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Haresh Patel


Chiropractic Manipulation, Analgesics, Opioids, Traumatic Brain Injury, Post-Surgical Syndrome, Fracture, Rehabilitation


Objective: To discuss the chiropractic management of a 21-year-old female with constant pain from a non-union fracture in the right hip with post-surgical pelvic fusion and severe traumatic brain injury (TBI). She was initially treated with physiotherapy which improved vestibular functionality and mobility after surgery for three to four months then discharged. This case report aims to contribute to the existing literature about the role of chiropractic care and how it may support patients in decreasing opioid usage for pain relief while recovering from a severe TBI. With the evolving opioid crisis, chiropractors can provide assistance to support the health system by managing patients with musculoskeletal complaints who are suing painkiller medication such as opioids.

Clinical Features: The patient sustained the injury when she fell from a single floor to the ground and landed on her right leg, causing her right hip to fracture and break through the right ischium, also sustaining a severe TBI. She sought chiropractic care 7 months after physiotherapy and 1 year after the incident took place. Seeking improvement in pain in her right hip, lower back and TBI symptoms

Intervention and Outcome: High-velocity low-amplitude (HVLA) chiropractic adjustments were delivered using Diversified technique, alongside mobilizations, soft-tissue therapy and exercise rehabilitation at a frequency of twice a week for 3 weeks, once a week for 6 weeks and once a fortnight for 4 weeks, followed by maintenance once per month. She received rehabilitation exercises/stretches including cardiovascular, vestibular and nutritional advice about 2 weeks into treatment, targeting her severe TBI. After the reduction of the severe TBI symptoms, she underwent rehabilitation for the chief complaint of her right hip. Improvement was seen after every chiropractic visit; she progressed from using morphine for the past year to no painkillers at all in 4 weeks of chiropractic care.

Conclusion: This case study demonstrates the elimination of opioid medication while improving severe TBI symptoms, nonunion fracture pain and post-surgical intervention using chiropractic management. Further research is required to investigate the effects of chiropractic treatment on opioid use in pain management.


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