| OBJECTIVE: To discuss an example of the integration of chiropractic care with medical treatments for the management of chronic LBP in a United States Marine Corps F/A-18 aviator. No previous literature discussing the use of chiropractic care for jet pilots is published. CLINICAL FEATURES: An aviator instructor had insidious severe acute LBP without radiation or neurological deficit, resulting in 24 hours of hospitalization. Spinal degenerative disc disease was discovered on plain film and magnetic resonance imaging. Four months after the initial pain episode, it still took as long as 10 minutes for him to get out of bed due to stiffness and pain. He had discontinued his regular Marine Corps fitness training due to pain avoidance. He experienced severe pain after flying and getting out of the jet. He rated the severity of pain during the day at 1.5 cm on a 10 cm visual analog scale and 7.1 cm upon waking. His modified Roland Morris Disability Questionnaire score was 5 out of 24. INTERVENTION AND OUTCOME: When the pain began he was prescribed naprosyn, diazepam and hydrocodone/acetamiofen for pain control and confined to quarters to rest. The hospital physiatrist provided a home TENS unit, gentle osteopathic manipulation and some home exercises. His pain decreased with prone lumbar extension and hip adductor stretching. A physical therapist recommended back flexibility and core stability exercises, which provided further relief. Chiropractic care was begun approximately 4 months after the initial pain episode and included high- and low-velocity low-amplitude spinal manipulation, soft tissue therapy, home spinal exercise, and an individualized reconditioning program. After 15 chiropractic treatments he had no pain on the visual analog scale and his Roland Morris Disability Questionnaire was rated 0. He was able to fly multiple training missions per week and exercise to Marine Corps standards. CONCLUSION: A course of care integrating flight medicine, chiropractic, physical therapy, and physiatry appeared to alleviate pain and restore function to this F/A-18 aviator with chronic LBP. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. This abstract is reproduced with the permission of the publisher. |
