Treatment of Visceral Disorders Using Manipulative Therapy

As the necessity for researching the effectiveness of chiropractic treatment for visceral conditions is discussed more widely, it might be wise to consider what has been done in this field by manual therapists in Russia (see articles about manual therapy in Russia in "DC" #2 and #4 this year). Unfortunately, the results of most of the Russian studies are unavailable because they are not translated into English, and only some abstracts are available through MEDLINE. Let us take a look at three of them.

Blood Pressure

There are some chiropractic studies which present the effects of adjustment on blood pressure (BP).^1,2,3 Their results show a decrease in both systolic and diastolic BP after treatment,^1,2 and a reduced need on the part of the patient for hypertensive medication.³ Similar results were published by Dr. A.I. Fedin and colleagues in 1991.⁴ They investigated the efficacy of manual therapy (4-7 sessions) along with hypertensive drug (inderal, dorinfar) treatment. Patients were diagnosed with cervical dystrophic and degenerative disease (osteochondrosis in Russian terminology) and vertebrobasilar insufficiency in addition to hypertension. X-ray, rheoencephalography, electroencephalography, and ultrasound Doppler echography of the head and neck vessels was used to document the patients' conditions before, during and after treatment. Improved circulation in the vertebral arteries along with fewer clinical signs of vertebrobasilar insufficiency was noted along with the decrease of BP. The authors note that a small dose of hypertensive medication provides a more consistent and pronounced decrease in BP.

Abdominal Pain Syndrome

To our knowledge, the nonaltered appendix after surgery for "acute appendicitis" is a relatively frequent finding. One of the reasons for this finding is a misdiagnosed abdominal pain due to a spinal syndrome most commonly due to alterations at vertebral motion segments (VMS) of the lower thoracic area of the spine. The article on this subject was published in 1991 by Dr. O.V. Davydov.⁵ He used manual therapy in 36 patients with abdominal pain syndrome, and 30 of them were successfully treated. The author explains the success by recovery of physiological coordination between the elements of the VMS, thus correcting abnormalities in the nerve roots related to compression and affected circulation.

Impaired Hearing

The first chiropractic patient was treated for deafness, but we can find few other studies published on this subject. Dr. L.G. Svatko and colleagues published in 1987 results which address that historical event for chiropractic.⁶ Nineteen patients with hearing defects and cervical spine pathology were treated using manual therapy. DeKlein's audiometric test was used to determine the effectiveness of treatment. Seventeen patients responded to the procedures and the authors showed that it is possible to improve dull hearing by functional blocks of the upper cervical spine, especially in the atlanto-occipital joint.

References

1. McKnight ME, DeBoer KF. Preliminary study of blood pressure changes in normotensive subjects undergoing chiropractic care. JMPT, 1988; 11:261-266.

    

2. Yates RG, Lamping DL, Abram NL, et al. Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. JMPT, 1988. 11: 484-488.

    

3. Plaugher G, Bachman TR. Chiropractic management of a hypertensive patient. JMPT, 1993; 16: 544-549.

    

4. Fedin AI, Kakorin SV, Gaikin AV, et al. Impact of chiropractic methods on blood pressure in patients with essential hypertension and cervical osteochondrosis. Kardiologiya, 1991; 31: 56-59.

    

5. Davydov OV. Spinal syndrome of abdominal pain pathogenesis and treatment. Klin Med, 1991; 69: 90-91.

    

6. Svatko LG, Ivanichev GA, Sobol IL. Manual treatment of impaired hearing associated with cervical spine pathology. Vestn Otolaringol, 1987; 2: 28-31.

Vyatcheslav Kharin, MD, PhD
Medical Research Institute,
Ministry of Internal Affairs, Russia