Human telomere length (TL) is affected by genetic and environmental factors.1
TL decreases with age and is considered a biomarker of biological aging.2,3 Research has shown that TL is associated with disease and dysfunction throughout the body as well as mortality.3,4 Additionally, lifestyle choices such as diet, tobacco and alcohol use, physical activity and sleep habits have been shown to affect TL.3 Research shows that healthy interventions or removal of unhealthy stressors will have a positive effect on TL.5-10
Interest in telomere lengthening or length maintenance is growing due to the notion that this will slow down or cease a person’s biological clock, providing youthfulness and health longevity.4 The effects of chiropractic care on TL, however, have not previously been studied. In fact, the effects of vertebral subluxation and chiropractic care on youthfulness and health longevity have neither been thoroughly tested nor documented despite being a major focus of chiropractic marketing.
Introduction to telomere length
Common to all documented concepts or definitions of vertebral subluxation in scientific research are some form of biomechanical and neurological dysfunction.11,12 Research across all health disciplines that have studied the spine have concluded that spinal alignment and posture have an impact on health and quality of life (QoL). Moreover, correction of spinal alignment and posture has been shown to alleviate neurological dysfunction.13-16
Many chiropractic techniques claim to produce structural correction of the spine. But few support their claims with clinical scientific evidence. Chiropractic BioPhysics (CBP) has an extensive amount of quality, peer-reviewed scientific evidence showing that the reliable, reproducible correction of spinal and postural misalignment and vertebral subluxation yields improvements in neurological, musculoskeletal, and visceral conditions.13-22 It seems logical to inquire, then, whether improvements in spinal and neurological health have a beneficial impact on TL.
The following is a prospective case report on increased TL and improvements in dysautonomia, QoL, and neck and back pain in a patient following correction of sagittal cervical spinal alignment using Chiropractic BioPhysics Technique. Institutional review board (IRB) approval was issued by the Foundation for Vertebral Subluxation. The manuscript was published in 2017, in volume 11, issue 2 of the Journal of Molecular and Genetic Medicine and indexed in PubMed of the National Institutes of Health.23
A 35-year-old elementary school teacher presented with the primary complaint of neck and mid-back pain at 5/10 on the numeric rating scale (NRS) for five years following a head-on motor vehicle collision (MVC) as well as nocturnal polyuria. The patient reported drinking three to five Mountain Dew soda drinks per day.
Heart rate variability (HRV) was performed and the patient scored 75.35 on the autonomic activity index (AAI) (normal is 80 to 100) and 55.20(S) on the autonomic balance index (ABI) indicating increased sympathetic nervous system (S) activity (normal is 80(S) to 80(P), where P stands for parasympathetic nervous system activity). On the Short Form 36-Question (SF-36) QoL health survey, the patient scored 50/100 in physical function, 20/100 in physical role limitations, 33.33/100 in emotional role limitation, 35/100 in vitality, 76/100 in emotional wellbeing, 62.5/100 in social functioning, 55/100 in pain, 45/100 general health, and 50/100 in change-in-health status (0/100 represents the poorest possible result and 100/100 indicates the best possible result).
The patient had her blood drawn for TL analysis. The patient’s telomere value was 73 and is a calculation of the patient’s TL derived from nucleated white blood cells obtained from whole blood.
Posture analysis revealed anterior head translation. An anterior-to-posterior (AP) cervicothoracic view revealed a spinal alignment within normal limits (WNL). A neutral lateral cervical (NLC) radiograph was analyzed according to the Harrison Posterior Tangent method for sagittal spine views.24-26 The NLC view revealed anterior head translation of 24 mm (normal is 0 mm), an atlas plane line (APL) of -20.2° (normal is -29°), and an absolute rotational angle (ARA) from C2 to C7 of -18.8° (normal is -42°).
Treatment and response
The patient was seen for 36 visits over five months per CBP technique protocols incorporating mirror image exercises, adjustments, and traction to correct the vertebral subluxations of cervical hypolordosis and anterior head translation. Treatments consisted of full-spine chiropractic manipulations and CBP mirror image treatments, which involve placing the patient into an opposite, over-corrected spinal posture during exercises, adjustments, and traction to correct vertebral subluxations.
