Haas Jason W, Fortner Miles O, Woodham Thomas J, Harrison Deed E
Research, Chiropractic BioPhysics (CBP) NonProfit, Eagle, USA.
Chiropractic Biophysics, Western Plains Chiropractic, Gillette, USA.
Cureus. 2024 Sep 1;16(9):e68393. doi: 10.7759/cureus.68393. eCollection 2024 Sep.
We present a case report of a patient suffering from chronic low back pain (CLBP) and chronic non-specific neck pain (CNSNP), both of which were caused and complicated by a physically demanding occupation, a history of mixed martial arts, and lumbar scoliosis. Improvements in patient-reported outcomes (PROs) and radiographic findings were observed following conservative spine rehabilitation. The patient, a 34-year-old male, had experienced chronic spine pain, particularly CLBP and CNSNP, for several years. He reported severe pain and increasing disability after a recent neck injury sustained while practicing jiu-jitsu. Radicular pain, along with numbness and tingling, was noted in the right upper extremity, extending to the first three digits, and there were also altered sensations and temperature changes in both feet. He described sharp, pinching mid-back pain and worsening disability due to the persistent pain, which led him to seek manual manipulative chiropractic spine therapy, though he reported little benefit from it. The patient had relied on over-the-counter pain medications for many years without achieving long-term pain and disability relief, and these medications were no longer used following treatment. Chiropractic BioPhysics® (CBP®) spinal structural rehabilitation protocols were used to improve coronal and sagittal balance, as well as paraspinal muscular strength, addressing posture, mobility, and related aspects. These protocols include postural exercises, postural Mirror Image® traction, and postural spinal manipulative therapy. All PROs improved, with a near resolution of all initial symptoms of chronic spine pain. Outcomes measured included disability indices and health-related quality of life (HRQoL) indicators. Radiographic parameter improvements were significant, demonstrating improved coronal and sagittal balance as a result of the treatment. Following 30 in-office treatments, administered three times per week for 10 weeks, initial outcomes were reassessed. The patient then received 13 in-office treatments periodically over one year, and all initial outcomes were repeated. The improvements remained stable over time. A 26-month follow-up found that the improvements were sustained over a very long period without additional treatment after the 13-month examination. Chronic spine pain, specifically CLBP and CNSNP, is a significant source of suffering and contributes substantially to the global burden of disease. Improvement in HRQoLs, PROs, and objective spine parameters are desirable clinical outcomes. Our case report documents objective improvement in lumbar scoliosis and spine pain, which is rare in conservative studies. This successful treatment of chronic pain with long-term follow-up contributes to the growing evidence supporting conservative, non-surgical treatments for CNSNP and CLBP. Successful management of chronic spine pain was observed in a patient undergoing CBP® treatment. The treatment was designed to address abnormal sagittal and coronal postural balance and radiographic abnormalities indicating spinal misalignment and reassess progress in PROs, as well as objective and subjective HRQoL measures, both following treatment and 13 months later. However, larger studies are needed to draw firm conclusions regarding the efficacy of this treatment for chronic pain.
我们报告一例患有慢性下腰痛(CLBP)和慢性非特异性颈部疼痛(CNSNP)的患者,这两种疼痛均由体力要求高的职业、综合格斗史和腰椎侧弯引起并使其复杂化。在进行保守性脊柱康复治疗后,观察到患者报告的结果(PROs)和影像学检查结果有所改善。该患者为34岁男性,多年来一直患有慢性脊柱疼痛,尤其是CLBP和CNSNP。他报告说,最近在练习柔术时颈部受伤后,疼痛加剧且残疾程度增加。右侧上肢出现放射性疼痛,伴有麻木和刺痛,延伸至前三指,双脚也有感觉改变和温度变化。他描述中背部有尖锐的、压榨性疼痛,由于持续疼痛导致残疾加重,这促使他寻求手动整脊脊柱治疗,不过他表示从中获益甚微。该患者多年来一直依赖非处方止痛药,但未实现长期的疼痛缓解和残疾改善,治疗后不再使用这些药物。采用脊椎矫正生物物理学(CBP®)脊柱结构康复方案来改善冠状面和矢状面平衡以及椎旁肌肉力量,解决姿势、活动度及相关问题。这些方案包括姿势锻炼、姿势镜像牵引和姿势性脊柱手法治疗。所有PROs均有所改善,慢性脊柱疼痛的所有初始症状几乎都得到缓解。所测量的结果包括残疾指数和健康相关生活质量(HRQoL)指标。影像学参数有显著改善,表明治疗后冠状面和矢状面平衡得到改善。在进行了每周三次、共10周的30次门诊治疗后,对初始结果进行了重新评估。然后,患者在一年中定期接受了13次门诊治疗,并重复了所有初始结果评估。随着时间推移,这些改善保持稳定。26个月的随访发现,在13个月检查后无需额外治疗的情况下,这些改善在很长一段时间内得以持续。慢性脊柱疼痛,特别是CLBP和CNSNP,是痛苦的重要来源,对全球疾病负担有重大影响。HRQoL、PROs和客观脊柱参数的改善是理想的临床结果。我们的病例报告记录了腰椎侧弯和脊柱疼痛的客观改善,这在保守性研究中较为罕见。这种对慢性疼痛的成功治疗及长期随访为支持对CNSNP和CLBP进行保守性非手术治疗的证据不断增加做出了贡献。在接受CBP®治疗的患者中观察到了慢性脊柱疼痛的成功管理。该治疗旨在解决矢状面和冠状面姿势异常平衡以及表明脊柱排列不齐的影像学异常,并在治疗后及13个月后重新评估PROs以及客观和主观HRQoL指标的进展情况。然而, 需要进行更大规模的研究才能就这种治疗对慢性疼痛的疗效得出确切结论。