People scratch the itch with hand, Elbow, itching, Healthcare And Medicine, Men with skin problem concept

Imagine itching constantly for no reason. Imagine consulting several physicians trying a litany of creams, diets and antihistamines only to continue to suffer from discomfort, sleep deprivation and continue scratching until you bled. This is chronic, severe pruritis and it is the primary complaint that a 36-year old male presented with when he sought help from a chiropractor who authored a recent case report on the topic. Here’s the spoiler though: the condition that had eluded other primary care practitioners resolved concomitant with chiropractic care.

The case report in question appeared in the Journal of the Canadian Chiropractic Association, and lead authors of the report to hypothesize that this case of pruritis was linked to some biomechanical dysfunction in the spine. It actually isn’t the only case report involving pruritis. Eleven other case reports exist (and are cited in the recent study), but all eleven involved women and linked the pruritis to the spinal segment or nerve root which was implicated.

That’s where this case report differs: the itching started across his back, but after three years spread to his arms. He would frequently itch until he bled (and even then would still continue to scratch), and the itching prevented him from sleeping well at night. His attempts at other cures included:

  • Consulting several physicians who advised him he was suffering from allergies
  • Prescribed anti-histamines
  • Sleeping pills
  • Moisturizing creams
  • Gluten free, dairy free and hot-pepper free diets
  • Fasting
  • Rotation diets

The case report, available at the reference below, contains full details of the examination and findings but the first thing a reader is likely to notice is the postural pictures of the (deidentified) patient. “He was so stiff that anterior-posterior and lateral x-rays of the cervical, thoracic and lumbar spine were ordered to rule out possible pathologies, such as ankylosing spondylitis, before completion of his physical examination [1].” The examination found mild straightening of the cervical spine and minimal degenerative changes from C4-C6, with anterior disc calcification as well as some narrowing of the L1-L2 disc space. He had substantially reduced cervical range of motion “in all planes” along with T5-T7 restrictions and widespread diaphoresis (sweating).  

Thus commenced a ten session course of care. This occurred weekly due to travel issues. While full details of the chiropractic intervention are outlined in the case report, his progress was noteworthy:

  • The diaphoric (sweating) reaction occurred only in the first few visits.
  • By the fifth visit, his cervical spine was moving normally but his thoracic spine wasn’t extending or gliding forward normally yet.
  • By the seventh visit, he had no open sores or bleeding and was sleeping well without medication.
  • He was treated twice more and then discharged. He experienced complete relief from the condition.

Authors remarked that “The attribution of dermatomally distributed pruritis to spinal cord or spinal nerve root impingement does not appear to be controversial when a frank pathology is evident. Is it possible, however, that spondylogenic pruritis could be triggered by relatively trivial anatomical changes in the vertebral column or purely biomechanical changes as seen in this case?” They went on to remark that the distinction between structural and functional disorders of the spine seemed arbitrary.

We know that case reports are stand-alone cases upon which no greater generalisation can be built. However, this isn’t a standalone case. There are eleven others and in each case the condition was “severe, chronic and …resolved quickly when spinal manipulation was introduced.” There is still limited evidence, which means we still need to do further research, but it certainly looks as if there is something to see here.

But until further research occurs, what we know is this: this man is the 12th person documented in chiropractic literature to recover under chiropractic care, and his recovery must come as a profound relief. It is another piece of evidence in the chiropractic bank that illustrates the healing potential when correct biomechanics are restored to the spine.

References:
1. Faye L, Budgell B, (2020), “Presumptive Spondylogenic Pruritis: A case study,” Journal of the Canadian Chiropractic Association, https://www.chiropractic.ca/wp-content/uploads/2020/09/118460-1_Chiro_64_2f_Faye.pdf

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