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Syndrome : A Highly Effective
Approach Using Manipulative
manipulative treatment (or “body work”) is described which has been very
effective in the treatment of chronic fatigue syndrome.
This approach involves no medication, and can easily be used as an
adjunct to other natural methods such as nutritional therapy, food allergy
removal, heavy metal detox, etc. The importance of structural
treatment in illness is discussed.
Marilyn was a 33 year old career woman, whose father was a
chiropractor. When seen in my office she had a five year history of chronic
fatigue syndrome, which came on following a flu. She had marked irritable bowel
symptoms, headaches, difficulty sleeping, fever, swollen lymph nodes, and low
back pain. She had had previously unsuccessful chiropractic and nutritional care
. After five weeks of treatment, all of her symptoms completely resolved.
was a 50 year old dentist with a 3 year history of chronic fatigue syndrome. She
barely had the energy to work at her practice. All previous work -ups had been unrevealing. After being treated for several
weeks, her symptoms disappeared, and she went on to develop a full size
came in with the longest typed list of
symptoms I had ever seen. She had severe fatigue, was unable to work or
exercise, and was the mother of two. Her symptoms included almost every one of the
usual chronic fatigue line up. After a month of treatment she was symptom free.
She began running, and went back to work.
fatigue syndrome is a debilitating illness characterized by severe fatigue
lasting longer than 6 months, which causes a reduction of at least 50% in one's
daily leisure and employment activities. Other symptoms present
often include fever, swollen lymph nodes, headaches, multiple joint
pains, sleep disturbances,
irritable bowel syndrome, etc.
is extensive discussion in the medical and alternative
literature regarding the etiological agents in CFS.
Some feel the cause is viruses,
yeast, fungus, bacteria ,mycoplasma, or other infectious agents.
Others discuss nutrient deficiencies, food or environmental allergies or
toxins, or other chemical causes. Because
the syndrome often (but not always) starts after a cold or flu, it used to be
referred to as post viral fatigue syndrome.
The occasional existence of it in multiple
members of the same family argues for an infectious or common
environmental agent. The term
“chronic fatigue immune deficiency syndrome” implies a failure of proper
immune response. In spite of all
this, agreement on the offending agent(s) remains elusive.
of all these approaches report successes with their methods.
I also utilize extensive nutritional support, environmental clean-up and
avoidance, food allergy and yeast elimination, etc.
These approaches obviously have great merit.
What I wish to describe here is an adjunctive approach utilizing applied
kinesiological methods and soft tissue manipulation.
Although some of these techniques involve training in specific
chiropractic methods, the most significant ones can be applied by any skilled
body worker. I have treated several
hundred patients with CFS in the past twenty years and have well over an 85%
success rate. Almost all patients return to completely normal functioning.
Unemployed patients typically return to work. Results seem to be long-lasting.
No medication is involved, and there is therefore no danger of side effects
or dependency from this
From a biomechanical or structural point of view, the following
disorders are always examined for, and commonly found and treated.
trigger Points: There are areas of trigger points or muscle spasm all
along the rectus abdominus muscle. When pressed, these trigger points often
cause radiating pain in bizarre patterns. For example, an area of abdominal
spasm when pressed may refer pain up to the substernal area, down to the
anterior or lateral thigh, around to the back, or over to the contralateral
abdomen! There are usually many areas of tenderness on chronic fatigue patients.
However, with treatment by ischemic compression as described by Travell (1) or
Prudden(2), the areas will usually normalize, often within three or four
sessions. When this is done along with the other manipulations, the patient
usually has a marked improvement in their symptoms, and an increase in energy
levels. This technique is a modified version of one described in Hara
Diagnosis, by Matsumoto and Birch (3)
Joint Dysfunction. CFS patients often have a malpositioned sacroileac
joint. This is corrected by standard Applied Kinesiology methods, usually
involving pelvic wedges, as developed by George Goodheart, D. C. (5) and
described in Walther (4). The sacroileac lesion is an old concept in
chiropractic and osteopathic literature. It is one of the central focuses in
Sacro Occipital Technique (7). Because of the size of the joint and it's
location, a disturbance here may give rise to reflex disturbances throughout the
body. Goodheart (5)
in his writings on Applied Kinesiology has theorized that it
often accompanies adrenal dysfunction, contributing to consequent fatigue.
