Chiropractic Management of Patients with Bilateral Congenital Hip Dislocation with Chronic Low Back and Leg Pain
Francisco Dı́ez, DC
Journal of Manipulative and Physiological Therapeutics
Volume 27, Issue 4 , Page 280, May 2004
Objective To discuss conservative methods for treating patients with chronic low back and leg pain associated with the biomechanical and postural alterations related to bilateral congenital hip dislocation.
Clinical Features This report describes the cases of 2 adult female subjects with bilateral congenital hip dislocation without acetabula formation who suffered from chronic low back and leg pain managed conservatively by chiropractic methods.
The first subject is a 45-year-old woman with a 9-month history of right
buttock pain and radiating right leg pain and paresthesia down to the first 2
toes, with a diagnosis of a herniated L4 intervertebral disk. The second subject is a 53-year-old woman who complained of chronic intermittent low back pain and constant unremitting pain on her right leg for the last 3 years.
Intervention and Outcome Chiropractic manipulation utilizing Logan Basic apex and double notch contacts, as well as sacroiliac manipulation on a drop table with a sacrum contact and with a posterior to anterior and superior to inferior (PA-SI) rocking thrust, together with a spinal stabilization exercise program, were used on these 2 patients. Both patients had significant clinical improvement, with reduction on the Visual Analogue Scale (VAS) of 67% and 84%, Oswestry Disability Index improvement of 73% and 81%, and an improvement on the Harris hip score of 71% and 44%, respectively.
Conclusion A conservative management approach, including specific chiropractic manipulation and a spinal stabilization exercise program, can help manage the treatment of adult patients with chronic low back and leg pain related to bilateral congenital dislocation of the hips.
Chiropractic management of Neurofibromatosis (von Recklinghausen’s disease): a case study.
Bedell, LL, Proceedings of the national conference on chiropractic pediatrics.
International Chiropractors Association, Arlington, VA, October 1993, Palm
Springs, California, and November, 1993, Palm Beach, Florida.
This is the case of a 13-year-old white female patient with neurofibromatosis (Von Recklinghausen’s disease).
Chiropractic care was administered to reduce secondary symptomatology and
improve posture. Symptoms included neck and lower back pain, pain in the right temple, and severe aching pain in her lower mid-dorsal region. She also
experienced loss of sleep, amenorrhea and a low energy level, poor muscle tone, anorexia nervosa and depression.
The child was diagnosed with NF at age five by a Public Health Department nurse who noticed that her fine and gross motor skills were slower than normal.
Chiropractic care: a 5mm heel lift was placed on side of sacral inferiority,
which was also the side of lumbar body rotation. Patient received spinal
adjustments and Logan Basic once a week for one month and twice a month for two months. The heel lift was raised to 7mm after three months.
Patient reported less back pain and more energy. The effects of the anorexia
have been reversed as she has gained 20 lbs. in the past year. She resumed her
menses with the help of hormones. Her doctor reports, “Her general appearance has improved greatly and she looks healthier”.