intervention in menorrhagia through chiropractic and spondylotherapy: a case report

Intervention in Menorrhagia Through Chiropractic and Spondylotherapy: A Case Report

William J. Boro, D.C., C.C. | Annapolis, MD | www.nosnappingnocracking.com

Dr. William J. Boro™, Advanced Chiropractic Techniques™

Hey Doc, you gotta help me!


I don’t want surgery!


“I’ve never had regular periods.

I’ve been bleeding heavily for over two weeks.

My gynecologist says “deal with it.”

Can you help?”


Menorrhagia“Surgical management has been the standard of treatment in menorrhagia due to organic causes (eg, fibroids) or when medical therapy fails to alleviate symptoms. Surgical treatment ranges from a simple D&C to a full hysterectomy.”


Why Chiropractic?

• According to the National Board of Chiropractic Examiners job analysis report, ‘menstrual disorder is the only female reproductive condition that chiropractors see more than rarely’

• 72% of patients with dysmenorrhea also have low back pain


Incidence of Common Female Problems

Fibroids

Benign tumors on the uterus

Affects 4-18% of women



Adenomyosis

Endometrial tissue grows into wall of uterus

Affects 20% of women



Endometriosis

Uterine lining becomes implanted outside the uterus

Affects about 10% of women, 25-35% of infertile women



• Dysmenorrhea—pain during menstruation that interferes with daily activities (50%)

• Menorrhagia—heavy bleeding (20%)


Normal Menstrual Cycles

• 21-35 day cycle, with 3-5 days of bleeding

• Average blood loss 25-80 ml


Normal Tampon Use in a Whole Menstrual Period

In a typical period, a woman will lose 25-80 ml of blood. If regular tampons used, this will soak 9 tampons.


Menorrhagia Tampon Use in 2 Days

This patient was going through a super plus tampon every hour and a half for 2 days straight. This amounts to 32 super

plus tampons, each holding 12-15 grams.


Menorrhagia Facts

• Affects up to 10 million American women in their 40’s and 50’s (that’s 20%)

• Only about a third ever discuss it with their doctor

• Many doctors prescribe: • NSAIDs help reduce blood loss and relieve cramps

• Hormone therapy regulates cycles and reduces episodes of prolonged bleeding

• IUD (progestin) makes the uterine lining thin and decreases blood flow and cramping

• Tranexamic acid controls heavy bleeding


Menorrhagia Symptoms

• Blood loss more than 80 ml

• Period lasting more than 7 days

• Soaking of one or more sanitary products every hour for several consecutive hours


Normal Blood Loss Compared to Menorrhagia

Normal Menorrhagia


Surgical Options

• Hysteroscopy allows a view of the uterine cavity to possibly remove polyps

• D&C scrapes the lining of the uterus

• Endometrial resection removes the lining of the uterus

• Endometrial ablation destroys the lining of the uterus

• Hysterectomy removes the uterus and cervix


Case History

• 37 year old woman

• 5’4”, 164 lb.

• No children

• History of severe pain in left hip, headaches and asthma

• Nonstop menstrual bleeding for 2 weeks

• Similar bout of nonstop bleeding the previous spring


Case History

• Since the age of 16, never had a normal menstrual cycle• Migraines and significant cramping every month• Typical cycles were 36-45 days, with bleeding lasting 7 days• On days 2 and 3, she needs to use a super plus tampon every 1-1½

hours• This calculated to more than 80 ml of blood on each of these days,

which is the high side of normal for an entire period


Case History—MRI (3/29/11)

• Moderate postero-central disc protrusion with annular tear at L4/5, pressing on L5 nerve root bilaterally. Also, mild left lateral stenosis at L4/5.

• Large central and left posterior herniation at L5/S1 with posterior displacement contacting S1 nerve root bilaterally.

• Moderate postero-central disc protrusion with annular tear at L5/S1, pressing on L5 nerve root bilaterally.


Prior Doctor’s Visits

• Gynecologist suspected fibroids

• No fibroids observed on ultrasound

• Hormone levels were normal

• Gynecologist recommended that the patient “just deal with it”

• Patient said to me, “Because you fixed my back and I thought...what the hell? I was willing to try. Plus no cramps, etc. since seeing you.”


Treatment—Three Sessions Over Ten Days

• Positive Trendelenberg

• Positive sitting SLR

• SOT™ CAT II indicators

Assessment—Limited Examination


Visit One—11/6/12

• SOT™ CAT II supine block placement• Standing lumbar adjustment with range of motion• Adjustment to femoral heads bilaterally


Spondylotherapy—Visits One and Two

• 200 beats per minute• C7, 4 minutes• L3, 2 minutes• L5, 2 minutes

Plexor

Pleximeter


Spondylotherapy Applied to C7


Patient reported bleeding had stopped by

the morning after the first treatment


Visit Two—11/13/12 (one week later)

• Adjustment to T3,T5,T7,T9 vertebral levels and discs, using disc plexor • Spondylotherapy, 200 beats per minute• C7, 4 minutes• L3, 2 minutes• L5, 2 minutes


Visit Three—11/16/12 (on the 10th day)

• Adjustment to lumbar spine, discs and associated muscles• Adjustment to cranium using anterior cranial pattern according to

Van Rumpt protocol


Anterior Pattern Findings


Challenging for Pattern DeterminationPosterior sphenoid

Anterior sphenoid


Anterior Pattern Correction


Interview with Patient—3/5/14 (1 ½ years later)

• Patient reports more normal periods• Mostly every 28 days• Not very heavy• Minimal cramping


Spondylotherapy Explained

• Developed by Albert Abrams around 1903

• He believed that visceral reflexes can be evoked by concussion of the spinous processes

• In his words:

“The author has thus far examined about fifty patients who suffer from painful menstruation and has noted points of tenderness located either to the right or left side or both sides of one or more of the spines of the first four lumbar vertebrae. Firm pressure with the end of the thumb over one or more sensitive areas will abolish the pain for several hours or during the entire period of menstruation.”


Spondylotherapy Explained

• Alva Gregory, DC stated that “spinal concussion, combined with adjustment is more effective than either method alone.”

• Spondylotherapy was part of the curriculum at the National College of Chiropractic in the 1940’s

• Stimulation of C7 induces a very decided and general vaso-constriction

• Stimulation of L1-3 produces the following results:• Excites uterine contraction, overcomes uterine hemorrhage

• Overcomes atonic constipation

• Excites contraction of liver, spleen, stomach and intestines

• Increases tone of colon and intestines


Conclusion

• There is little research correlating the relationship of menorrhagia to low back pain.

• There is little research discussing the use of spondylotherapy as a treatment protocol.

• The chronicity of the patient symptoms and the temporal relationship between treatment and response to care is of interest.

• While there have been few studies reported utilizing conservative chiropractic methods in the care of menorrhagia, it appears that such treatment can provide therapeutic benefit to those suffering from this disorder.

• It is hoped that this study may generate greater interdisciplinary cooperation so that patients can have an option of therapy that offers a lower risk than surgery.


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http://www.hystersisters.com/vb2/showthread.php?t=490988

intervention in menorrhagia through chiropractic and spondylotherapy: a case report

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