The Healthy China Initiative 2030 represents a major shift in China's healthcare policies for health promotion and disease prevention. Chiropractic care, with its focus on musculoskeletal health and nonpharmacological treatment, can contribute to the goals of this initiative. However, its potential contribution is hampered by the lack of official recognition and regulation in mainland China, which restricts its general awareness and integration into healthcare systems, and potentially leads to untreated musculoskeletal disorders. This research proposes the inclusion of chiropractic care in the Healthy China Initiative 2030 framework. It provides an overview of the goals of this initiative and the current state of chiropractic care in China. The alignment of chiropractic principles and practices with the aims of the Healthy China Initiative 2030 is also discussed. Policy recommendations for integrating chiropractic care into the healthcare system are proposed, which include the establishment of education standards, licensing protocols, and collaborative research initiatives. Potential challenges, including regulatory barriers, a lack of awareness, and research limitations are highlighted. We also present potential strategies to leverage opportunities for promoting chiropractic care, such as the rising demand for musculoskeletal care. This research provides the first focused discussion on the integration of chiropractic care into China's evolving preventive healthcare landscape under the Healthy China Initiative 2030.
In Hong Kong, chiropractic care developed under the national policy of "one country, two systems," whereby Hong Kong retained its own economic and political systems while remaining part of mainland China. This environment allowed Western education standards and practices to be adopted while integrating local cultural beliefs. In this respect, chiropractic healthcare emerged as an early model of culturally synergistic East meets West care. However, despite Hong Kong's large population and interest in natural health options, the field faces several challenges, including competition with other professions, costs of education, and political uncertainty. Collaborating across professions, demonstrating value through outcomes, and adapting to cultural contexts may facilitate the integration of chiropractic care into Hong Kong's healthcare system. Moreover, positioning chiropractic care within Hong Kong's integrative East meets West healthcare movement may help sustain the practice regardless of political shifts. Through strategic partnerships and the maintenance of high standards balanced by cultural sensitivity, the chiropractic field in Hong Kong exemplifies the global spread of healthcare professions. Overall, chiropractic care in Hong Kong has had to navigate complex sociocultural and political circumstances and evolve into an integrated approach, reflecting the region's pluralistic society. The study first discussed the development of the chiropractic profession in Hong Kong under the "one country, two systems" policy. It then examined the opportunities and challenges faced by the profession and concluded by delving into the future prospects of chiropractic in the region.
This study explores the significant role chiropractic care can play in the sports industry, with a focus on countries like China and Hong Kong. As a vital component of sports medicine, chiropractic care can enhance athletic performance, health, and competitiveness by addressing biomechanical imbalances and optimizing neuromuscular function. The potential impact of chiropractic care on the sports industry includes attracting international events and investments, leading to increased economic opportunities, and the overall growth of the industry. Key strategies for promoting chiropractic care in the sports industry encompass developing a robust chiropractic care infrastructure, raising public awareness through targeted campaigns, and implementing supportive policies by governments and sports organizations. The integration of chiropractic care within sports medicine not only benefits individual athletes but also contributes to the broader development and success of the sports industry as a whole.
Hong Kong's healthcare system is moving toward preventive and primary care to address the complicated demands of the aging population. Chiropractic professionals are in an advantageous position to support a prevention-focused strategy by identifying musculoskeletal problems early, reducing risks, and promoting healthy lifestyles. This article examines how the involvement of chiropractors in public health programs could improve population health in Hong Kong and boost primary care. The inclusion of chiropractors in district health centers and other initiatives would offer safer and more cost-effective choices for treating functional problems and chronic pain. Chiropractors should be involved in policymakers' attempts to create a sustainable healthcare system that meets Hong Kong's long-term healthcare requirements.
