Each patient education article in this column details research documented in Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach, co-edited by Dr. Masarsky and Marion Todres-Masarsky, DC.
Charles Masarsky, DC. Previous articles, a "Talk Back" forum and a brief biography of the author are available online at www.chiroweb.com/columnist/masarsky.
Sometimes a patient mentions a clinical problem almost apologetically, saying something like, "I guess this isn't in your field." For instance, the patient may assume that a bladder problem is the domain of the medical specialist in urology, and has nothing to do with chiropractic.
It is vital to get across the idea that even if we can't fix an internal organ's "machinery," we are very much involved in its "circuitry." The following patient education article should be useful in sending that message.
Most people understand that problems in the lumbar vertebrae (vertebrae in the low back) can irritate the nerves controlling the muscles of the low back. Anyone who has experienced shooting pain from the back into the buttocks, thighs and legs (sciatic pain) has probably figured out that these nerves also control the muscles of the lower limbs. Relatively few people are aware of how nerves from this same region of the spine help control the internal organs. In fact, it is possible for misalignment or restriction (subluxation) of the lumbar vertebrae to disrupt the circuitry of the lower abdominal organs without any low back pain at all. A 36-year-old woman with a history of bladder discomfort, diarrhea, pain during intercourse, and an inability to experience orgasm consulted with a doctor of chiropractic. Despite numerous pelvic surgeries and other medical interventions, her symptoms had continued for 18 years. Interestingly, the patient denied having any history of low back pain.
The chiropractor's examinations revealed evidence of a subluxation of the fifth lumbar vertebra, complicated by disc involvement. After four weeks of chiropractic adjustments, bowel and bladder function were normal. All pelvic pain was gone within eight weeks, and the patient was reportedly enjoying a normal sex life by the time her case was published in the literature.1
While this is a particularly striking case, it is just one of many examples in the chiropractic clinical literature of lumbar spine subluxation being related to pelvic pain and pelvic organic dysfunction.2 When there is no pathology in an organ - when the "machinery" is okay - it is time to check the "circuitry."
References
- Browning, JE. Mechanically induced pelvic pain and organic dysfunction in a patient without low back pain. J of Manipulative & Physiological Therapeutics 1990;13:406-411.
- Browning, JE. Pelvic Pain and Organic Dysfunction. In Masarsky CS, Todres-Masarasky M (editors): Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach, Churchill Livingstone, New York, 2001.
Charles Masarsky, DC
Vienna, Virginia
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