We have placed a big emphasis on adaptability in recent years, even making it a key focus of our annual Case Report Project. Development goes hand in hand with adaptability, and there has been a real buzz around emerging paediatric case reports and trends in this area. That said, there are a few areas that require further research before confident claims can be made. While we can postulate as to what the mechanisms behind their improvements might be, investigations into Asthma improving concomitant chiropractic care is one such issue.
Still, cases do exist in which asthma symptoms have improved while a patient has been under chiropractic care. Being that Asthma affects individuals of all ages, across the world, it’s certainly worth investigating. Prevalence within the paediatric population has been increasing in recent years, with prevalence in school-aged children estimated to be 8.6%. [2,3]
The case report we are discussing this week was published in the Asia Pacific Chiropractic Journal and illustrates the potential for improved adaptability (affecting both structural issues and immune-related issues) when the nervous system is supported through subluxation-based care.
A 9-year-old male was brought to a chiropractic clinic for care by his parents, following an initial diagnosis of bilateral Server’s disease (SD). Sever’s disease is a common condition within the paediatric population, causing pain at the back of the heel. Most often, the condition arises during the developmental phase when the growth plate of the heel is open, with repetitive movement of the Achilles tendon driving the pain. Current conservative treatments include altering activity, shoe design adaptations, use of orthopaedic devices, and stretches targeting the gastrocnemius muscle. Children engaging in high rates of physical activity, and in particular, boys, tend to have a greater risk of developing the condition.
The patient’s paediatrician performed the diagnosis and recommended physical therapy. However, the parents reported minimal improvement during the two months of physical therapy, with the child rating the pain as 6/10 and 7/10 on the right and left sides, respectively. The patient was also experiencing asthma. He had been diagnosed at just six months of age following hospitalisation from breathing difficulties. Thus far, the patient had been taking medication to relieve asthma-related symptoms and was assessed as a ‘poorly controlled condition’ during the initial evaluation using the Childhood Asthma Control Test.
The chiropractor’s examination in the case revealed multiple postural abnormalities and ‘severe’ thermography readings at multiple levels of the spine. This was in addition to severe ankle pain upon palpation and a loss of the arch in both feet.
This case was one in which multimodal care was thought to be best for the patient. Thus, the chiropractor delivered subluxation-based chiropractic care using aspects of the Chiropractic Biophysics Technique (CBP) and the Pettibon System. The care plan included manual and instrument-assisted chiropractic adjustments. Postural correction exercises were completed in the office, as well as home exercises such as cervical extension using a resistance band, as well as Denneroll Spinal Orthotic. The patient received 17 adjustments, at a frequency of about two sessions each week for four weeks.
Essentially, this supported the nervous system, by targeting subluxations through adjustments and nurtured improvements in musculature through stretches and posture correction devices between sessions.
Upon re-evaluation, the patient reported a significant reduction in pain, rating it a 2/10 on both the left and right sides. There was also no pain elicited when the back of the feet was palpated. The loss of arch in the feet persisted, and continued use of Orthotics was advised. However, there was a significant improvement in asthma control, from poorly controlled to well-controlled – a clinically meaningful change, especially given the patient was only a child. The patient’s gait, stance, and posture all improved. Following the examination, the patient was recommended a wellness care plan.
While we certainly need more research into chiropractic care and asthma, this change alone would have made a significant change to his quality of life (and of stress on the parents, foreseeably!).
Care for a paediatric patient is always care for the whole family. As we work to support optimal nervous system function and potentially a reduction in symptoms for the child, we are essentially working to relieve the burden on those who love and care for the patient. In this case, pain and symptoms both decreased.
That’s a win for everyone.
References
- Osuna A, Pérez-Uñate A. Resolution of Asthma symptoms and Improvements in Gait Parameters in a paediatric patient with Sever’s Disease receiving Chiropractic care: A case report. Asia-Pac Chiropr J. 2023;3.4:Online only. URL www.apcj.net/papers-issue-3-4/#OsunaSevers.
- Global initiative for asthma. (2019). Global Strategy for Asthma Management and Prevention. https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-June-2019-wms.pdf
- Center for disease control. (2022, May 25). Most recent national asthma data. https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm
