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Headaches, arm and neck pain
Miss S, 33, visited a chiropractor because she had pain in her neck and right arm, headaches and tightness when rotating her neck. When she was asked about past injuries, she explained how, 16 years ago, she had a fall onto her right shoulder. At first, this resulted in pain in her right shoulder, but over the years she developed neck and arm pain on the left side. By the time of her first visit, she was having constant muzzy headaches, which were made worse by reading or computer work but eased by warmth and watching how she sat. She had seen both a physiotherapist and an osteopath for treatment on her neck and arm in the past, and she was taking non-steroidal anti-inflammatory drugs (such as ibuprofen) prescribed by her GP.
The chiropractor gave Miss S a full examination, including blood pressure, pulse, sensation, reflex and muscle tests. All were normal, other than the range of movement in her right shoulder, and the movement of her neck, which were restricted. He found that some of her spinal joints were not moving properly, affecting the nerves in her neck. He diagnosed chronic traumatic cervical facet irritation – ongoing irritation of the joints of the neck, causing arm pain, due to the fall 16 years ago.
Treatment consisted of chiropractic manipulation to her spine. During the 24 hours following, Miss S had no headache, for the first time in four years. Her symptoms then returned, but less severely, and a treatment plan was agreed. As treatments continued, she experienced increasing improvement. She had a total of ten visits, after which her symptoms were 90% better.
Miss S was advised by her chiropractor to return for more treatment if necessary; as she had had the symptoms for so long, it is likely that they will return from time to time. Now she makes an appointment when she needs to.
Low back, hip and testicle pain
Mr P, 65, had suffered increasing pain in his lower back, hip and left testicle for six months when he consulted a chiropractor. He was asked about previous injuries and his general state of health. He confirmed that he had no history of injury or pain, and had noticed no change in his bowel, bladder or sexual function. To be certain, the chiropractor sent him for blood tests, which ruled out prostate problems such as cancer. He also took X-rays, as Mr P’s doctor had told him he may have an arthritic hip, and there was nothing to be done. The X-rays showed only mild degenerative changes in the left hip and a spinal disc in the lower back.
During the physical examination, the chiropractor found that Mr P had slight tightness in the rotation of his left hip and his left quadriceps muscle (on the front of his upper leg) was weak when tested. In addition, a straight leg raise test showed reduced movement and caused pain in Mr P’s lower back. The diagnosis was chronic insidious mechanical sacroiliitis – ongoing inflammation of the pelvic joint.
The treatment plan consisted of chiropractic manipulation and ultrasound therapy. Mr P’s symptoms disappeared after seven visits and he was discharged.
Elbow and wrist pain
Mrs B, 45, had had pain in her right elbow and wrist for four months, and had been unable to work for two. She told her chiropractor that she had played badminton twice a week. She had also started a new job in an office, which required repetitive use of a computer mouse, six months ago. The pain started in the elbow, then spread to the wrist and the middle finger of her right hand, and kept her awake at night. She had no other history of medical problems, accidents or injury.
When the chiropractor examined her, he found that her right grip was weak, and tests led to a diagnosis of tennis elbow and carpal tunnel syndrome – inflammation of the muscles in the forearm and of one of the nerves that passes through the wrist. This was aggravated by the loss of proper movement in two vertebrae in her neck, which further irritated nerves from the neck down the arm.
Treatment involved manipulation to the elbow, stretching of the carpal tunnel tissues, spinal manipulation, ergonomic advice about the use of her computer and the use of an ice pack to help reduce inflammation. Mrs B’s symptoms began to subside after four treatments. She went back to work after three weeks, and was discharged after eight weeks, when all symptoms had gone.
The parents of a 12-year old boy took him to see a chiropractor when “growing pains” in his back and legs had not responded to painkillers or physiotherapy prescribed by the GP. The GP advised rest, but the pain spread to the boy’s stomach/abdomen, although an ultrasound scan showed nothing of concern.
The boy told the chiropractor that the pain had come on gradually about 18 months before, and was aggravated by playing football or sitting on the floor (in school assembly, for example). It was getting worse and he was starting to miss time from school, although he was in good health otherwise.
During the initial examination, the chiropractor found stiff joints in the thoracolumbar region of the spine – the area of the spine in the middle of the back – but all other orthopaedic and neurological tests showed completely normal results.
The chiropractor therefore diagnosed chronic insidious thoracolumbar facet irritation – gradual development of nerve irritation in that area.
The boy was treated with gentle specific manipulation to the affected joints, and his symptoms started to improve within three treatments. His chiropractor also gave him ergonomic and postural advice and he returned to normal activity and pain free sport within three months.