Teenage Boy with Low Back Pain Help by Chiropractic Despite Having Rare Health Issues

The Journal of Pediatric, Maternal & Family Health published the results of a case study on October 4, 2021, that documented the improvement of lower back pain in a young teenage boy who also had the rare conditions of May-Thurner Syndrome and Superior Mesenteric Artery Syndrome.

The website WebMD explains, "May-Thurner syndrome, also known as iliac vein compression syndrome or Cockett's syndrome, affects two blood vessels that go to your legs. It could make you more likely to have a DVT (deep vein thrombosis) in your left leg." This condition is basically when an artery in the leg blocks the blood flow from a vein in the leg which can cause a number of issues including pain, swelling and sometimes varicose veins in the left leg.

According to the U.S. Department of Health & Human Services, Genetic and Rare Diseases Information Center, "Superior mesenteric artery syndrome (SMAS) is a digestive condition that occurs when the duodenum (the first part of the small intestine) is compressed between two arteries (the aorta and the superior mesenteric artery). This compression causes partial or complete blockage of the duodenum. Symptoms vary based on severity, but can be severely debilitating. Symptoms may include abdominal pain, fullness, nausea, vomiting, and/or weight loss."

In this case, a 13-year-old boy was brought to the chiropractor primarily for lower back pain. The boy's symptoms began approximately two months earlier while running playing baseball. The boy described that he felt a sharp, aching pain in his left lower lumbar back that caused him to "sit out" for the rest of the game. Although the boy's back pain went away, it returned weeks later while playing basketball. He described the pain as sharp and aching pain that he rated as an 8 out of 10, with 10 being the worst.

After a chiropractic examination, and with the permission of his parents, chiropractic care was started on the boy. He noticed relief after each adjustment but continued to have reoccurrences of his back pain. A computer tomography (CT) scan was performed which showed Superior Mesenteric Artery Syndrome with external compression of the left renal vein and duodenum. The CT scan also demonstrated an external compression of the left common iliac vein suggesting May-Thurner Syndrome.

With these complicating factors, chiropractic care was continued. The boy's progress was slower than expected, but he continued to improve. By his 10th and 11th visits, the boy reported experiencing only mild intermittent low back tightness with activity.

In describing their reason behind publishing this case study, the authors stated, "The primary purpose of this case report is to describe the clinical encounter and outcomes of a pediatric patient presenting with low back pain. Additionally, we wished to document the safety of chiropractic care in a patient presenting with concurrent May-Thurner Syndrome and Superior Mesenteric Artery Syndrome." In their conclusion they wrote, "This case report highlights the benefits of spinal adjustments in children with LBP without adverse events despite comorbidities of Superior Mesenteric Artery Syndrome and May-Thurner Syndrome."