Case report
Chiropractic management of a patient with symptoms of attention-deficit/hyperactivity disorder

https://doi.org/10.1016/j.jcm.2011.10.009Get rights and content

Abstract

Objective

The purpose of this study is to report a case of a child with attention-deficit/hyperactivity disorder (ADHD) who was treated with chiropractic care.

Clinical Features

Parents of a 5-year-old boy with diagnosed ADHD brought him for chiropractic care to address his subjective signs (acting out, ability to follow instructions, and poor home and school performance), which also included waking at night due to asthmatic symptoms and low self-esteem. Palpation revealed hypertonicity and trigger points in the paraspinal muscles at the thoracolumbar region with local pain. A preliminary diagnosis included cervical and thoracolumbar facet joint irritation with concurrent muscle hypertonicity.

Intervention and Outcomes

Treatment including spinal manipulative therapy, soft tissue therapy, and stretching was provided. Treatment began on a thrice-weekly basis and declined to twice weekly over the course of approximately 12 weeks. After 1 year of treatment, subjective improvements were noted in episodes of acting out, ability to follow instructions, and general home and school performance.

Conclusions

The patient improved over 1 year in which he received chiropractic care, including manual treatments such as spinal manipulative therapy and soft tissue therapies. This suggests that there may be a role for doctors of chiropractic in the management of patients with ADHD.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a well-studied condition and is a common childhood-onset psychological disorders.1 The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,2 lists activities such as inattention to homework or chores, inability to follow instructions or remain seated, disorderly behavior, and fidgeting as behaviors consistent with ADHD. Treatment traditionally consists of pharmacological interventions and behavioral treatments.

As in many other areas, though, complementary and alternative (CAM) treatments are becoming more commonly investigated as a potential alternate to pharmaceutical intervention or in combination with other biomedical treatments. The CAM treatments for ADHD range from nutritional interventions such as natural supplements, vitamins, and minerals to biofeedback; to acupuncture3, 4, 5; and to chiropractic care. The evidence supporting the use of chiropractic care is preliminary but suggests that there may be some positive effects.6, 7 The supportive evidence is in the form of case reports and/or case series,8 with few clinical trials investigating the efficacy of chiropractic treatments for ADHD.9 The evidence generally has shown positive trends,10, 11 although the body of evidence remains inadequate. The purpose of this case report is to describe the chiropractic management of a patient with symptoms of ADHD.

Section snippets

Case report

A 5-year-old boy presented with his parents for evaluation of chiropractic treatment options for ADHD. The patient had been referred to a mental health practitioner by his family physician who diagnosed the patient with ADHD 1 year prior. Following biomedical treatments, the patient's parents were seeking alternatives because they thought that previous treatments had not been completely successful in managing his subjective signs of acting out, ability to follow instructions, and poor home and

Discussion

Attention-deficit/hyperactivity disorder is a common pediatric condition characterized by symptoms including inattentiveness, distractibility, hyperactivity, and impulsivity.12, 13 Treatment options for ADHD are varied and wide-ranging and include pharmacological and CAM treatments.

There are few examples in the peer-reviewed literature of clinical studies attempting to determine the effect of spinal manipulative therapy on the symptomatology of ADHD.6, 10, 14 Although the cumulative results

Conclusion

Over the course of a 1-year treatment period, subjective improvement was noted in the behavioral patterns and ADHD-associated symptoms in a 5-year-old patient who was treated with chiropractic care. This suggests that there may be a role for chiropractors in the treatment of patients with ADHD.

Funding sources and potential conflicts of interest

No funding sources or conflicts of interest were reported for this study.

References (18)

There are more references available in the full text version of this article.

Cited by (0)

View full text