As research starts to delve further and further into the world of non-musculoskeletal possibilities in the world of chiropractic, a new theme is taking its place under the proverbial microscope. This theme goes right to the heart of chiropractic – if chiropractic reduces subluxation so the nervous system can better self-heal and self-regulate, can this translate to better physical resilience? What does this mean for practice members young and old?
We often think of resilience in relation to frailty and ageing, but there is a wider application to the topic. Resilience can be physical, mental or emotional, and is widely interpreted to be our ability to adapt or bounce back. Research has indicated that individuals with high physical resilience can recover more quickly and completely than those with low resilience. (1, 2) While this research came out of the traditional medical model, it’s also an important chiropractic question because the ability to better adapt to our environment is a core aspect of self-healing and self-regulation.
Research in broader health disciplines is beginning to understand this topic and its importance across the lifespan on a deeper level (1,2), and so, it seems, are we.
Here at the Australian Spinal Research Foundation, we define as a ‘diminished state of being, comprising a state of reduced coherence, altered neurological function and altered adaptability’. (3) Thus, the concept of physical resilience aligns well with the chiropractic perspective on adaptability. Reduced physical resilience can be seen as a diminished state of adaptability, which may result in or manifest through subluxation.
With this in mind, a new case report has looked at some core elements of resilience. It is one case report which means we can’t generalize to the whole population, but it provides key insights and it is likely more case reports on similar topics will emerge over time.
The New Case Report
The case study, recently featured in the Asia-Pacific Chiropractic Journal, discussed a 46-year-old female who sought Chiropractic care for constant pelvic pain resulting from a car accident a year earlier. She was new to Chiropractic treatment and reported that activities such as walking for more than 10-12 minutes, lying down, staying in one position too long, or standing for over five minutes made her pain worse. In addition to her primary concerns, she also experienced bilateral shoulder and neck pain.
Upon presentation to the Chiropractic clinic, the patient provided a thorough history and underwent an examination. She had been T-boned on the driver’s side of her car, resulting in a pelvic ring fracture and an L1 vertebra fracture.
The patient’s medical history included abuse, trauma, a gastric bypass, a fall downstairs, an ulcer repair, and a hysterectomy in 2016. She also had a recent history of various medical issues, including sore throat, bronchitis, focus and memory issues, anxiety, stress, depression, and chronic fatigue syndrome. Other concerns included gallbladder issues, stomach pain, sciatica, menstrual issues, and migraines, which had worsened since the car accident. All of these issues could foreseeably impact a persons resilience and stress levels – physically, mentally and emotionally.
She also had a history of balance and coordination issues, poor metabolism, weight control problems, reflux, and asthma. She had present symptoms of ear and sinus infections, sinus congestion, post-nasal drip, migraines, low energy, difficulty sleeping, and pain in various areas. Diagnosed with Crest Syndrome, scoliosis, and scleroderma, she was on multiple medications.
Initial Chiropractic assessments showed various musculoskeletal issues, including a left leg discrepancy, positive tests for sacroiliac dysfunction, and decreased range of motion. Functional neurological exams revealed notable balance and coordination deficits. She had a right head tilt, reduced neck curvature, and forward head position as well as limited neck movement, uneven pelvic alignment on the right side, and a curvature in the lower back bending to the right. Chiropractic analysis found misalignments in the upper cervical, lower back, cervicothoracic junction, and mid-thoracic area.
Following assessment, the patient commenced a course of Chiropractic care comprising two visits per week for twelve visits using a variety of chiropractic techniques (listed in full at the case report below).
After the initial twelve visits, a progress evaluation showed significant improvements for the patient. She reported easier movement and improved sleep quality, finding it easier to fall asleep and stay asleep longer. She was n ow happier and had more energy. She also experienced a reduction in dermatitis breakouts resulting in using less medication. Chronic constipation, occurring every three to four weeks previously, had resolved and was now able to have a bowel movement daily. She noted improved digestion, reduced gas, and decreased heartburn.
Objective measures indicated improvements in autonomic tone and neurospinal function across various assessments. Electromyography (EMG) readings confirmed decreased neurospinal tension, with a modest improvement in the cervical region, reflecting enhanced postural energy expenditure. This is significant considering previous cervical radiographs showed biomechanical changes due to past trauma. Additionally, thermal scans demonstrated enhanced autonomic tone, primarily in the lower cervical region, indicating overall progress in neurospinal health.
The patient stated that her experience with chiropractic had been
‘Absolutely life-changing. Haven’t felt this alive in years.
New to chiropractic care, this patient presented to the clinic hoping for an improvement in mechanical pain. However, given that better nervous system function means better organisation and expression of life, by adjusting her subluxations and removing interference, we allowed for the best possible situation for optimal nervous system functioning, self-regulation and healing, thus significantly impacting quality of life. The significant stressors throughout the patient’s life should give pause for Chiropractors to consider the widespread neurophysiological impact of stress held in the body. It provides an impetus for more research into complex trauma recovery even from a salutogenic perspective – that is building up health rather than reducing symptoms.
We hope to see more reports like this in the future. Understanding and illustrating the ways in which chiropractic might be able to break someone out of years of low resilience and into a greater state of adaptability is something exciting indeed.
References:
- Whitson, H. E., Cohen, H. J., Schmader, K. E., Morey, M. C., Kuchel, G., & Colon-Emeric, C. S. (2018). Physical Resilience: Not Simply the Opposite of Frailty. Journal of the American Geriatrics Society, 66(8), 1459–1461. https://doi.org/10.1111/jgs.15233
- Chhetri, J. K., Ma, L., & Chan, P. (2022). Physical Resilience: A novel approach for healthy aging. Journal of Frailty, Sarcopenia and Falls, 07(01), 29–31. https://doi.org/10.22540/jfsf-07-029
- for Research and Practice. Australian Spinal Research Foundation. https://spinalresearch.com.au/wp-content/uploads/2017/06/The-VertebralSubluxation.pdf
