Archive for category Case Studies

Abstract:

The objective of this article is to describe  several cases (n = 3) in which patients with plantar fasciitis,  associated with heel spurs, were successfully treated via chiropractic  adjustments, emphasizing the correction of posterior calcaneal  subluxation.

This particular group of patients presented with heel pain  varying from 2 months to over 4 years in duration. Radiological  confirmation of heel spur was evident in each case. Previously  unsuccessful treatment regimens included oral anti-inflammatants,  steroid injections, orthotics, and sustaining physical therapy. Two of  the patients had been deemed candidates for surgical removal of the  spurs but had declined to pursue that option, electing instead to use  chiropractic care and conservative management in an effort to resolve  the condition.

All patients were treated with short-lever mechanical force,  manually assisted chiropractic adjusting procedures, with special  emphasis to the foot, ankle, and calcaneus. Although the specific nature  of the relevant subluxations varied with each patient, a common  denominator with this particular patient population group was the  occurrence of a posterior subluxation of the calcaneus. All adjustments  were delivered via the use of an Activator Adjusting Instrument and were  comfortably tolerated by each patient. Said treatment resulted in a  complete resolution of all symptoms in this studied group of patients,  with no recurrence being demonstrated over a protracted follow-up period  of time.

The conservative management of heel spur syndrome may be  effectively implemented through the use of specific chiropractic  adjusting procedures in selected patients presenting with this  particular problem Attention to the possibility of posterior subluxation  of the calcaneus should be emphasized during the chiropractic  examination process. Although other pedal subluxations can be involved  as well, the posterior calcaneus is often a common denominator in the  subluxation complex associated with this condition. The use of a  mechanical force, manually assisted short-lever adjusting technique,  such as with an Activator Adjusting Instrument, can provide effective  delivery of the chiropractic treatment. Further study, involving larger  patient populations, should be provided to more thoroughly investigate  this treatment on a wider scale.


Chiropr Sports Med 1995b; 9(2):44-51.

Author information: Polkinghorn BS. Private practice of chiropractic. Santa Monica, CA, USA.

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Abstract

Patients often present themselves for  chiropractic treatment with conditions that may include  contraindications for manipulative therapy. This report describes  successful chiropractic treatment of acute shoulder pain involving a  patient who presented with mixed metastatic carcinoma affecting the  humerus, scapula, and clavicle using an Activator Adjusting Instrument.

The successful outcome of the case demonstrates the possible value of  instrumental chiropractic adjustment in treating neuromusculoskeletal  cases where a forceful, high-velocity adjustment or manipulation would  be contraindicated because of the underlying osseous pathology involved.  Further study into this possibility should be provided to help train  those physicians who are called upon to treat these cases and to help  further define risk management protocols for the chiropractic  profession.


Chiropr Tech 1995; 7(3):98-102.

Author information: Polkinghorn BS. Private practice of chiropractic. Santa Monica, CA, USA.

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Abstract

OBJECTIVE:

To describe treatment of frozen shoulder syndrome (adhesive capsulitis) via conservative chiropractic treatment to the shoulder joint, utilizing specific contact, low force, instrumental adjusting procedures. A case report, providing an illustrative example of the same, is presented along with a review of the relevant literature.

CLINICAL FEATURES:

A 53-yr-old woman suffered severe shoulder pain of over 6 months’ duration. The patient had been diagnosed as having adhesive capsulitis and had undergone a variety of different treatment regimens without obtaining relief, including various NSAIDs, analgesics and physical therapy. At the time of her presentation, her condition had progressed to the point of near total immobility of the shoulder joint, accompanied by severe pain with resulting marked restriction in her normal activities of daily living.

INTERVENTION AND OUTCOME:

The patient’s shoulder was conservatively managed with chiropractic adjustments to the affected shoulder joint, as well as to the cervicothoracic spine. Treatment consisted of mechanical force, manually assisted short lever chiropractic adjustments, delivered via an Activator Adjusting Instrument. Successful resolution of the presenting symptomatology was achieved.

CONCLUSION:

Chiropractic care may be able to provide an effective mode of therapeutic treatment for certain types of these difficult cases. Low force instrumental adjustments, in particular, may present certain benefits in these cases that the more forceful manipulations and/or mobilizations cannot. As such, further formal investigation of this type of therapeutic intervention for treatment of frozen shoulder may be warranted on a larger scale.


J Manipulative Physiol Ther. 1995 Feb;18(2):105-15. [PMID:7790781]

Author information: Polkinghorn BS. Private practice of chiropractic. Santa Monica, CA, USA.

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Abstract

OBJECTIVE:

To present the first reported case of successful chiropractic intervention in treatment of a torn medial meniscus of the knee, the meniscal tear being documented by magnetic resonance imaging (MRI).

