Veteran with Myofascial Pain Helped by Chiropractic - A Case Study

The Journal of the Canadian Chiropractic Association published the results of a case study in their April 2023 issue that documented the improvement of a patient suffering with myofascial pain who had been diagnosed with Hirayama disease.

As described on the National Library of Medicine’s website, "Hirayama disease, a rare neurological disease, is characterized by insidious unilateral or bilateral muscular atrophy and weakness of the forearms…" This condition is also known as distal bimelic amyotrophy, and is rare but occurs more frequently in males. This condition typically causes muscular atrophy and weakness of the forearms and hands.

In this case, a 30-year-old U.S. veteran was referred by a Veterans Health Administration (VHA) physical medicine and rehabilitation physician to a VHA chiropractic clinic for neck pain and upper back tension. His history revealed that ten years ago, he began suffering with neck pain and hand weakness that limited his ability to complete his service duties. His condition got worse over the next two years until he finally had to be medically discharged from military. A neurosurgeon determined that the man was not a candidate for surgery and recommended conservative care. For the next eight years the veteran’s care consisted of physical medicine, a rehabilitation physician, psychologists, and occupational therapists.

Upon his first visit to the chiropractor, the man’s symptoms included neck and upper back pain which he rated as a 4 out of 10, with 10 being the worst. He also reported bilateral upper extremity weakness, atrophy, and muscle fatigue which was made worse by aerobic activity and cold weather. He also reported that he had a "clumsiness of his hands" and would commonly drop things and had a loss of dexterity.

After an examination, chiropractic care and specific exercises were started. After several weeks of care, the man reported that he had felt moderate improvement. He reported that his pain had gone from a 4 out of 10 down to zero. Additionally, his neck disability had improved from a 28% disability, down to just 10% as measured by the numeric pain rating scale. The study reports that the man experienced an improvement in his quality of life and there were no adverse reactions or events from his chiropractic care.

In response to this study, Dr. Robert Braile, a chiropractor for over 45 years and past president of the International Chiropractors Association, commented, "People with rare and serious conditions should be encouraged to seek chiropractic care." Dr. Braile further explains, "It’s not that chiropractic treats those types of conditions, but rather that chiropractic removed interference from the body’s nervous system thus allowing the patient own amazing healing abilities to address a wide variety of health problems."