3) Upper cervical
dysfunction. This often gives rise to headaches, neck pain, and in many
cases that I have seen, frequent and lingering
colds. I correct slight malpositions (chiropractic subluxations) in the cervical
vertebrae by a technique I developed of gently opening up the cervical facets by
lightly pressing the transverse processes of the cervical vertebrae. In the past
I have used cervical adjustments and often found that that worked well. However
some patients cannot tolerate that approach, so I developed a much gentler, more
acceptable one. Interestingly, every patient that I have seen with frequent
(often monthly) and lasting colds has responded to
this treatment of their cervical column. After several weeks of
treatment, their colds stop and occur at the "normal" level
of once or twice a year. I have seen many children and adults with this
problem of lowered immune function and so far all have responded to this
thoracic-upper lumbar spinal fixation. This area of the spine provides
nerve supply to the adrenal glands. I believe that treatment to the spine here
strongly stimulates adrenal hormone function. I occasionally manipulate this
area with spinal adjustments but usually I apply the previously mentioned
treatment of loosening the spinal facet joints. This often causes a marked
improvement in energy and immediate increase in vital capacity, because
of it's effect on the diaphragm. Possibly a lot of the improvement in energy
levels from soft tissue manipulation is due to this increase in ventilatory
capacity and the consequent improvement in tissue oxygen saturation.
release of the gastrocnemius muscles. I don't know why this works, but
in Applied Kinesiological thinking the gastrocnemius muscles are related to adrenal function. I speculate that
this may be due to parasympathetic inhibition
through the S1 nerve root (this innervates the gastrocs), but truly I have no
idea. What I have observed is that myofascial release of the gastrocs often
causes a person's stuffed or draining nasal sinuses to open up, and they often
have more energy following treatment. Regardless of the exact mechanism
involved, it seems to help.
adjustment of thoracic fixaations. The thoracic spine is the one area
that I do consistently adjust. Chronic fatigue patients often have irritable
bowel symptoms, and the greater, lesser, and least splanchnic nerves innervate
the digestive system and come from the thoracic segments. Additionally,
respiratory function can be positively influenced by treating thoracic
fixations, either through spinal adjustments or the non-force method previously
of neurolymphatic reflexes for the adrenal glands, thyroid, gonads, liver, and
small intestine. Frank
Chapman, an osteopath in the early 20th century, observed that there are reflexes on the front and back of the torso which,
when rubbed, are of benefit in generally encouraging normal functioning of
related organs. For example, rubbing the sixth intercostal space on the right,
front and back, seemed to aid liver function.
Goodheart revived this method in the 60's and made it an essential part
of applied kinesiology protocol. (4)(5)
release of the teres minor ,quadriceps, and pectoralis major sternal muscles.
As mentioned for the gastrocs, treatment of these muscles seems to enhance the
functioning of their related internal organs, the thyroid, liver, and small
release of the neck flexors and extensors. This often helps open up
blocked sinuses and reduce post nasal drainage. This is not surprising and can
certainly be explained by improved circulation and lymphatic drainage of the
head and neck. Teitelbaum in his
book From Fatigued to Fantastic (6) mentions a connection between chronic
sinus problems and fatigue. I think there
is a lot to this and future research may along these lines would be valuable.
Ileocecal valve misfunction. This is a common area of attention
in Applied Kinesiololgy. Specific symptoms often include bowel dysfunction,
headaches, low back pain, etc. Attention here is an important therapy to reduce
toxicity in CFS patients, and especially those with a candida involvement.
Although candida and yeast infections are usually treated via chemical means
with anti fungals ( natural or otherwise), much of the symptomatology associated
with these syndromes will resolve by manipulation of the ileocecal valve.