CLINICAL FEATURES:

A 54-yr-old woman complaining of right knee pain of several months’ duration with accompanying marked functional impairment was diagnosed as having a tear in the posterior horn of the ipsilateral medial meniscus, verified by MRI studies of the same. Independent consultation with three medical specialists resulted in the unanimous decision that surgical intervention for the purpose of meniscectomy provided the only therapeutic approach indicated for the problem. However, the patient was reticent to undergo said surgical procedure and chose, instead, to utilize chiropractic care and conservative management in an effort to resolve her condition without having to resort to surgery.

INTERVENTION AND OUTCOME:

The patient received chiropractic treatment to the knee via mechanical force, manually assisted short lever chiropractic adjusting procedures (MFMA) utilizing an Activator Adjusting Instrument. Auxiliary treatment included the use of homeopathic therapy as an adjunct to chiropractic care. Said treatment resulted in a complete resolution of the patient’s disability, the patient recovering full function of the knee joint and achieving an asymptomatic status without having to submit to surgical intervention and its possible adverse sequelae.

CONCLUSIONS:

Conservative management of meniscal tears via chiropractic treatment may provide a therapeutically effective and financially cost containing alternative to routine meniscectomy in certain cases involving torn medial menisci of the knee.


J Manipulative Physiol Ther. 1994 Sep;17(7):474-84. [PMID:7989881]

Author information: Polkinghorn BS. Private practice of chiropractic. Santa Monica, CA.

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Abstract

Bell’s palsy is a relatively common, painful, unilateral facial paralysis of unknown etiology. While often claimed to be successfully treated by chiropractic methods, no standard treatment approach is generally recognized within the profession, nor has any report of chiropractic treatment of this condition been reported in the literature. This article discusses two cases of Bell’s palsy successfully treated by mechanical force, manually assisted chiropractic adjusting technique combined with high-voltage electrotherapy. While these two cases do not necessarily represent any rule for the chiropractic treatment of Bell’s palsy by the methods used, or for other chiropractic methods that may be used, they do represent an initial time/treatment “baseline” by which future inter- and intratechnique comparisons may be made for the determination of relative effectiveness.


J Manipulative Physiol Ther. 1992 Nov-Dec;15(9):596-8. [PMID:1469344]

Author information: Frach JP, Osterbauer PJ, Fuhr AW. Activator Methods, Inc., Phoenix, AZ 85060-0317.

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Abstract:

Bell’s Palsy is a relatively common, painful, unilateral facial paralysis of unknown etiology. While often claimed to be successfully treated by chiropractic methods, no standard treatment approach is generally recognized within the profession, nor has any report of chiropractic adjusting technique combined with high-voltage electrotherapy. While these two cases do not necessarily represent any rule for the chiropractic treatment of Bell’s Palsy by the methods used, or for other chiropractic methods that may be used, they do represent an initial time/treatment “base-line” by which future inter-and intratechnique comparisons may be made for the determination of relative effectiveness.


J Manipulative Physiol Ther. 1992 Nov-Dec;15(9):596-8. [PMID:1469344]

Author information: Frach JP, Osterbauer PJ, Fuhr AW. Activator Methods, Inc., Phoenix, AZ 85060-0317.

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Abstract

In this case, a 23-month old female with  chronic otitis media who has undergone traditional medical treatment  with no relief of symptoms finds sustained improvement with chiropractic  care. A mechanism for the etiology of chronic otitis media is  suggested.


Chiropr. 1992; 8(2):38-9.

Author information: Phillips NJ. Private practice of chiropractic, Galion, OH, USA.

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INTRODUCTION

Back pain is frequently accompanied by pain radiating in to the  buttock and above the knee. In severe cases it can extend below the  knee into the foot. Precise diagnosis, of the cause of leg pain is  difficult due to a multiplicity of, causes. First. it can be due to  referral from structures of the spine and pelvis, such as facet,  sacroiliac joints, spinal ligaments, and muscles. This type of pain is  characterized by a diffuse ache. Second, impingement of the nerve roots  which join to form the sciatic nerve. by mechanical means is possible  (e.g.. disc bulge, muscular tension, bony architecture. etc.) or by  swelling secondary to inflammation. If the nerve roots are affected the  pattern of pain usually follows specific derma tomes, and may be  accompanied by one or more neurologic symptom’s. These two causes may  occur concomitantly, creating a confusing clinical picture. While  special examinations such as electro diagnostic tests and imaging  studies may be helpful in making a diagnosis, they are not always  definitive and require close correlation with clinical findings.

