Chiropractic

Herein, the author presents two cases where chiropractic techniques appear to have been successful in alleviating postlaminectomy syndrome (PLS). PLS is a condition characterized by persistent back pain or leg pain after spine surgeries. Nerves can get damaged or inflamed due to various (preexisting, intra- or postoperative) conditions, resulting in continued low back pain.These cases are notable because the precise cause of this condition remains unclear and, currently, effective strategies for patientswith this painful syndrome have not been established.

Adolescent idiopathic scoliosis (AIS) remains the most common and potentially severe form of scoliosis during the rapid growth period. It is generally accepted that AIS is a multifactorial disease controlled by genetic, hormonal, neuromuscular, and environmental factors. Herein, we describe a case of 12-year-old scoliotic girl with a double curve of initially 26° thoracic and 23° lumbar, seeking chiropractic care. The therapy was provided three times/twice a week for 6 months. Adjustments of the spine through chiropractic, both soreness and mobility, were shown to improve. A total correction in Cobb angle of 6° (23%) in the thoracic curve and 7° (30%) in the lumbar curve was illustrated on consequent radiographs. This case highlights the advantage of chiropractic adjustment of early scoliosis primarily because the medical community does not offer any treatment for such a mild scoliosis. Further, randomized trial is warranted to support this viability for AIS.

The purpose of this report is to present an interesting case of cervical radiculopathy in a patient with a prominent cervical hypolordosis treated by chiropractic adjustment. A 55-year-old office worker with severe neck pain and numbness of the right arm sought chiropractic treatment. Following 12 sessions of cervical adjustment, the patient experienced complete alleviation from radiculopathy and full restoration of cervical curvature. Neck pain is common and the cause is usually multifactorial. About 88% of uncomplicated neck pain is self-limiting. Conservative treatment is advocated as initial modality for most patients. Cervical radiculopathy, however, is a potential problem because nerve impingement can cause disability due to numbness or paresthesia, and even weakness, requiring surgical intervention. The best chance for sensorimotor recovery is with prompt intervention to decompress the pinched nerve. Instead of watchful waiting, early application of chiropractic adjustment may help release nerve impingement, and avoid medications and operations in patients with neglected nerve compression.

We report the case of a 44-year-old school teacher who experienced long-term relief from tension-type headache (TTH) and
major depression following chiropractic treatment. It is well recognized that psychiatric comorbidity and suicide risk are
commonly found in patients with painful physical symptoms such as chronic headache, backache, or joint pain. Recent studies
indicated that autonomic dysfunction plays a role in the pathogenesis of TTHs and depressive disorders. The autonomic
nervous system is mainly controlled by reflex centers located in the spinal cord, brain stem, and hypothalamus. This report
highlights the rewarding outcomes from spinal adjustment in certain neuropsychiatric disorders. Long-term results of
chiropractic adjustment in this particular case were very favorable. Further studies with larger groups are warranted to better
clarify the role of chiropractic.

Benign acute childhood myositis is a self‐limiting muscle disorder characterized by calf pain with an isolated finding of elevated serum creatine kinase, being preceded by an influenza‐like illness. The classic clinical and laboratory features may allow for a correct diagnosis. This report describes some accompanying symptoms which are not usually perceived. An incorrect diagnosis could lead to unnecessary treatments.

Spontaneous resolution of myopic retinoschisis is an unusual event due to the fact that most
eyes of patients with this condition have already undergone certain morphological changes and vision will
progressively worsen over time. We present a case of spontaneous anatomic and visual improvement in a
myopic eye with a macular retinoschisis. The patient was monocular oculus dextrus (OD) with a history
of left eye enucleation for recurrent retinal detachment and glaucoma for 30 years prior. Recent optical
coherence tomography (OCT) depicted features characteristic of myopic retinoschisis. At the same time,
the patient sough chiropractic treatment for neck pain and numbness in upper limbs. The patient had
received 12 sessions of cervical adjustment which helped attain symptomatic relief of her neck and upper
limb complaints at which time the patient also reported substantial recovery in her vision. Restoration of the
normal retinal morphological appearance was illustrated upon re-evaluation of OCT. Spontaneous resolution
of myopic retinoschisis may be a multifactorial cause. Further studies elucidating the exact mechanism
resulting in visual improvement after chiropractic adjustment are needed before any claims regarding its
efficacy for the treatment of myopic retinoschisis can be made.

Myasthenia gravis (MG) is an autoimmune disorder, caused by circulating antibodies against the acetylcholine receptor (AChR) and associated proteins. Anticholinesterase medications and immunomodulating therapies are the mainstays of current treatment. Presented here is a case of a 51-year-old female who had been diagnosed with MG based on symptoms and continued elevation of antibody to AChR (anti-AChR) by her family physician. The patient’s anticholinesterase medication was halted due to significant side effects affecting bowel function. She only received acupuncture treatment in the past 4 months prior to this presentation. Myasthenic symptoms deteriorated and the anti-AChR titer kept elevating after stopping medication. She originally came to us due to neck and back pain rather than myasthenic complaints. This case is interesting that her back pain and myasthenic symptoms went into complete remission within 1 month of initiating chiropractic adjustment. The concomitant recession of the myasthenic symptoms raises considerable interest for the mystery of MG, including the causal link between stress and autoimmune disease, the role of ACh in immune regulation, and the possible mechanisms of disease amelioration. Further studies would shed more light on the efficacy of various modalities in treating MG.

We report a 58-year-old male with sequelae of polio who presented with low back and left buttock pain, and pitting oedema of both legs for four months. The patient had a history of poliomyelitis at the age of 1 year which resulted in bilateral lower leg weakness, particularly on the left side. Magnetic resonance imaging showed cervical spinal stenosis secondary to posterior osteophyte formation, left paracentral disc extrusion at L2/L3 and L3/L4 levels with compression of the traversing L4 nerve root. The findings confirmed a diagnosis of lumbar radiculopathy caused by a herniated disc. The patient subsequently underwent a chiropractic treatment. The painful symptoms and pitting oedema in this case resolved with spinal adjustment in addition to scraping therapy to strengthen bilateral low back and the gluteal muscles. This case provides circumstantial evidence of a scarcely mentioned association between pitting oedema and lumbar radiculopathy caused by disc herniation. The pathophysiological mechanism is elusive, but might involve a complexity of cytokine-mediated inflammation and interconnection between somatic and autonomic nervous systems.

Abstract: Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66‑year‑old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the
musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.