Relief of Asthma with Chiropractic Care - Case Study Example

? Relief of Asthma with Chiropractic Care al Affiliation address, e-mail, phone number Advisor's Abstract Objective: This article describes and discusses relief of asthma in a patient with back and shoulder pain receiving chiropractic care. Clinical features: A patient admitted to a hospital with back pain, shoulder pain and asthma as a co-condition was presented for chiropractic care. Intervention and Outcome: The patient received spinal adjustments based on the full spine technique protocol and analysis with subluxation found at T5 and C2. After six weeks of chiropractic care, the patient was able to exercise without the use of an albuterol inhaler, nearly no chest tightness or shortness of breath and no interruptions of sleep at night due to asthma symptoms occurred. Conclusion: There are a growing number of case reports that provide detail of an improvement in asthma symptoms in patients receiving chiropractic care. Relief of back pain and shoulder pain is also one of the significant improvements that have been reported by this group. However, further studies and data from clinical trials is essential in establishing a direct link between asthma relief and chiropractic care as a form of alternative medicine. Keywords: Spinal manipulation Chiropractic Subluxation Alternative medicine Introduction Asthma, a respiratory disease affects a number of people and is characterized by a certain level of discomfort when breathing (Alcantara, Roo and Oman 7). It affects the lungs and causes narrowing of the airways leading to restricted breathing that can be extremely frustrating. It is considered a chronic respiratory disease as its causes are not fully understood. Over the years, a growing number of not only adults, but children have been diagnosed with the condition prompting government health officials to seek understanding into the condition. The most compelling factors that place one at risk of developing the disease is genetic predisposition. It has been observed that those whose parents or family member have asthma are more likely to develop the condition when compared to those whom the condition does not exist in their families. In addition, environmental exposure to various irritants is also likely to trigger the onset of the condition. Indoor allergens including dust in carpets, bedding and furniture have been known to induce difficulty in breathing; a major symptom of the disease. Outdoor allergens such as pollen and moulds have also been implicated with tobacco smoke, chemical irritants and common air pollutants also topping the list. Other fundamental causes that are not often considered primary include cold air, extreme arousal in the event of anger, fear or joy and certain medication. Beta blockers used in the treatment of high blood pressure and heart conditions, even though considered essential, have been known to trigger the condition. Physical exercise, another leading trigger of asthma, often goes unnoticed as a result of the potential health benefits that are associated with the practice (Field et. al 858). People have participated in exercise activities without fully understanding its role as potential trigger to asthma. This realization limits the level and nature of activity that the patient can undertake prompting common management methods to manage the condition. Asthma is referred to as a chronic respiratory disease because it cannot be cured. Once a person acquired the condition then the best that can be done is proper management to enable the person to perform their day to day activities. The quality of life can be improved through the management of the symptoms that are associated with the condition. The symptoms range in nature from those that are life threatening to those that merely cause a certain level of discomfort to the patient. Medications are often the best option whereby people with life threatening symptoms whereby the drugs are prescribed for a certain period of time. However, those with persistent symptoms often have to contend with taking medication on a daily basis to control the underlying inflammation and prevent symptoms and exacerbations (Field et. al 858). Other common management methods include total avoidance of the triggers that can irritate and inflame the airways. Wearing warm jackets during cold weather, cleaning the house often and avoiding areas where one is likely to inhale cigarette fumes are just but some of the methods of avoidance that one can implement. Each asthma patient must thus learn which triggers to avoid in order to reduce their reliance on medication. A component of patient education is thus essential in the management of the condition as well. Through learning, patients will understand the condition and accept the fact that they have the condition, a process that will enable them to reduce the cost of medication that they use. Although asthma as a disease does not lead to death, the various symptoms that it presents with and failure to adhere to a proper medication regimen can often lead to death. Most asthma patient commonly have inhalers, drugs and other steroids on standby to manage the condition when it is triggered at any point in their lives. These items can often be found stored in handbags and medicine cabinets in the house as a form of emergency protocol for managing respiratory distress. However, recently, there have been advancements in research that have implicated chiropractic treatments in relieving the condition (Alcantara, Roo and Oman 5). Chiropractic treatment is recommended under the care of a trained professional and is an alternative treatment method that has provided relief for the condition (Balon et. al 1015). The treatment option places emphasis on the concept that the respiratory system is affected by the nervous system. As such, the treatment options seek to improve the functions of the nervous and musculoskeletal system which in turn improves the functioning of the respiratory system (Postles, Taylor and Holt 37). This however, is still a form of alternative treatment and may not work for some patients who may still have to use conventional medicine. The treatment often involves a process that relieves neck and back pain through careful cervical adjustments and spinal thrusts (Cherkin et. al 1023). The effects of the treatments may be experienced either immediately or after several months of therapy (Alcantara 30). The result is not only efficient breathing system for asthma patients but also general overall wellbeing of the individual. Case Report A patient identified as #123708 was admitted at C-HOP clinic with upper back pain and shoulder pain. On admission, he filled out a PGIQ form and listed asthma as a co-condition before the initial physical examination. The patient was to be placed under the care for the management of back and shoulder pain in connection to the underlying asthma condition that may have been related. The full spine technique protocol was initiated in order to manage the back and shoulder pain that the patient has presented with. This involves application of specific thrusting movements to the vertebra, utilizing parts of the vertebra and contiguous structures as levers that directionally correct a condition (Alcantara, Roo and Oman 5). This was done with the intention of correcting the alignment, motion and function of vertebral joint and vertebral subluxations. The patient was subjected to this treatment twice in a week; in addition, he also had subluxation in the cervical region at C2 and the thoracic region at T5. Following exposure of the patient to this treatment regimen for 6 weeks, the patient reported some improvement. He was able to exercise without the use of albuterol inhaler and had nearly neither chest tightness nor shortness of breath. He also reported no interruptions of sleep at night due to the symptoms of asthma. Discussion Asthma presents with various symptoms including coughing at night, difficulty in breathing and shortness of breath, wheezing, pain, pressure or tightness in the chest. This presents a considerable level of suffering to children or adults with the condition who may suffer for a long time without relief. The muscles around the airways are constricted and inflamed which is what commonly leads to manifestation of the asthma symptoms (Kaminskyj et, al. 30). If left untreated for long, the condition may lead to a significant deterioration in lung function. Even in the absence of the symptoms, inflammation may still occur which leads to related pain in other areas of the body causing shoulder pain. As such, it is vital that the condition be managed effectively to ensure overall well-being before waiting for the symptoms to be serious. The government's medical care system spends a significant amount of revenue acquiring drugs for the management of the condition for patients all over the country (Hondras, Klaus and Arthur 67). As a result of its complex nature of manifestation, there is no known cure; treatment for the symptoms associated with the conditions can be lifelong making it an extremely costly venture not only for the government, but for the individual as well. Various sections of the spine control different functions of the body allowing one to adapt and live in the environment. The spinal cord acts as the major cable from the brain to the various levels of the spine. Subluxations cause he nervous system to function sub optimally resulting from their interference with the nervous system. The following table shows the various areas of the spine and the nerves that are located in that area (see table 1). Chiropractic care, a concept that has been practiced over the years for the management of musculoskeletal conditions is now increasingly being used to manage asthma in both children and adults. Case studies are increasingly documenting that patients who have been enrolled in chiropractic care no longer need to use asthma medications and inhalers. In addition, they have received significant relief from various asthma symptoms; a situation that has enabled them to resume sports and other physical activities (Alcantara 24). In this study, the chiropractors used a variety of techniques to deliver their care including low force, activator and manual adjusting. The force can be delivered to the patient through a variety of mechanisms that can be as simple as a hand delivered low force blow to a more complicated activator method. The activator method uses the activator adjusting instrument instead of the use of hand adjustments in order to provide a consistent mechanical low force, high speed clicks to the body. Full spine technique protocol and subluxations were implemented in this care. The full spine was examined and adjusted, and the patient also had subluxations in the cervical region at C2 and in the thoracic region T5 of the spine (Alcantara, Roo and Oman 6). The patient received relief from back and shoulder pain through the use of spinal adjustment, which is a technique that has been used over the years. This is as a result of the technique's