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1.
Cureus ; 16(9): e68393, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39224496

RESUMEN

We present a case report of a patient suffering from chronic low back pain (CLBP) and chronic non-specific neck pain (CNSNP), both of which were caused and complicated by a physically demanding occupation, a history of mixed martial arts, and lumbar scoliosis. Improvements in patient-reported outcomes (PROs) and radiographic findings were observed following conservative spine rehabilitation. The patient, a 34-year-old male, had experienced chronic spine pain, particularly CLBP and CNSNP, for several years. He reported severe pain and increasing disability after a recent neck injury sustained while practicing jiu-jitsu. Radicular pain, along with numbness and tingling, was noted in the right upper extremity, extending to the first three digits, and there were also altered sensations and temperature changes in both feet. He described sharp, pinching mid-back pain and worsening disability due to the persistent pain, which led him to seek manual manipulative chiropractic spine therapy, though he reported little benefit from it. The patient had relied on over-the-counter pain medications for many years without achieving long-term pain and disability relief, and these medications were no longer used following treatment. Chiropractic BioPhysics® (CBP®) spinal structural rehabilitation protocols were used to improve coronal and sagittal balance, as well as paraspinal muscular strength, addressing posture, mobility, and related aspects. These protocols include postural exercises, postural Mirror Image® traction, and postural spinal manipulative therapy. All PROs improved, with a near resolution of all initial symptoms of chronic spine pain. Outcomes measured included disability indices and health-related quality of life (HRQoL) indicators. Radiographic parameter improvements were significant, demonstrating improved coronal and sagittal balance as a result of the treatment. Following 30 in-office treatments, administered three times per week for 10 weeks, initial outcomes were reassessed. The patient then received 13 in-office treatments periodically over one year, and all initial outcomes were repeated. The improvements remained stable over time. A 26-month follow-up found that the improvements were sustained over a very long period without additional treatment after the 13-month examination. Chronic spine pain, specifically CLBP and CNSNP, is a significant source of suffering and contributes substantially to the global burden of disease. Improvement in HRQoLs, PROs, and objective spine parameters are desirable clinical outcomes. Our case report documents objective improvement in lumbar scoliosis and spine pain, which is rare in conservative studies. This successful treatment of chronic pain with long-term follow-up contributes to the growing evidence supporting conservative, non-surgical treatments for CNSNP and CLBP. Successful management of chronic spine pain was observed in a patient undergoing CBP® treatment. The treatment was designed to address abnormal sagittal and coronal postural balance and radiographic abnormalities indicating spinal misalignment and reassess progress in PROs, as well as objective and subjective HRQoL measures, both following treatment and 13 months later. However, larger studies are needed to draw firm conclusions regarding the efficacy of this treatment for chronic pain.

2.
Cureus ; 16(9): e69913, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39329043

RESUMEN

Cervical hyperlordosis is a rare condition in the pediatric population. We present a unique case of the application of Chiropractic Biophysics® (CBP®) technique protocols to reduce a hyperlordotic cervical spine corresponding with many craniocervical symptoms, including chronic migraines and neck pain. A 15-year-old female presented with chronic headaches, neck pain, and neck stiffness among other complaints following a martial arts sprain injury several months prior. There were many positive orthopedic tests and limited range of motion. Radiographs revealed a cervical hyperlordosis and a right lateral head translation. CBP® treatment was given and involved cervical distraction traction as well as corrective exercises twice a week for 12 weeks, and then monthly for one year with a complementary home program. After 12 weeks, there was a full recovery from migraines and neck pain correlating with an 8° reduction in lordosis and correction of head translation. At 15 months, the patient remained well and achieved a 13° total reduction in the neck curve. This is the first case documenting the successful application of CBP® methods to reduce cervical spine hyperlordosis in peer-reviewed literature. We propose too much curve may be as detrimental as too little curve in the cervical spine with respect to causing adverse stresses and strains in the surrounding soft tissues leading to pathological processes and nociceptive tendencies.

3.
Cureus ; 16(9): e69935, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39329038

RESUMEN

We present a chronic migraine (CM) patient demonstrating significant improvement in subjective and objective reported outcome measures with deeper cervical lordosis parameters and reduced forward head posture on radiographs. A 29-year-old male suffered from CM reporting significant pain and disability with aural, sensory, and motor disturbances during the migraine headaches. Aura with visual disturbances, abnormal facial and extremity sensation, sporadic motor weakness, and other signs of CM were found in the patient's history since age 10. The patient reported previous physical therapy, manual chiropractic, and over-the-counter medications. Migraine-specific prescriptions without long-term reduction in pain and disability were reported. The pain and suffering had been reported to be worsening, and he sought Chiropractic BioPhysics® (CBP®) spine and postural rehabilitation protocols. These protocols were used to increase cervical lordosis, reduce coronal imbalances, increase mobility, and create better posture. These protocols include specific prescriptions based on radiography for postural exercises, postural mirror image® (MI®)traction, and specific spinal manipulative therapy (SMT) focused on posture. All outcome measures improved with the resolution of all initial symptoms of CM. There was a 16° improvement in cervical lordosis, a 30% decrease in headache disability, and additional improvements. These improvements were maintained at a seven-month follow-up during which the patient received infrequent maintenance treatments. This successful treatment of a patient with CM with long-term follow-up adds to evidence that CBP® spinal structural rehabilitation may prove effective and serve as a possible tool for clinicians, physicians, and therapists to treat CM.

