.

Estimates show that at any given time, nearly 13% of the population suffers with some form of neck pain. Overall, nearly 50% of the population will suffer with neck pain at some point in their lives. Neck pain is one of the more common condition that people seek chiropractors for. About 25% of all patients that see chiropractors did so because of neck pain.

According to the study, neck pain is more common in people whose work requires performing repetitive static tasks, or physically demanding work. Neck pain is also more common in people who have had previous neck trauma, and those suffering from other conditions such as depression, low back pain, or headaches.

In this case, a 28-year-old man suffering with neck pain and tingling in his hands sought chiropractic care. The man reported that his neck pain started about five months earlier, though he could not recall any particular incident that brought on the problem. He also reported that he did not remember when his hands started tingling. He had not seen any other type of doctor, and was not taking any medications for these conditions.

The man described the neck pain as a dull achy kind of pain in his lower neck that he rated as only a 2 out of 10 in severity. He noted that his hands felt like pins and needles with the feeling be more prevalent in his right hand. Although he felt that these annoying conditions did not prevent him from performing normal daily activities, he did state that these issues prevented him from working out as hard as he used to.

An examination was performed at the chiropractic office which included checking his vital signs, orthopedic and neurological exams, cervical static and motion palpation, along with range of motion tests in both the cervical and lumbar region. A postural analysis did reveal some abnormal positioning as well as limitations is specific motions of some neck vertebrae. Cervical thermographic scans showed irregularities. X-rays of the neck showed malpositioning of cervical vertebrae in addition to moderate disc degeneration and spurring in the neck.

Based upon the finding of the examination and x-rays, it was determined that subluxations were present and specific forms of chiropractic adjustments were started. After the first adjustment, at his subsequent visit the patient did not report any improvement. Care was continued based upon specific findings that indicated the need for a chiropractic adjustment.

On the sixth visit, the man reported that his neck pain was gone and he only had some minor neck stiffness. He also stated that his hand tingling had reduced to only occasional tingling in his fingers. By the seventh visit, the man reported no neck pain or stiffness, and his hand tingling was completely gone. He elected to continue chiropractic care for correction of subluxations.

Neck pain & Hand Numbness helped by Chiropractic

Posted: March 5, 2019
By: Dr. Meredith Oudt

Neck Pain and Hand Numbness Helped by Chiropractic

The Journal of Upper Cervical Chiropractic Research published the results of a case study on July 9, 2018, documenting the improvement under chiropractic care of a woman who was suffering with neck pain and numbness in hands.

This study begins by noting that neck pain is common. Statistics show that 37.2% of the population will experience neck pain lasting over one year's duration. Over 50% of the population suffers some form of neck pain in their lifetime. Additionally, neck pain is the fourth leading cause of years lost to disability. Women more commonly suffer with neck pain then men.

In this case, a 46-year-old woman with chronic neck pain and left-hand numbness presented herself to a chiropractic clinic. The neck pain was long-term, and the woman could not recall when and how the problem first started. The numbness she was experiencing in her left hand was intermittent with no defined pattern or timing. She had not seen any other type of doctor for these conditions prior to her visit to the chiropractor.

She described the pain as achy and stiff. She initially rated the pain as a 4 out of 10 initially on a scale of 0 to 10 where 0 is no pain. She noted that her pain worsened after working long hours or traveling for work. However, she reported that none of her daily activities were affected. Massages did give her some short-term relief for the pain.

In addition to her primary complaint of neck pain and hand numbness, she also reported that she experienced low back pain and tingling, and numbness into the toes. She had previously been diagnosed with lumbar disc herniation and was treated by a physical therapist.

A chiropractic examination was performed which included spinal palpation, range of motion, relevant orthopedic and neurological exams, thermographic heat scans, and a postural analysis. Spinal x-rays of her neck were also performed. The x-rays showed moderate degeneration of mid-neck area.

Based upon the examination and x-rays, specific chiropractic care was started. She was initially seen twice per week and adjusted based upon an evaluation performed each visit. After two months of chiropractic care the patient reported a total resolution of her neck pain and the numbness she was experiencing in her left hand.

Neck pain is one of the more common conditions for which people seek chiropractic care. The authors of the study noted, "Chiropractic care has been used to manage numerous musculoskeletal conditions including neck pain. Neck pain accounts for 25% of the initial consultations and examinations rendered at chiropractic offices."

