Chiropractic in Interdisciplinary Rehab: a Case Report
Written by Editor   
Tuesday, December 11, 2018 06:49 PM

Approximately 70% of patients suffering from spinal cord injury (SCI) experience persistent pain, which can substantially influence cognition, emotional status, activities of daily living, and quality of life. Musculoskeletal pain is commonly experienced in both acute and chronic postinjury phases and pharmacotherapy is often an insufficient pain management strategy.  Rehabilitative care for patients with SCI requires multi-specialty coordination to address the common presence of multiple overlapping conditions.

This case report describes interdisciplinary rehabilitation, including chiropractic, for a 51-year-old male recovering from incomplete cervical SCI and multiple comorbidities following an automobile accident.

The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures. The interdisciplinary team formally coordinated rehabilitative care from multiple disciplines. 
  • Internal medicine managed medications, monitored co-morbid conditions, and overall progress. 
  • Chiropractic care focused on alleviating shoulder and thoracic pain and improving spinal and extremity mobility. 
  • Physical therapy addressed upright tolerance, transfer, gait, and strength training. 
  • Occupational therapy focused on hand coordination and feeding/dressing activities. 
  • Psychology assisted with coping strategies. 
  • Nursing ensured medication adherence, nutrient intake, wound prevention, and incontinence management, whereas physiatry addressed abnormal muscle tone.

Eleven months post-admission the patient's progress allowed discharge to a long-term care facility. At this time he was without dysphagia. Orthostatic hypotension and bilateral shoulder pain symptoms were also resolved while bowel/bladder incontinence and upper and lower extremity motor strength loss remained. He was largely independent in transferring from bed to wheelchair and in upper body dressing. Lower body dressing/bathing required maximal assistance. 

This case report demonstrates that several specialties functioning within an interdisciplinary team fulfilled complementary roles to support rehabilitation for a patient with SCI.