4.
Cureus ; 16(7): e63774, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38974394

RESUMEN

A 19-year-old male suffered from sporadic hemiplegic migraine (SHM) for several years and experienced significant pain and disability with sensory and motor disturbances during the migraine headaches. Weakness, abnormal vision, abnormal sensation, one-sided disabling motor weakness, and other signs of SHM were diagnosed. The patient had received previous physical therapy, chiropractic and over-the-counter medications, as well as migraine-specific prescriptions without lasting improvements. Chiropractic BioPhysics® (CBP®) spinal structural rehabilitation protocols were used to increase cervical lordosis and improve cervical muscular strength, mobility, and posture. These protocols include spine-specific prescriptions for Mirror Image® postural exercises, traction, and spinal manipulative therapy. After 24 treatments over eight weeks, all subjective and objective outcomes improved dramatically with a near resolution of all initial symptoms of SHM. There were a significant increase in cervical lordosis and a reduction in forward head posture. The neck disability index improved from 26% to 6%, and all pain scores for all regions improved following treatment. A 10-month follow-up exam showed the outcomes were maintained. SHM is rare and debilitating, is part of the global burden of disease, and is a major cause of disability in the world. Reports of successful conservative and non-conservative long-term treatments for SHM are rare, and there are no clinical trials showing successful treatments for SHM. This successful case demonstrates preliminary evidence that CBP spinal structural rehabilitation may serve as a treatment option for SHM. Future studies are needed to replicate the findings from this case.

5.
J Phys Ther Sci ; 36(1): 44-50, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38186967

RESUMEN

[Purpose] To present the case of the amelioration of chronic pain and disability in a patient suffering from failed back surgery syndrome. [Participant and Methods] A 27-year-old male with chronic low back pain was treated with a Coflex® intra-spinous instrument, however, it was removed shortly after due to poor outcome including worsening pain and disability. Radiographic assessment revealed significant posterior translation of the thorax complicated by significant loss of the normal lumbar lordosis and a left lateral translated thoracic cage posture. Chiropractic Biophysics® technique was applied over a 5.5-month period leading to structural spine improvements as well as improved pain, Oswestry disability index (ODI) and quality of life (QOL). [Results] There was a 21 mm reduction in posterior thoracic translation, a 6.2° improvement in lumbar lordosis and a 16 mm reduction in lateral thoracic translation corresponding with improved ODI and QOL scores. A 6 year follow-up showed successful outcome despite some degenerative changes in the spine at the prior surgical level. [Conclusion] This case adds to the growing literature showing the efficacy of non-surgical spinal rehabilitative methods in improving outcomes in patients with spinal deformity and associated disabilities. This case also demonstrates necessity of the continued criterion standard of spinal radiography for biomechanical assessment.

6.
Cureus ; 16(1): e51620, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38179324

RESUMEN

The aim of this case report is to provide clinicians with an option for the treatment of spine pain, spine disorders caused or complicated by abnormal spine alignment, and failed prior interventions for pain and suffering with a conservative protocol. Multi-decade chronic widespread pain (CWSP), low back pain (LBP) headache (HA), and neck pain (NP) cause significant disability and reduced quality of life across all socio-economic and societal categories. Treatment options for decades-old long-term pain with good outcomes are uncommon with non-surgical and surgical interventions. Herein is a single case of positive outcomes with Chiropractic BioPhysics® (CBP®)protocol and long-term follow-up. A 60-year-old male with a lifting injury working on a farm at age 12 suffered for decades with LBP, mid-back pain (MBP), NP, HAs, radiculopathy, and poor health-related quality of life (HRQoL). Prior over-the-counter (OTC) medications with diminishing results over 48 years were reported. The patient had multiple abnormal patient-reported outcomes (PROs) as well as measured postural and spine structural abnormalities at the initial assessment. Following 12 treatments, PROs and other measures improved dramatically. Continued brief treatment showed continued progress followed by no treatment beyond continued home exercises and home postural orthoses. All subjective and objective outcome measures improved at one-year follow-up and remained long-term. Improvements in sagittal and coronal postural balance with improved spine alignment, better PROs, and measurably improved HRQoLs were found at one- and three-year follow-ups from the initial evaluation. Chronic NP, LBP, MBP, and extremity pain with altered sensation, loss of function, and failed drug therapy are common across the globe and combined represent the greatest contributors to disability and the global burden of disease (GBD). Economic, efficacious, repeatable, and reliable methods for treating pain will reduce GBD and improve PROs. Larger studies of CBP® methods for multi-decade chronic pain are challenging; however, continued case reports and RCTs for similar conditions are warranted.

7.
J Phys Ther Sci ; 34(2): 167-171, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35221522

RESUMEN

[Purpose] To present the successful structural improvement in cervical lordosis in a patient suffering from cervicogenic headache having cervical kyphosis. [Participant and Methods] A 26 year old female presented with the primary complaint of headache. Radiography demonstrated a cervical kyphosis. Chiropractic BioPhysics® methods were used to restore the cervical spine alignment. Twenty-five treatments were given over 8 weeks. A 2.5 year follow-up was also reported. [Results] Radiography showed a dramatic increase in cervical lordosis following initial treatment. The patient also reported substantial reductions in headache frequency and severity as well as other bodily improvements, reduced disability and improved quality of life. The long-term follow-up showed a maintenance of lordosis correction and patient wellness. [Conclusion] A cervical kyphosis was reversed back to a normal lordosis in 8 weeks and coincided with dramatic resolution of cervicogenic headache in a young female. The cervical lordosis may be a key biomechanical biomarker in cervicogenic headache.

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