Resolution of Chronic Seizures in an Infant

Posted: February 19, 2019
By: Dr. Meredith Oudt

The Journal of Pediatric, Maternal & Family Health published a case study on December 27, 2018, documenting chiropractic bringing about the resolution of chronic seizures in an infant. A seizure is a sudden surge of electrical activity in the brain.

The study begins by explaining that seizures or epilepsy can occur from an interference with the mechanism creating an over excitement of brain firings, or from an inhibition of the mechanisms that control brain firing. The study reports that epilepsy occurs in between 41 and 187 individuals per 100,000 children.

In this case, a 15-month-old male infant who was suffering with seizures was taken to the chiropractor. The infant's history revealed a traumatic birth process that ended in a cesarean section delivery. Since the infant's mother had had difficulty with previous pregnancies, she had progesterone shots during her pregnancy with this baby.

The infant boy began having seizures at 6 months of age with episodes occurring two to three times per week and lasting between one and two minutes each. These initial seizure episodes did subside. The seizures returned again 8 months later. At that time, the seizures were occurring every couple of days. After a month of these issues, the infant was brought in for a chiropractic evaluation.

The mother described her baby's episodes as unresponsiveness and limpness after awakening from a nap. He would suddenly be unable to move parts of his body including his arms and legs. Additionally, the infant would have these episodes after a bowel movement. The infant would not lose consciousness and the episodes lasted from one to two minutes.

Specific forms of chiropractic adjustments specifically focused toward the correction of subluxations were started and continued over an 8 month period. As care was ongoing, it was reported that the baby continued to show improvement until he was no longer suffering with seizures at all.

In their conclusion the authors of the study stated, "The results of this case study and relevant research pertaining to chiropractic’s role in reduction and resolution of chronic seizures support the hypothesis that subluxation reduction may have a positive impact on the symptoms associated with epilepsy."

Ear Infections and Bedwetting Resolved with Chiropractic - A Case Study

Posted: January 31, 2019
By: Dr. Meredith Oudt

Ear Infections and Bedwetting Resolved with Chiropractic - A Case Study

On April 2, 2018, the Journal of Pediatric, Maternal & Family Health published a case study documenting the resolution of ear infections and nocturnal enuresis in a young girl who received chiropractic care. Nocturnal enuresis, more commonly known as bedwetting or nighttime incontinence, is when a child urinates in bed while sleeping, after the age when they should have been able to control their bladder.

The technical name for ear infections is otitis media. The study authors explain this condition by saying, "Otitis media is very common in children. Generally, it is referred to as acute otitis media (AOM) or otitis media with effusion. Otitis media is the most common reason that children, visit the doctor, take antibiotics, and have surgical procedures."

Common medical treatment of bedwetting involves some form of behavioral modifications or rarely medications. However, otitis media is commonly treated with medications and surgery by the insertion of tympanostomy tubes into the ears.

In this case, a 12-year-old girl was brought to the chiropractor by her mother. The girl's primary health issues were recurring ear infections and bedwetting. A health history showed that the girl, who had been adopted at an early age, had been suffering with repeated ear infections almost since birth. She was born with low birth weight and was drug addicted at birth.

The girl underwent her first surgery to insert tympanostomy tubes at the age of two. Over the next ten years, the girl had five additional surgeries for insertion of the tympanostomy tubes as each previous attempt had only lasted for a short time. The most recent tubes only lasted two weeks before falling out. Her medical physicians wanted to schedule the girl for a seventh surgery when her mother decided to try chiropractic care. During this entire time, the girl was also suffering from nightly bedwetting which was starting to cause sleep difficulties.

A chiropractic examination was performed which included observation, a postural evaluation, spinal range of motions tests, spinal palpation, and functional leg length checks. A determination of the presence of spinal subluxations was made. Chiropractic care was recommended at the rate of three visits per week for the first three weeks with gradual reduction in frequency as care continued.

On each visit, the girl was monitored for changes in her ear infections or her bedwetting problem. After 11 visits, the girl reported that she had no symptoms of ear infections. The study also reports that the girl had a progressive decline in frequency of bedwetting as a result of her chiropractic care.

The authors of the study noted that the patient and her mother stated the effectiveness of chiropractic. The study notes, "The patient's mother stated that prior to seeing a chiropractor the patient was having episodes of bed wetting every night and was constantly having ear infections. Since being under chiropractic care these conditions have stopped completely or have occurred noticeably less often."

