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Arthritis Research
ORIGINAL RESEARCH
CASE STUDY
Improvement in Cervical Curvature and Health Outcomes in a Patient with Rheumatoid Arthritis Undergoing Chiropractic Care to Reduce Vertebral Subluxation
Jason Pero, DC Bio & David Jockers, DC Bio
Annals of Vertebral Subluxation Research ~ July 26, 2012 ~ Pages 77-81
Abstract
Objective: To report a case of corrective chiropractic management of a woman diagnosed with rheumatoid arthritis.
Clinical Features: A 54 year-old woman presented having previously been diagnosed seven years prior with rheumatoid arthritis. Her chief complaint was severe bilateral polyarthralgia, especially in the hands and fingers. Marked swelling was noted in her hands, fingers, knees, feet and toes. The patient experienced difficulty executing and sustaining weight-bearing activities due to the severity of pain. Methotrexate and Prednisone slightly reduced the pain and inflammation.
Interventions and Outcomes: The patient was evaluated using various assessment tools by the chiropractor including inspection, palpation, surface electromyography and x-ray imaging. The patient underwent chiropractic care that improved an 11-degree hypolordotic cervical curve to 21 degrees and an anterior head translation (AHT) of 33 mm to 29mm. The SEMG scan improved from severe hypertonicities at C1, C3, C5 and C7 to moderate hypertonicities at C1 and C5 only. Also, the patient’s pain scale was reduced from 9/10 to 1/10. The patient also experienced improved ambulatory gains and is now able to walk up-and-down stairs, dance and exercise without pain.
Conclusion: Chiropractic management was successful in this case report of a middle-aged female with rheumatoid arthritis.
Keywords: Rheumatoid arthritis, RA, chiropractic, subluxation, arthritis, inflammatory arthritis, chiropractic adjustment, CAM
Female, Age 45 years, Rheumatoid Arthritis
This 44-year-old female was diagnosed with RA as a teenager. She had taken arthritis medications for years but was still affected in her knees and wrists. On occassion, she experienced flare-ups of her condition where both knees and both wrists swelled substantially and she would have to have them drained. She reported being most dissatisfied with the condition of her wrists because those stayed swollen no matter how much medication she took. Her rheumatologist had no other advice so she sought help from upper cervical chiropractic care.
During her evaluation, an upper neck injury was discovered. She recalled being involved in an auto accident with her parents shortly before she was diagnosed with RA. Within the first two months of care, she reported substantial improvement in both wrists and knees. A few months later, she went back to her rheumatologist for a check up and her doctor was "wowwed" because she was so healthy. She was able to discontinue the arthritis medications.
Male, Age 44 years, Ankylosing Spondylitis / Arthritis
This 44-year-old male was diagnosed with Ankylosing Spondylitis (a chronic inflammtory arthritic condition of the spine that can result in spinal fusion) 16 years prior to seeking help from upper cervical care. Over the years, he noticed a decreased range of motion in his spine, primarily in his neck. There had been no medical treatment available to him other than large dosages of anti-inflammatory medications (NSAIDS), which caused stomach bleeding. He also tried various forms of massage to help keep his spine loose; however the inflammation, pain, and loss of range of motion worsened. At the time of his initial upper cervical examination, his 2nd through 5th cervical vertebrae were fused, resulting in a very limited cervical range of motion.
During this 44-year-old's upper cervical chiropractic exam, an upper neck injury was found. After the first 4 weeks of upper cervical care, he noticed that the inflammation had decreased, therefore relieving the pain in his spine and allowing a slight increase in the range of motion. After 4 months of care, he survived the entire summer with no flareups of inflammation and described this period as the most stable his spine had been in a long time. He was able to participate in a triathlon and felt fluid and smooth in his motion which would have previously been stiff and painful. While no reversal of the fusion in his spine is possible, upper cervical care will keep his immune system functioning properly and prevent further inflammation, pain, and fusion.
Male, Age 53 years, Rheumatoid Arthritis
This 53-year-old male was diagnosed with Rheumatoid Arthritis (RA) one year prior to seeking help from upper cervical care. Prior to the RA diagnosis, he had been treated for gout (another form of arthritis) and asthma (also an auto-immune condition). While he thought the gout had been "cured", he had continued problems with joint pain. He tried many medications such as celebrex, which didn't work. Eventually the Rheumatoid diagnosis was confirmed through blood testing. While he was told to take certain medications recommended by his doctor, he chose to take a more alternative route through acupuncture, nutrition, exercise, and other therapies. Unfortunately, none had a profound effect so he began reconsidering taking the medications but he was concerned about the long-term side effects. Before he began the medications, he was referred for an upper cervical chiropractic evaluation.
At the time of his initial chiropractic evaluation, his most profound joint pain existed in his fingers, knees, ankles, bottoms of his feet, and left hip. He also complained of low back and neck stiffness. His knees were so swollen that they required frequent draining, sometimes as many as 40-70 cc's worth of fluid, and were so painful that he could hardly walk. Attempting to run was impossible due to the pain.
During his initial evaluation, an upper cervical injury was discovered. He recalled several traumas in his past which could have caused the injury including being punched in the face in high school as well as various sports accidents. During the first month of care, he reported noticing little change in the amount of swelling in his joints, however, the pain had decreased and he could move around a bit more. During the second month of care, the swelling decreased somewhat so he stopped having to drain his knees. By the third month of care, he was reporting feeling better and not having any flare-ups of any joint swelling. Six months after initiating upper cervical care, he stated that he felt "exceptional", that he had no swelling in his joints, and was able to go for long walks and even runs without pain. At ten months, he said he felt "essentially cured". When his blood work was retested, all values were normal and the elevated rheumatoid factor was no longer found in his blood.