Goodheart defined this syndrome in the early 70's,(4) (5),
and I have often seen it dramatically improve patient's symptoms. In
other words, proper mechanical
functioning of the gut will often be enough to eliminate the offending organism.
of diaphragmatic dysfunction. The diaphragm is the second most important
muscle in the body. Improper respiration can easily be seen to lead to fatigue.
We certainly need air to utilize energy. If
diaphragm function is
suboptimal, each breath short changes us of oxygen by a slight amount. At the
end of the day, this can add up to a lot!
13) Correction of
sleep disorders. Sleep disorders are often the causative agent in chronic
fatigue. Any patient with fatigue should be carefully questioned about her sleep
patterns. It is foolish to treat a patient with low energy by giving them
stimulants when in fact they don't sleep well at night. Stimulants to improve
their energy , (even natural ones like DHEA, B1,and herbs that stimulate adrenal
function) may worsen their sleep and compound their problem. Instead, attention
should be focused on getting normal sleep. Often, relieving trigger points and myofascial discomfort in
the neck can help restore normal sleep patterns.
Specific acupuncture points for insomnia may be utilized including H7, P6, An mien 1 and 2, and ear
acupuncture. I have also found areas on the lower part of the sternum and rib
cage which produce a marked relaxation response and greatly improved sleep when
treated. Nutrients which can be of great help in insomnia are 5HTP, melatonin,
CDP choline, calcium, magnesium, potassium, theanine, inositol, niacinamide,
valerian and the lately maligned kava (which the German government has just
Dysfunction and Irritable Bowel Syndrome. The fatigued patient may
be constipated or have diarrhea. Watch out for the chronically
constipated cases of chronic fatigue syndrome! I have seen some patients who
move their bowels once every 7-1o days! No doctor ever asked them about their
bowel habits! Obviously, we know as natural practitioners that daily(or close to
daily) elimination is important. These people will get a lot more energy as
their bowel function and consequent auto toxemia is improved. (Isn't it a wonder
that orthodox medicine still teaches that once weekly elimination is
"normal", even in a patient who is crippled with CFS symptoms?)
found an extremely useful treatment
for chronic constipation is to stimulate acupuncture points
LI 2, LI 4, S36, S40, GB 34, and Liv 3, usually with 30 seconds of digital pressure to
each point, or with a tei shin instrument. This treatment is often effective
even in patients with constipation of decades long standing. It is quite
effective in infants and young children.
manipulation of the body’s structure is an often overlooked factor in illness
in alternative medicine. The emphasis of
most “alternative” practitioners is on chemistry (nutrition, IV therapies,
herbals, pharmaceuticals, etc.), psychology (the various forms of mind body
therapy) or perhaps energetic medicine (acupuncture, homeopathy, therapeutic
touch,etc.) Structural therapies
such as chiropractic and osteopathic manipulation, deep tissue therapies,
cranial sacral therapy, etc. are most often thought of as applicable to
musculoskeletal disorders. The
founders of chiropractic and osteopathy, with perhaps a 19th century
naïveté, certainly envisioned
their techniques as having a much broader scope. Further developments of the
past hundred years have born that out. Many
forms of “ body work” are widely practiced, but often even their
practitioners may be unaware of
their true potential for effectiveness. Applied Kinesiology as developed by
Goodheart in particular has aimed
for a very broad range of symptomatologies.
fatigue syndrome, with it’s wide range of symptoms, responds very well to a
combination of physical interventions. This approach is not widely known for
this disorder, but deserves to be. A
future paper will address nutritional protocols for chronic fatigue. These are
quite effective but in my opinion are much
slower to take effect than when they are combined with soft tissue
manipulation. Patients using the combined protocol in the vast majority of cases
will feel much better in four to six weeks, and often sooner.
J. Kaufman, D. C. , is a practicing
chiropractor in Denver, Colorado. He has practiced chiropractic, applied
kinesiology, myofascial and trigger point therapies, acupuncture, acupressure,
Thought Field Therapy, yoga, and cranial osteopathy since 1978. He has developed
many new techniques in soft tissue therapy and has published over 75
professional papers. He can be reached at (303)
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