Chiropractic care and the Situs Inversus patient: Modifying technique to match anatomy

Zablotney J, Blum CLJ Chirop Ed.2009;21(1): 119

INTRODUCTION: In situs inversus totalis the heart chambers, lung lobes, abdominal organs and colon are all found in a mirror image arrangement of normal. The purpose of this paper is to present a novel case report of a patient with situs inversus treated by chiropractic care involving chiropractic manipulative reflex techniques (CMRT) modified to the patient’s condition.

CASE REPORT: The Assessment: This patient was a 60 year old mother of 4 who has been a chiropractic patient for over 20 years receiving spine-only chiropractic care. The patient began care in this office in and was seen for 16 office visits utilizing Blair Upper Cervical (BUC) x-ray spinography protocols, Sacro Occipital Technique (SOT) categorization, and CMRT procedures. Treatment/Intervention: Her response to Blair and SOT protocols was good and as expected however CMRT protocols needed to be modified in novel ways to compensate for her situs inversus presentation. Occipital fiber analysis found an active visceral reflex on 13 out of her 16 visits. On visits that necessitated treatment to the ileocecal or pancreas reflex arc the reflex patterns were opposite to normal.

RESULTS: The outcome to treatment involved reduction in pain and increased function in various areas of the spine, pelvis, and right shoulder as well as reduction of prior sleep disturbances and constipation.

DISCUSSION: While the response to BUC and SOT Category Two protocols were as anticipated, the CMRT evaluation and treatment was unusual based on the patient’s situs inversus presentation. The patient’s immediate response to treatment suggests that further investigations may be indicated.

CONCLUSION: Future studies could compare a blinded evaluation of patients with situs inversus and normal organ anatomy to determine if side of CMRT reflex and referred pain patterns is consistent. Greater research is needed to investigate what subset of patients may respond to viscerosomatic/somatovisceral chiropractic reflex treatment. (This is an abstract from a conference presentation only and does not represent a full work that has been peer-reviewed and accepted for publication.)

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