In their conclusion, the authors summed up the results of this case by saying, "This case demonstrates the health outcomes following chiropractic adjustment to resolve neurological interference and decrease symptoms of enuresis and otitis media."

Quality of Life with Diabetes and Sugar Levels Improved with Chiropractic

Posted: January 29, 2019
By: Dr. Meredith Oudt

Quality of Life with Diabetes and Sugar Levels Improved with Chiropractic

The Annals of Vertebral Subluxation Research published a case study on November 19, 2018, documenting the care of a young man who was suffering with diabetes mellitus and chronic mid back pain being helped by chiropractic.

The study begins by stating that type 1 diabetes mellitus has serious short-term and long- term health implications. The U.S. Centers for Disease Control report that if a 10-year-old child was diagnosed with type 1 diabetes in the year 2000, they would probably lose on average between 18.7 and 19.0 life-years.

In explaining the chiropractic approach to health, the authors of the study wrote, "Chiropractic is a health care discipline rooted in the philosophy optimal health and performance is sustained by neurological and spinal health. Conversely, neurological stress and strain contribute to disease and dysfunction and are preceded by abnormal, unhealthy spinal alignment and posture known as vertebral subluxations. Vertebral subluxation involves a biomechanical dysfunction and a neurological compromise."

It is the neurological component of the subluxation that opens the door to studying the effects of chiropractic on a wide variety of health issues such as the one discussed in this study.

In this case study, a 26-year-old man went to the chiropractor with the primary complaint of chronic mid-back pain for the past nine years. Additionally, he had been medically diagnosed with type 1 diabetes mellitus since he was 3 years old. The young man reported that he had managed his blood-glucose with insulin therapy via an insulin pump. He rated his mid back pain as a 7 out of 10 with 10 being the worst.

A chiropractic examination was performed which included using an SF-36 health survey form designed to measure a patient's assessment of their quality of life. In addition, the man was vigilant in continuing to monitor his blood glucose level as he had been for years.

Specific forms of regular chiropractic care were started. The care rendered was not for treatment of his diabetes, but was focused on correction of the subluxations which were determined to be present in his mid-back, known as the thoracic spine. The man was instructed not to change any of his treatments or managements of his diabetes.

After 7 weeks of chiropractic care, the man reported that his mid back pain had reduced significantly. Upon testing, it was also shown that the man had an improved blood glucose average. Since the man monitored his sugar level in real time, he reported that his blood glucose levels were lower on the days that he received chiropractic care.

The man was reassessed 16 months later to see how his progress was maintained. From this assessment, it was shown that his mid back pain had maintained the reduction he had previously experienced. His quality of life assessment had also shown significant improvement. Additionally, it was shown that his blood glucose level had remained lower and he was able to reduce the amount of insulin that he had needed.

In the study's discussion section, the authors noted that chiropractic was the only change made in this man's daily routine. "Certain circumstances and concurrences need to be highlighted within this report. The patient did not alter his lifestyle throughout or following care. It is remarkable that he continued to consume processed foods high in sugar and still yielded the extraordinary health improvements documented. The patient stated that chiropractic care was the only change in his everyday routine. During and following correction of the thoracic spinal alignment, the patient yielded significant improvements in blood glucose levels."

Why Do Seniors Seek Chiropractic?

Posted: January 2, 2019
By: Dr. Meredith Oudt

Why Do Seniors Seek Chiropractic?

