It was a condition made famous by the inimitable Celine Dion. Prior to that, it was simply a condition that languished in obscurity, with a prevalence of 1-2 sufferers per million. While it was first recognised in literature in 1956, it hasn’t reached public discourse until now, owing equally to its low prevalence and to its complexity as a neuro-immunological condition on which little research exists.
A new case report in the Asia Pacific Chiropractic looked at a case in which a patient went from wheelchair bound to walking in just nine months following engagement with chiropractic care. But before we delve into this case, let’s talk about what the condition is and what it means for those that are diagnosed with it.
Stiff Person Syndrome
Stiff Person Syndrome (SPS) is an autoimmune disorder where the immune system attacks the body’s own nervous system, interfering with the signals that typically help muscles relax. As a result, the muscles go into a state of constant rigidity, with sudden, painful spasms that can be triggered by something as simple as a loud noise, a sudden movement, or stress. Over time, this stiffness can make movement difficult and impact everyday life in profound ways. Because it’s so uncommon, SPS is often misdiagnosed for years, sometimes mistaken for anxiety, Parkinson’s, or multiple sclerosis, before the real culprit is identified.
Cognitive and mood symptoms are also associated with the condition, along with gastrointestinal dysfunction, and issues with swallowing and bowel movements. Understandably, the condition has severe impacts on quality of life.
The exact cause isn’t fully understood, but it’s often linked with other autoimmune conditions, such as type 1 diabetes, thyroid disease, or certain cancers. The GAD65 antibody, as well as GABA receptors and related proteins, are thought to be central to this condition. Treatment focuses on calming the overactive, inappropriateimmune response and reducing muscle stiffness, often through pharmacological interventions such as muscle relaxants, immunosuppressants, or medications that modulate nerve activity, with benzodiazepines, IVIG, and Botox making up the first line of attack. However, their effectiveness is known to reduce over time. There is currently no cure.
With poor prognostic outcomes, low awareness, and a scarcity of literature on the issue, exploring chiropractic care as a potential management option is vital. It could be argued that chiropractic’s nervous-system-centric approach may be significant in calming the nervous system of people who suffer from SPS. However, the paucity of literature spans to chiropractic, with only one case report in existence and thus an inability to make broader claims.
Of course, more research is needed, especially as we see other research emerge that links chiropractic with neurological and immunological improvements. So let’s examine that one case report and the impact chiropractic care had on this particular patient.
The case report
A 66-year-old female presented for chiropractic care. At the time of her presentation, she was wheelchair bound and had been so for five years owing to the severity of her muscle spasms and other SPS complications. As is typical of the condition, she had confirmed elevated GADD65 levels, and IVIG and Botox treatments had provided temporary relief in the past but were waning in effectiveness. Prior chiropractic carehad been helpful, consistently offering relief for 24-48 hours. She was unable to tolerate physiotherapy.
At the time of presentation, she was suffering from severe and constant spasms which lead to hip, trunk, and knee flexion, as well as ‘ballistic’ spasms of both upper and lower limbs as well as spasms in the neck. She was in a state of constant severe muscle contraction across several areas of the body including feet and toes. This had lead to venous insufficiency, as well as swelling and discolouration in the feet if they were lowered below hip level.
She sought care under a new chiropractor, who started her on a twice-weekly course of care. The specific techniques used were Advanced Biostructural Correction (ABC) with meningeal releases.
While the significant findings of this case report were that she was able to transition from being wheelchair bound to walking with support within six months, and to walking independently and tolerating physiotherapy within nine months, there were other benefits noticed much sooner. After the first treatment, spasms through the whole body reduced, and voluntary movement in the feet began to return. Spasmodic flexion in her torso, hips, and knees reduced to ‘intermittent’ within the first month and she was able to lie down on her back. Within four months, she was able to move her knees at will, she could flex and extend her legs, and began progressing in weight bearing.
This represented a significant change in pain, symptoms, function, and quality of life. Confoundingly, all of these changes were achieved despite a rise in her GAD65 serum levels. With the current level of research (traditional medical and chiropractic), we can’t explain this. All we know is that, in this case, ABC with meningeal release was able to alleviate symptoms and restore function. This may be due to the reduction of mechanical tension in the meninges.
We need more research, specifically randomised controlled trials, but given the extreme rarity of the condition, we can’t expect them to emerge quickly. In the meantime, this is what we know: chiropractic care helped this woman gain significant improvements in pain, function, and quality of life.
If we can offer hope and relief to this population, then that is a beautiful thing. This case report is the first piece of evidence that this is a possibility.
Reference:
Osborne M, Woods B, Chu E. Wheelchair to walking in 9 months: ABC™ Meningeal Releases and Stiff Person Syndrome: A case report. Asia-Pac Chiropr J. 2025;5.3. www.apcj.net/papers-issue-5-3/#OsborneWheelchairWalking
