Geriatric Chiropractic Care: Case Report Reveals Improvement in Gross Spinal Deformity

For a long time, chiropractors have suggested that chiropractic care may be of benefit right across the age spectrum. The belief has been that, while early intervention is certainly preferable, it is never too late to reap some benefit under chiropractic care. A recent case report seems to have put this idea to the test, with an 87-year old patient presenting for chiropractic care for the first time. 

To make the case more interesting, the patient reported low back pain and disability for the last thirty years. This would almost certainly represent subluxations and compensatory patterns that were quite set in. She reported few injuries other than some minor falls, and a family history of osteoarthritis and osteoporosis.

However, it was the primary complaint of sciatica and chronic low back pain that caused this patient to overcome her self-reported fear of chiropractors and undergo chiropractic care.

The attending chiropractor used the Chiropractic Biophysics® technique to treat the patient, and of course, this began with a thorough physical and radiographic assessment. These revealed the following:

• Restricted lumbar range of motion
• 7/10 on the numerical pain scale for low back pain
• 8/10 on the numerical pain scale for bilateral sciatica which was more prominent on the left leg
• Lower than normal scores on the Health-Related Quality of Life aspect of the SF36 Quality of Life Questionnaire
• Extreme anterior sagittal balance (which is an abnormal front to back posture that sees the patient curved over or hunched forwards), with forward head posture and thoracic kyphosis.

The study’s authors noted that “The patient was treated using CBP [Chiropractic Biophysics] technique methods with the goal of improving the structural alignment of the spine and posture; specifically to reduce the excessive anterior sagittal balance subluxation.” They further noted that these methods, which combine mirror image exercises traction and spinal adjustments, have been “shown to offer superior long-term patient outcomes versus traditional or conventional physiotherapeutic interventions that do not achieve structural correction to the spine [1].”

While a commencement age of 87 years old, and with a 30-year history of pain and disability, one could be sceptical as to the prognosis, the patient responded well to care. Her course of care involved 24 sessions over 8 weeks before re-examination. The re-examination results after the 8-week course of care were positive indeed: she had no sciatic pain on the right side, and a 90% reduction in symptoms on the left, improved lumbar range of motion, low back pain reduced to a 2/10 on the pain scale and an improvement in her Quality of Life scores. Notably, for those who might be nervous about commencing chiropractic care, she reported that she “enjoyed the treatment protocol and was motivated by feeling relief right from the beginning of treatment.”

While certainly, symptomatic relief is likely to be front of mind for the person under care, the paper’s authors paid special attention to the reduction in her structural spinal deformity. They reported a “dramatic improvement of the spine that was accomplished in a short duration” and further remarked that “this suggests that the elderly may not be as fragile as one may presume, and as long as the patient does not have outright osteoporosis, aggressive non-surgical spinal traction methods can be employed safely.”

It is notable that the patient had no other co-morbidities (or co-occurring disabilities or diseases that might affect treatment), however, it still offers up positive indicators for geriatric chiropractic care.

While this case report was a stand-alone, and thus more research is required before we can make generalisations or big claims, it is still noteworthy. It follows other research that indicates chiropractic care can decrease falls risk in older adults and have impacts on proprioception (our sense of where we are in space) and reaction times.

Time and further research will help us understand the mechanisms behind the improvements, but for the meantime, it certainly is a positive indicator.

The full case report, including details on pre and post-adjustment subluxation listings, can be accessed at the reference provided below.

REFERENCES:

Haas, J., Oakley, P., & Harrison, D. (2020). NON-SURGICAL REDUCTION IN ANTERIOR SAGITTAL BALANCE SUBLUXATION AND IMPROVEMENT IN OVERALL POSTURE IN A GERIATRIC SUFFERING FROM LOW BACK PAIN AND SCIATICA: A CBP® CASE REPORT. Journal of Contemporary Chiropractic, 3(1), 45-50. Retrieved from https://journal.parker.edu/index.php/jcc/article/view/101