ability to reduce muscle tension and reduce stress in these patients. In addition, there is an improvement in the neurological functions which lead to an improvement in asthma related symptoms. The full spine technique protocol details a less active manual method during which a three joint complex is taken past the normal range of movement but not too far that could lead to a joint dislocation. It involves the implementation of a dynamic thrust in a manner that does not lead to damage of a joint in which the sudden force is meant to cause an audible release in an attempt to increase the joint's range of motion (Alcantara, Roo and Oman 7). This skill materially varies from one practitioner to another with the duration and amplitude of thrust profoundly affecting the degree of spinal activation. These skills are often employed using the hands which are used to massage, adjust and stimulate the spine in order to achieve the desired effects. Joint misalignment is one of the leading causes of back and shoulder pain, greatly affecting the body's daily functions and ability to heal itself. Vertebral subluxation is also carried out in chiropractic care in which the joint surfaces remain intact (Postles, Taylor and Holt 38). However, the movement integrity, alignment and physiological functions are altered in order to enhance their functions. The biomechanical and neural integrity of the joints is enhanced thus ensuring that they function optimally with minimal resistance that can cause pain to the person (Leboeuf-Yde and Eva 300 And because the effects of this kind of therapy cannot be represented in an x-ray or other form of media, it is becoming increasingly difficult to demonstrate the effects of this therapy on an individual (Gibbs 142). Subluxation is essentially a functional entity and not a structural one that enhances the essential and optimal functioning of the musculoskeletal system (Postles, Taylor and Holt 39). Conclusion There are a growing number of case reports that provide detail of an improvement in asthma symptoms in patients receiving chiropractic care. Relief of back pain and shoulder pain is also one of the significant improvements that have been reported by this group. However, further studies and data from clinical trials are essential in establishing a direct link between asthma relief and chiropractic care. Works Cited Alcantara, Joel, Laura V. Roo, Rosemary E. Oman. Chiropractic Care of a Pediatric Patient with Asthma, allergies, chronic colds and vertebral subluxation. Journal of Pediatric, Maternal and Family Health – Chiropractic. (2009). 3: 1-7. Print. Field, Tiffany, Tanja Henteleff, Maria Hernandez-Reif, Elena Martinez, Kunjana Mavunda, Cynthia Kuhn, and Saul Schanberg. Children with asthma improved pulmonary functions after massage therapy. Journal of Pediatrics 1998; 32(5): 854-858. Balon, Jeffrey, Peter D. Aker, Edward R. Crowther, Clark Danielson, Gerard Cox, Denise O'Shaugnessy , CorinneWalker, Charles H. Goldsmith, Eric Duku, and Malcolm R. Sears. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. New England Journal of Medicine 1998; 339: 1013-1020. Postles, Ali, Heidi H. Taylor, and Kelly Holt. Changes in asthma symptoms and bedwetting in a four year old child receiving chiropractic care: A case report. Chiropractic journal of Australia. (2010). 40: 34-36. Print. Cherkin, Daniel C., Richard A. Deyo, Michele Battie, Janet Street, and William Barlow. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. New England Journal of Medicine 1998; 339: 1021-1029. Alcantara, Joel. The Chropractic Care of a Pediatric Patient with Asthma, a systematic review of the literature to inform clinical practice. Clinical Chiropractic (2012), 15: 23-30. Print. Kaminskyj, Adriene., Michelle Frazier, Kyle Johnstone, and Brian Gleberzon. Chiropractic care for patients with asthma: a systematic review of the literature. J Can Chiropractic Association. (2010). 54: 24-32. Print. Hondras, Maria A., Klaus Linde, and Arthur P. Jones. Manual therapy for asthma. Cochrane Database Systematic Review 2000; 2: 67-68 Leboeuf-Yde, Charlotte, and Eva N. Pedersen . Self reported nonmusculoskeletal responses to chiropractic intervention: A multination survey. Journal of manipulative physiology. (2005). 28: 294-302. Print. Gibbs, Amy L. Chiropractic co-management of medically treated asthma. Clinical Chiropractic (2005). 8: 140-144. Print. Tables Table 1 Area of spine and portion of nerves that are innervated by nerves from that area. Area Nerve supply Upper cervical spine Upper neck C1-C2 Head, face, upper neck. Inner and middle ear, sympathetic nerve system, sinuses, eyes and auditory nerves. Cervical Spine Mid and Lower Neck C3-C7 Neck, shoulders, thyroid, tonsils, teeth, outer ear, nose, mouth and vocal cords. Thoracic spine Mid Back T1-T12 Arms, hands, heart, coronary arteries, oeophagus, trachea, lungs, bronchial tubes, gall bladder, liver, pancreas, stomach, spleen, kidneys, ureters, adrenal glands and small intestines. Lumbar Spine Lower back L1-L5 Large intestines, appendix, abdomen, bladder, reproductive organs, lower back, lower extremities, ankles and feet. Sacrum and Coccyx Basebone or Tailbone Hip bones, tail bone, buttocks, rectum and anus. Source: http://www.echiropractic.net/nervechart.htm COVER LETTER I do hereby declare that this is my original work and has not been presented for publication in any academic or professional institution. Neither has it been presented for consideration for publication in any other academic or professional institution. Name Date Signature Read More