It’s long been said that chiropractic isn’t a treatment modality but a care modality – that is, we care for the nervous system and let the body to the rest. What happens when we check and adjust subluxations is increasingly being supported and explained by important clinical and research studies. Still, case report data plays an important role in telling individual stories of how symptoms have changed or resolved while under care. This creates conversations, raises awareness, and potentially leads to bigger studies. After all, while regulators look at the big studies, the thing that matters the most to the person under care is what it did for them.
One thing that hasn’t come up in chiropractic literature until now is Ehlers-Danlos Syndrome. Ehlers-Danlos syndrome is a connective tissue disorder thought to be caused by a group of inherited disorders affecting joints and skin. People who suffer from this condition might have overly flexible joints, sometimes dislocating easily, and stretchy, fragile skin that might, for example, break easily and not hold stitches well. In more severe cases, vascular Ehlers-Danlos Syndrome (EDS) can lead to the rupture of blood vessels or even the intestines or the uterus. [1]
Given the complications that arise from this condition, you’d be forgiven for thinking chiropractic care is not an option for EDS sufferers. However, a recent case report has emerged, marking the first chiropractic paper on the issue. In the paper, which was published in the Journal of Contemporary Chiropractic, a 24-year-old female sought care for migraines and severe chronic neck and low back pain. She also had bilateral hip pain following recurrent hip dislocations. She already had a medical diagnosis of EDS as well as migraines, recurrent joint dislocations, joint hypermobility and mitral valve prolapse (which occurs when the valve between the right and left chambers of the heart bow back and forth). Additionally, she had Postural Orthostatic Tachycardia Syndrome and Raynaud syndrome.
As a result of her EDS, the patient had undergone several surgeries. She also reported that her migraines came with neck pain and had no known triggers. Chiropractic examination revealed hypertonicity and extensive restricted spinal segments (subluxations). Imaging, including MRI and X-rays were undertaken. Radiographs revealed Spina Bifida Occulta and Juvenile Idiopathic Arthritis. She had suffered a motor vehicle accident two years prior, which provoked an escalation in her back pain and migraine symptoms, at which point she was also diagnosed with Scheurmanns Disease and Kypheoscoliosis. As a young woman, with a lot of life ahead of her and a mounting list of medical diagnoses, it was clearly evident that quality of life was being affected.
Her chiropractor began caring for her using low-force manipulation to relevant spinal segments. A variety of methods are used, including manual, drop and instrument-assisted techniques. Manual pressure is also used for myofascial release in both spinal and extremity muscles. Prior engagement with higher-force chiropractic care had resulted in increased pain and inflammation, but lower-force chiropractic care under this care approach resulted in consistent pain relief after each visit, which lasts for a few days.
As a result, she incorporates chiropractic into her care regime, which now includes low-weight, low-intensity strengthening exercises to improve her function and lengthen the pain-relief effect.
This case report is significant, and well worth the read, as gentler methods of care can make all the difference in cases like these where significant comorbid conditions complicate the persons ability to cope with high-impact adjustments. As obvious from this case report, EDS requires ongoing management. But it starts the conversation about the best methods of supporting people like this, who have complicated health realities and may not think that chiropractic can improve their lives.
Its one case, and more research is required of course, but it may offer hope that some relief is possible. We can’t wait to see what else emerges in time.
Reference:
[1] Lawrence EJ. The clinical presentation of Ehlers-Danlos syndrome. Adv Neonatal Care. 2005;5(6):301-314. doi:10.1016/j.adnc.2005.09.006