Although registered under Hong Kong's legislative framework, chiropractors are not able to certify sick leave, restricting the effectiveness of their services for patients with musculoskeletal issues requiring time away from work. This paper explores the evolution of chiropractic regulation in Hong Kong, the growth of the profession, and the tardy recognition of chiropractors' power to issue sick leave certificates. The chiropractic profession and its patients have long lobbied for this authority, but the government has been slow to respond. This document presents a comprehensive analysis of the benefits and restrictions of allowing chiropractors prescriptive authority for sick leave and requests that this change in policy be considered. Developing responsible criteria for chiropractors to prescribe sick leave within their scope of practice could legitimize chiropractic's position in the population's health and interdisciplinary pain care while lowering the burden on injured workers.
The primary healthcare system in Hong Kong plays a crucial role in addressing the healthcare needs of its population. However, the integration of radiology services into primary care settings has not been fully realized, and there is significant potential for improvement. Incorporating radiology services into primary healthcare can enhance patient care, promote cost-effectiveness, and increase the overall efficiency of the healthcare system by enabling earlier diagnosis and intervention for various health conditions. To successfully integrate radiology services, key strategies include the establishment of public-private partnerships, the adoption of teleradiology and telemedicine services, the development of comprehensive regulatory and policy frameworks, and the exploration of innovative financial models and incentives. By embracing these strategies, Hong Kong can optimize its primary healthcare system and ensure more equitable, effective care for its population.
Patients with pre-existing cervical pathologies who experience dizziness and related neck pain are referred to as having cervicogenic dizziness. We describe a case of a 49-year-old female who presented with acute onset of vertigo and imbalance following self-manipulation of the cervical spine. Examination revealed a restricted cervical range of motion, muscle hypertonicity, and positive neurological signs. Radiographs demonstrated loss of normal cervical lordosis. The patient was diagnosed with cervicogenic dizziness and prescribed chiropractic treatments that included spinal manipulation, soft tissue release, and rehabilitative exercises. After four weeks of care, her symptoms had improved. At the six-month follow-up, the patient remained asymptomatic with a full cervical range of motion. This case highlights the risks associated with neck manipulation and the effectiveness of chiropractic treatment for cervicogenic dizziness. Patients should be counseled to seek evaluation and treatment from appropriate medical professionals for neck issues or dizziness/imbalance.
Bilateral lower-extremity cellulitis is a rare but serious condition that can lead to long-term health complications if left untreated. Herein, we report a case of a 71-year-old obese male with a two-month history of lower-extremity pain and ankle swelling. Magnetic resonance imaging (MRI) revealed the presence of bilateral lower-extremity cellulitis, which was confirmed through blood culture by the patient's family doctor. The patient's initial presentation of musculoskeletal pain, limited mobility, and other features coupled with MRI findings served as indications for timely referral to the patient's family doctor for further evaluation and management. Chiropractors should be aware of the warning signs of infection and the importance of advanced imaging for diagnosing such cases. Early detection and prompt referral to a family doctor for care can help prevent long-term health complications associated with lower-extremity cellulitis.
Hand injuries are extremely prevalent in sports such as ball sports. Delayed diagnosis or improperly managed injuries have the potential to prolong the athlete's return to the competition and permanently damage their abilities. We report the case of a 35-year-old male professional basketball player who presented to a chiropractor with pain and swelling of the right fifth finger two days after a basketball game. The injury occurred when a player passed the basketball and the ball hit his fifth finger "head-on". Examination revealed enlargement of the middle joint of the right fifth finger and a boutonniere deformity. He was diagnosed with a central slip injury using magnetic resonance imaging (MRI). Since there are no standard treatment guidelines for central slip injuries, multi-model chiropractic therapy was applied to the injury and adjacent sites. The patient returned to the game by the end of the third week and fully recovered within six weeks. Chiropractors must understand how to best guide athletes' clinical management of these injuries, given the inherent need for immediate and complete recovery.
We report the case of a 78-year-old woman who presented with a 14-month history of progressive bilateral knee spasms and pain and reduced quality of life. The patient had undergone bilateral total knee arthroplasty after a diagnosis of osteoarthritis and failure of conservative treatment. Symptoms reappeared 8 months postoperatively, and the patient was diagnosed with cervical spondylotic myelopathy. Consequently, she was successfully treated with chiropractic rehabilitation which involved scraping therapy, spinal manipulation, and intermittent motorized traction to relieve cervical nerve pressure. Thus, cervical spondylotic myelopathy should be considered in the differential diagnosis of cases of persistent knee pain.
Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia that's characterised by an abnormal heart rate response to a positional change. A 50-year-old female presented with lightheadedness, palpitation, and neck pain for 3 years. Lightheadedness and palpitation occurred when shifting from a prolonged seated or lying position. Standing radiographs showed spinal misalignment with cervical kyphosis and thoracic scoliosis. Continuous static stress on these minor variants could aggravate biomechanical and autonomic disorder like POTS. After ruling out cardiovascular, neurological, or vestibular pathophysiology, a multicomponent treatment approach was adopted including the use of thermal ultrasound therapy, cervical and thoracic spinal manipulation, and intermittent motorized cervicothoracic traction to manage her neck pain complaints. Following 3 months of regular treatment, the patient reported a full resolution of neck pain, dizziness, and POTS. At 12-month follow-up, all radiographic metrics showed improvement, including improvement of cervical alignment and thoracic curvature. POTS is a prevalent, under-diagnosed dysautonomia. This study might arouse the alertness of clinicians that symptoms related to POTS may be erroneously attributed to other neuro-cardiovascular disorders.
Dropped head syndrome (DHS) is manifested as the inability to maintain the head in an upright posture. It has been associated with a wide spectrum of myopathies and neurological conditions. Isolated neck extensor myopathy (INEM) is one of many potential causes of DHS. This is a case report of a 72-year-old man who presented with degenerative cervical spondylosis and DHS for 2 years. He had previously failed to achieve a positive outcome to medication, cervical collar and exercise rehabilitation. However, he was able to regain his voluntary head control after a 4-month chiropractic program. It is believed that INEM is caused by isolated myopathic changes from chronic injury and overloading of the cervical muscles. Cervical spondylosis has been attributed as the cause of DHS secondary to denervation of the cervical extensors. While INEM associated with degenerative spondylosis is not medically treatable, manipulative therapies may be adopted before considering surgical intervention.
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.
A variety of age-related problems, including salivary secretory disorders, poor oral motor coordination, neuromuscular weakness, neurodegenerative diseases, stroke, and structural changes, can result in swallowing disorders. Given that causes of dysphagia differ from patient to patient, individualized treatment plans tailored toward patients' specific conditions are needed. Here we present a case of an elderly woman with upper neck stiffness and dysphagia sought chiropractic treatment. Radiographic findings suggested cervical spondylosis with a vertical atlantoaxial subluxation. Following 20 sessions of chiropractic treatment, the patient experienced complete relief from neck problems and difficulty in swallowing. Rhythmic swallowing movements are controlled by a central pattern-generating circuit of the brain stem. In this case, the brain stem could have been compressed by the odontoid process of the axis due to C1/2 instability. Cervicogenic dysphagia is a cervical cause of difficulty in swallowing. Cervical complaints in the context of dysphagia are mostly under-estimated. A high degree of clinical suspicion is pivotal in timely intervention.
Neck-tongue syndrome (NTS) is a rarely reported disorder characterised by paroxysmal episodes of intense pain in the upper cervical or occipital areas associated with ipsilateral hemiglossal dysaesthesia brought about by sudden neck movement. The most likely cause of this clinical entity is a temporary subluxation of the lateral atlantoaxial joint with impaction of the C2 ventral ramus against the articular processes on head rotation. NTS is an under-recognised condition that can be debilitating for patients and challenging for the treating physicians. Here, we report a 47-year-old man who fulfilled the International Classification of Headache Disorders, third edition criteria for a diagnosis of NTS was treated successfully with a chiropractic approach. There are currently no consensus guidelines for dealing with this disorder. Reassuringly, chiropractic care for uncomplicated NTS appears highly effective.
Headache Disorders/diagnosis , Diagnosis, Differential , Headache Disorders/therapy , Humans , Male , Manipulation, Chiropractic , Middle Aged , Neck Pain/diagnosis , Syndrome , Tongue Diseases/diagnosis