The Journal of Chiropractic Education published the results of a study on August 1, 2018, that looked at the reasons that people over the age of 65 most sought out chiropractic care. The study was conducted at the New Zealand College of Chiropractic (NZCC) intern training center. The authors of this study begin by defining the aging process. "Aging is a nonreversible fact of life that results in an eventual decline in the total capacity of various organs and systems, decreasing the body’s ability to adapt to the stresses of the environment." They note that the world's population is getting older with 8.5% of the population being older than age 65, which translated out to 617 million senior citizens world-wide. It is expected that by the year 2050, there will be 1.6 billion people over 65 years of age representing 17% of the total world population. An increase in the likelihood of injury as well as additional health challenges for an aging population means a large increase strain on the world-wide healthcare systems. Less expensive alternatives such as chiropractic could represent an area that could help with the issues of an aging population. In this study, files were reviewed for patients at the NZCC intern training center who were over the age of 65 when they first started chiropractic care at that facility. Information from the file must have included the patient's chief complaint for which they started chiropractic care. From a total of 3513 active patients at the clinic at the time of the study, 100 patients (2.8%) met the criteria and were eligible for inclusion into this study. The youngest patient in the study was 65-years-old and the oldest was 88-years-old when they started chiropractic. The average age of patients in the study as 69.5 years. There were slightly more women than men in this study. According to the study, there were eight categories of chief complaints for which these patients sought chiropractic care. The most common reason that seniors looked to chiropractic in this study was lower back pain, with 45% listing this as their chief complaint. Of these patients, 28% sought chiropractic on their own and 17% sought chiropractic based upon a referral. Neck pain was the second most common reason for seniors to seek chiropractic with 21% listing this as their chief complaint. Of these, only 4% did so because of a referral while the rest sought chiropractic on their own. The third most common reason that seniors sought chiropractic care, representing 14% of the study participants, was for wellness care. These patients had no specific chief complaint or symptom that drew them to seek out chiropractic. It can be assumed that these patients were looking for preventative care and the benefits inherent in the drugless approach of chiropractic. Other chief problems that brought seniors to chiropractic in this study included lower extremity pain (5%), upper extremity pain (3%), balance (4%), hip pain (3%), and a variety of other issues such as headaches, groin pain, and visceral conditions each representing 1% of those seeking chiropractic. Portions of the finding in this study were similar to other studies performed in both New Zealand and in the United States and Mexico. The one main differences between the studies conducted in New Zealand, and the ones in the U.S. and Mexico was that the percentage of seniors seeking chiropractic for wellness purposes in New Zealand was much higher than studies conducted in the U.S. or Mexico. With this one difference being noted between this study and those outside New Zealand, the study authors were able to conclude that, "In general, older patient characteristics and their chief complaints at our clinic appear similar to those of other chiropractic colleges studying all age groups."

Vaginal Birth of Twins After Prior Caesarean with Chiropractic Care

Posted: December 12, 2018
By: Dr. Meredith Oudt

On November 5, 2018, the Journal of Pediatric, Maternal & Family Health published the results of a case study documenting the successful vaginal birth of twins in a woman undergoing chiropractic care, who had previously had a cesarean birth.

When a woman has had a cesarean birth, the two options for subsequent births include a planned second cesarean birth, or a "VBAC", which is a vaginal birth after caesarean. The authors of the study acknowledge that there are risks and benefits for both these directions. Cesarean births are more commonly recommended by medical professionals in this case but there are no clear evidence favoring one procedure over the other. In the case of twin births, cesareans are far more common.

Many women desire to have vaginal births after cesarean due to vaginal birth enhancing the health and well-being of the mother and baby, promotion of maternal infant connection and easing the transition to motherhood.

In this case, a 34-year-old woman presented herself for chiropractic care in her 16th week of a pregnancy of twin girls. Her primary complaint was that she was suffering with intermittent left sacroiliac pain, as well as left posterior hip and left buttock pain which had been present for the past three weeks. Overall, the woman rated her pain as a 6 out of 10, with 10 being the worst. Some activities made the pain more pronounced while rest seemed to improve her pain.

A chiropractic examination was performed and revealed postural imbalance as shown using bilateral weight scales. Additionally, visible postural abnormalities were noted in inspection including head tilt, a high shoulder and an increase in the mid back curvature. Spinal palpation noted multiple areas of restriction and positional concerns throughout the woman's spine. From the examination, it was determined that subluxations were present in her spine.

The patient consented to a course of chiropractic care at the rate of 2 visits per week for an initial period of 8 weeks. This was followed by a weekly visit for the remainder of her pregnancy. After the third visit, the woman reported that she was not having any pain. She commented, "This is the first time in a long while that I haven't felt the pain every day." During the remainder of her care she reported only occasional discomfort which eventually disappeared altogether.

At 35 weeks and 5 days, the woman successfully delivered her twin girls vaginally. The babies were born 20 minutes apart and weighed 4 lbs., 13oz. and 4 lbs., 3oz. After being checked out in the neonatal intensive care they were returned to their mother who was told that her new daughters were healthy babies.

In a review of available literature on the subject, the study authors noted that there was not a lot of prior material available. "Despite the limited number of published cases in the care of patients with successful VBAC and/or twin pregnancies, we are of the opinion that literature does not truly reflect what occurs in chiropractic practice." Submitting this case study for publication was partially to increase the database of cases of vaginal birth after cesarean, (VBAC). The authors concluded, "This case report provides supporting evidence on the benefits of chiropractic care for the pregnant woman with the desire for VBAC."