Case Reports

Hearing Loss, Otalgia and Neck Pain: A Case Report on Long-Term Chiropractic Care That Helped to Improve Quality of Life
ROBERT COWIN and PETER BRYNER
(Source: Chiropractic Journal of Australia Vol 32, No 4, Dec 2002; pg 119-130)

Abstract: Objective to describe symptom reports, multiple chiropractic assessments and adjustments over 7 years with a patient experiencing neck pain and complex ear symptoms consistent with Meniere’s syndrome. Clinical Features: a 43-year-old female, injured years earlier in a motor vehicle collision, suffered recurrent exacerbations of otherwise continuous neck pain. Later she developed aural symptoms of severe otalgia, hearing difficulty, tinnitus and dizziness that increased and decreased in severity with her neck pain. Intervention and Outcome: The intervention was repeated application of chiropractic adjustments using a modified Pettibon adjusting device. Over 7 years of observation, the subject consistently reported reduction in symptom severity after adjustments, with relief lasting up to 2 months. Consistent with the natural history of Meniere’s syndrome, an overall deterioration was noted during the observation period. Hearing fluctuated in approximate synchrony with changes in angular displacements of upper cervical vertebrae during the treatment period. Conclusion: Observation over an extended period assists in understanding the progression of chronic disorders. This patient experienced substantially reduced symptoms with chiropractic care during the 7-year observation period. Of note is the repeated exacerbation of neck pain that often precedes exacerbation in ear symptoms, along with the relief of both following adjustment and an association between improved hearing and improved cervical alignment… read more
 
Editors’ Comments on above article:
First-time author Dr Robert Cowin, who was the principal clinician, has collaborated with an experienced researcher and writer, Dr Peter Bryner, to produce perhaps the most complex, best-documented case report we have seen. There are so many features that distinguish this paper that it is difficult to know where to begin. One important feature is that the main presenting complaints were non-musculoskeletal, which in itself is fairly unusual in the literature. The length of time the case was followed (7 years) and the patient’s long-term co-operation, especially in keeping detailed diaries, also make the case stand out. It makes an important contribution to assessing how regular chiropractic care might affect the natural history of an ultimately incurable disorder that is characterised by exacerbations and remissions. We have some idea of Cowin’s tenacity in documenting this case, because he has discussed with us various aspects of the work-in-progress from time to time over a period of several years. We have little doubt that it will be judged a landmark paper.”  (Source: Chiropractic Journal of Australia Vol 32, No 4, Dec 2002 pg 117)
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