Mirror image adjustments retrain the patient’s central nervous system (CNS) and spine to adapt to normal posture according to the Harrison Spinal Model. Mirror image exercises retrain the spine for optimum loading position balance. Mirror image cervical extension traction involves a prolonged over-corrected positioning of the spine to counter habituated abnormal spinal alignment and posture allowing for viscoelastic creep and spinal correction to take place.27
The patient stated that she maintained her lifestyle habits throughout care. After 36 visits, the patient was reassessed. The patient reported that her neck and mid-back pain was reduced from NRS 5/10 to less than 1/10. HRV improved to 80.38 on AAI and 88.51(S) on ABI. On the SF-36, the patient improved in all QoL domains. The patient had blood drawn again and her TL increased 8.23 percent, from 73 to 79. Post-treatment NLC X-ray analysis revealed improvements in anterior head translation from 24 mm to 17.7 mm, APL from -20.2° to -25°, and ARA C2-C7 from -18.8° to -27°. The patient reported being virtually pain-free and had been able to sleep through the night without having to micturate.
Discussion and conclusion
This report documents the successful outcome in a 35-year-old patient with neck and mid-back pain, nocturnal polyuria, autonomic dysfunction, and unhealthy spinal alignment and posture consistent with vertebral subluxation. The near complete resolution of symptoms was achieved following the correction of spinal alignment and posture by use of CBP technique protocols.
Certain circumstances and concurrences need to be highlighted in this report. First, the patient did not alter her lifestyle throughout treatment. Most notable is that she continued to drink three to five Mountain Dew sodas per day and still obtained the significant health improvements documented.
Following correction of the cervical spinal alignment and posture subluxations, the patient’s HRV improved considerably from a health risk to WNL. Research has shown that TL and HRV may be directly related to each other and inversely related to organ dysfunction (e.g., nocturnal polyuria), and explains why these variables are related as such for the patient in this study.28 Additionally, improvements in objective health measures (spinal alignment and posture, HRV, nocturnal polyuria, and TL) are directly related to the subjective improvements in the patient’s health (pain NRS and QoL).
Sagittal cervical deformities and vertebral subluxations are orthopedic abnormalities that apply abnormal tensile forces in the brain, brain stem, spinal cord, and nerve roots.29 This is a proposed mechanism for the source of this patient’s health conditions due to their resolution following sagittal cervical spinal correction.
One limitation to this case is the small number of participants (n=1) and lack of long-term follow-up. This study is a prospective case study and, as such, does not lend itself to selection bias. Another limitation is that multiple therapies were applied to the patient. Thus it is unclear which therapies or combination thereof had a positive impact on the patient’s health measures.
This case adds more evidence to claims that cervical spinal alignment may improve autonomic function (HRV and bladder function), QoL, and neck and back pain. Additionally, this case suggests, for the first time, that cervical spinal alignment and posture may be directly related to health longevity as represented by TL. The key word here is may. Case studies prove to be valuable in research by reporting novel and significant results, and providing the first step toward higher levels of evidence.
The Institute for Spinal Health and Performance (ISHP) is currently developing a case series to further study the effects of chiropractic care on TL. Case studies and case series provide a rationale for clinical trial approval from IRBs. And well-designed clinical trials provide conclusive evidence.
The ISHP has developed relationships with a company and laboratory for the collection, stabilization and preparation of saliva and telomere length analysis. The goal is to make health longevity testing a part of chiropractic exams available to chiropractors and affordable for patients. Accountability is essential in healthcare; it is vital for chiropractors to produce, document, and publish significant health improvements with objective results.
The ISHP acknowledges the Foundation for Vertebral Subluxation (Kennesaw, GA) for their contributions in funding laboratory costs for this case study and Chiropractic BioPhysics NonProfit for their support.
Douglas F. Lightstone, DC, is a founder of the Institute for Spinal Health and Performance, a peer reviewer for scientific journals, and a research fellow through the Foundation for Vertebral Subluxation. He has published chiropractic and spinal research in various peer-reviewed journals, is indexed in PubMed, and collaborates on research projects with institutions such as Emory University. He can be contacted through drlightstone.com.
Curtis Fedorchuk, DC, is a founder of the Institute for Spinal Health and Performance, a peer reviewer for various scientific journals, and serves on the executive board of the Foundation for Vertebral Subluxation. He has published chiropractic and spinal research in various peer-reviewed journals, is indexed in PubMed, and collaborates on research projects with institutions such as Emory University. He can be contacted at info@ betterhealthbydesign.com.
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