Meningitis 

Keywords; meningitis, head neck pain, migraine, chiropractic.


A bacterial or viral infection should always be considered in the patient with a stiff neck and headache, simply because it is so serious. Not many patients with infectious illnesses appear in the chiropractor's office, because this patient is sick. It's a highly contagious disease, so the doctor is also at risk.

In hospital the patient will be immediately be placed in isolation. Because we chiropractors treat so many patients with headache, this is a rare but very serious disease that we should keep in the back of our minds whenever treating the patient with a headache and stiff neck.

This is not the typical stiff neck where you can't turn your head to the side, but flexing the head onto the chest is very painful and severely restricted.

The classic test of Kernig is done with the patient lying on their back, with the hips and knees bent in the so called 90 stroke 90 position. If someone supports your thighs, and straightens your knees, and it causes neck pain, then it's definitely time to get to hospital. Not to your doctor, nor to your chiropractor. Do not pass GO, do not collect $200, GO STRAIGHT TO THE HOSPITAL. Remember this illness may be highly infectious. Your family and acquaintances should immediately be alerted.

The condition may be viral or bacterial. In the latter a rash is common.

Meningitis is a medical emergency. Don't mess around with Chiropractic Help!


Meningitis

SYMPTOMS

Severe headache is the most common symptom (87%) followed by neck stiffness 83%.

The classic triad of diagnostic signs are:

  • unable to flex the neck forwards onto the chest
  • sudden high fever (40 degrees C) and
  • altered mental status. This patient is Sick! with a capital S.

JOHANNESBURG. The Natal Witness, 25th May, 2010.

Tenor Siphiwo Ntshebe, who was to sing Hope at the World Football Cup opening ceremony, died in Port Elizabeth on Tuesday, his record company announced yesterday.

Within a week of realising his dreams of performing at the opening of the WFC he was struck down with the meningitis bug. It's a great sadness, said Sony's chief executive officer, Keith Lister.

Ntshebe, aged only thirty four, and dubbed South Africa's new Pavarotti had just finished recording an album when he was smitten by the bacterial meningitis bug.

A Sony spokesman said the Hope recording was still on the official WFC program. They hadn't yet decided what to do about Siphiwo's album.



Here's a tidbit from the chiropractic coalface. For years I had a weekly date with a good friend at the squash court. He has a spondylolysthesis, a low back condition that required occasional visits to my couch. We knocked a few kilos off after work, added a few more back with a couple beers, and generally shot the breeze. We were also both BMW motorcycle fans, and enjoyed a few rides together. One day he didn't arrive for our match. It was not like him. He phoned the next day to apologise, telling me his better half was in hospital with a very stiff neck.

In hospital? Why not in my office? I asked foolishly.

She died three days later. A teacher, she caught the bug from a child who survived. Has your child or partner got a headache, stiff neck, high temperature and isconfused? Don't mess with it.


These layers of tissues are the meninges that form the covering of the brain and spinal cord. Here you can see them peeled back during an autopsy of a patient who died from meningitis. Can you see the little bleeds where blood vessels have ruptured? This patient certainly had head neck pain.

The meninges extend from the brain right down to the low back, covering the brain and spinal cord. That is why in Kernig's test, straightening the legs stretches the meninges and reproduces the neck pain.

In a slipped disk in the lower back something similar happens, but without the infection. If flexing your head forward onto your chest causes low back pain, you have no fever or stiff neck, then make an appointment today with your chiropractor. 



VACCINATIONS


"Let me tell you the secret that has led me to my goal. My strength lies in my tenacity."

Louis Pasteur


Vaccinations remain a vexed subject in the Chiropractic profession, and I confess I have no strong opinion. That they sometimes cause death and disability is beyond debate. Just recently three healthy babies in the Netherlands died in one week, within ten days of having a vaccination against meningitis. However vaccinations also save many lives and we live today in a world without small pox thanks to Louis Pasteur. Headache and a fever? This is probably not headache chiropractic. Stiff neck with it? Get to the emergency rooms NOW.


Head Neck Pain

Two of the symptoms of meningitis are an every day finding at the Chiropractic Coalface; namely neck pain and headache. 

The difference is the high temperature and that it's neck flexion that is particularly limited which is a less common finding.

Errors of judgement are often made when a disease is not yet in its full blown state. In this case, when the patient has only a slightly raised temerature, perhaps.


NUTRITIONAL CORNER


A FAMILY AFFAIR

The sudden death of my friend's wife certainly shocked me, and her death in some ways never left me. One of those ongoing life's reflections.

Ultimately, I decided to use her story in my fourth book, now pending. Santie Veenstra, only twelve years old, suddenly loses her mother to meningitis with tragic consequences for her life. Until she meets Janet Twycross.

Actually it's a trilogy, and the first book you can sample for free at A Family Affair. It's a bit shocking; get ready to be challenged.



USEFUL LINKS



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Interesting challenges of the day

1. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


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