Improvements in a 16-year-old Female with Fibromyalgia and Postural Orthostatic Tachycardia Syndrome undergoing Upper Cervical Chiropractic Care and Neurorehabilitation
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1
Private Clinic, United States
Background
A 16-year old female presented with chronic symptoms related to fibromyalgia and postural orthostatic tachycardia syndrome. Her chief complaint was a feeling of anxiety and panic during POTS attacks which she felt once per month. She also had complaint of dizziness and wide-spread body pain.
Clinical Features and Intervention:
A comprehensive examination was performed that included an evaluation of the craniocervical junction per the NUCCA protocol, bedside oculomotor exam, and sensorimotor exam. The patient showed increased sway on dynamic balance testing on a foam surface, seated blood pressure measured at 108/83, supine BP at 98/70, standing BP measured at 97/68, seated heart rate measured at 72 bpm, standing resting heart rate measured at 97 bpm, saccadic intrusions on gaze fixation, dysmetria on right finger-to-nose testing, and convergence insufficiency that improved with head tilt to the left.
The patient was seen for 12 weeks. A vectored NUCCA upper cervical correction was performed alone on the first visit. On follow up visits where the patient did not meet the criteria for a NUCCA adjustment, neurorehabilitation was performed using canalith repositioning maneuver, gaze stability exercises, and complex figure-8 movements of her upper and lower extremity.
Results:
The patient self-reported decreased pain and dizziness after 2 weeks of upper cervical corrections along with canalith repositioning maneuvers. At 12 weeks the patient self-reported that she had not had any POTS or fibromyalgia flare ups in over a month and self-reported a 60% improvement in body pain. Seated heart rate measured at 75 bpm and standing heart rate was measured at 81 bpm on 12 week re-exam.
References
1. Woodfield HC, Dickholttz M. Quality of life improvement in patients with chronic fatigue syndrome following upper cervical chiropractic care. J Upper Cervical Chiropr Res. Fall 2012(2012:4):92-99.
2. Aoki M, Sakaida Y, Tanaka K, Mizuta K, Ito Y. Evidence of vestibular dysfunction in orthostatic hypotension. Exp Brain Res. 2012 Mar;217(2):251-259.
3. Moustafa IM, Diab AA. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial. Rheumatol Int. 2015 Jul;35(7):1163-1174.
Keywords:
POTS,
dysautonomia,
Vestibular Rehabilitation,
Chiropractic,
Functional Neurology,
Atlas
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Chung
J
(2018). Improvements in a 16-year-old Female with Fibromyalgia and Postural Orthostatic Tachycardia Syndrome undergoing Upper Cervical Chiropractic Care and Neurorehabilitation.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00062
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Received:
30 Mar 2018;
Published Online:
14 Dec 2018.
*
Correspondence:
Dr. Jonathan Chung, Private Clinic, Royal Palm Beach, United States, jonchungdc@gmail.com