Despite reports of effectiveness for treatments such as bed  rest, surgery, exercises, injections, physical therapy modalities and  chiropractic manipulation, no standard approach is recognized in the  profession. This is not surprising since it has been estimated that 80%  of patients with painful sciatic radiation are said to recover in within  3 months. (1) Few reports are available documenting cases and long term  follow-up with standard outcome measures (e.g., Oswestry disability  questionnaire[OLBQ], visual analog scale, or orthopedic tests). (2) This  study presents a case of chronic sciatica treated by mechanical force,  manually assisted short lever adjusting, high voltage electrotherapy and  a video assisted, home stretching program documented with common, easy  to use, outcome assessment tools over a period of two years.


Reference: Paul J. Osterbauer. D.C., Arlan w. Fuhr. D.C.  Activator Methods Inc. Phoenix, Arizona; Proceedings of the  California Chiropractic Foundation’s 293 7th Annual Conference on  Research and Education , Palm Springs , CA , June 19-21, 1992, pp. 293-5.

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Abstract

Two patients with sciatic neuropathy and confirmed disc  herniation were treated with a low force treatment regimen consisting of the Activator instrument adjusting, pelvic blocking, high voltage  galvanic current and exercises. CT scans with multiplanar data imaging  (MPDI) and clinical observation were used to monitor the cases both in  diagnosis and as treatment progressed. The results of the follow up CT  scans in the first case included complete absence of disc herniation.  The second case follow up scan revealed the continued presence of a silent disc bulge at the L3-4 level and partial decrease in a herniation  at the L4-5 level. The bulge appeared to have shifted away from the nerve root. Both patients’ pain levels decreased from severe to  minimal. The patients gained the ability to stand, sit and walk for  longer periods without discomfort; lifting tasks also became easier. The  patients were able to return to full work capacity at three and nine  months respectively. This case study is unique to the literature since it documents the use of a treatment regimen which included low force  adjustments. While no conclusions may be made concerning efficacy of  anyone type of treatment, the favorable patient outcomes are somewhat  encouraging.


Am J Chiropr Med. 1990; 3(1): 25-32.

Reference: Richards GL, Thompson JS, Osterbauer PJ, Fuhr AW. Private practice of chiropractic, Mentor, OH.

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Excerpt

As I start to put pen to paper so to speak, I  cannot help but reflect on the chain of events which brought me to this crucial momentous period in my life where something I am about to write  will actually be published (hopefully).

Rest assured that I have never in the past, nor will ever in  the future, delude myself with the Idea that I am an author, even if I  use the term in the loosest meaning of the word, however there are  things which I have learned in my eight years of practice plus some techniques which evolved from a blending together of various techniques  and knowledge that the time has come to at least share some of this  knowledge with those of you who are receptive to new Ideas.

Early in December, 1981. Dr. Peter Bull, our devoted editor, and myself traveled to North Queensland to give a seminar based on X-Ray  Diagnosis, Sacro-Occipital Technique (S.O.T.) and a composite of  X-Ray/S.O.T. Diagnosis featuring a Central Gravity Line superimposed on  X-Ray films. Peter put the films together from category 1, 2 and 3  standing analysis criteria which I supplied. The first time that I saw  the films was during our composite presentation. Peter showed the films, I then gave a diagnosis using S.O.T. criteria and the adjustment required. The result was 99% accurate which not only pleased the seminar participants, but validate S.O.T. category analysis and impressed an  otherwise pessimistic Editor. And in the words of the Good Book “it came  to pass” that on the flight home, Peter asked me to do I series of  articles on my approach to S.O.T., especially the two versions of a  category 2 or sacroiliac problems.

Time however has not permitted that article to take shape, but  during the social of 13th February, I mentioned my technique for Torticollis to Lindsay Collins and Peter Bull and after a few more glasses of Riesling, I agreed to whip up an article on this particular technique using the Activator.

In future articles, I shall describe the whole approach of  S.O.T. including the two Category 2′s, where sacral balancing cranial  fits into the procedures and why the Deerfield Test is not conclusive re  pelvic/cervical analysis.

The activator technique for Torticollis is actually a  combination of the Dr.’s Fuhr and Lee Activator system and an Atlas analysis of the Sacro-Occipital Technique.

As you are all aware, or you should be, and rest assured if you  are not you will be before long, the acute Torticollis is not an easily  handled patient, the pain and muscle guarding make it almost if not  totally impossible to adjust the patient manually and while some  traction techniques are helpful, nothing can compare with the ease of  correction that the Activator can achieve with very little effort on the  part of the practitioner and absolutely no distress or discomfort to  the patient.

I always remember the words of Dr. Fuhr when he visited  Australia in 1974/75 “that the main fault of a chiropractors today is over adjusting.”


Chiropr J Aust. 1982; 2: 13-14.

Author information: Henningham M.

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