Chiropractic Palliative Care for a Veteran With Chronic Low Back Pain and Advancing Testicular Cancer: A Case Report

Abstract

Objective

The purpose of this case report is to describe the management of chronic low back pain in a Veteran with advanced testicular cancer.

Clinical Features

A 34-year-old with testicular cancer, status post orchiectomy, was referred to the chiropractor for his chronic thoracolumbar pain at a VA medical center.

Intervention and Outcomes

Palliative treatment included lifestyle counseling, exercise, soft-tissue therapy, spinal mobilization, and low-force drop manipulation. A total of 13 visits occurred over 14 months. Pain intensity temporarily reduced from 5/10 to 3/10 for about 2 to 4 weeks following treatments. Despite persistent urging from multiple healthcare providers, the patient delayed follow-up on a concerning pelvic lesion. Metastatic spread to the lumbar spine was identified 14 months after his referral, and 5 months later he experienced a pathologic L3 vertebral fracture. Nine months after this fracture, widespread metastasis combined with a COVID-19 infection led to his death.

Conclusions

In this case, chiropractic care was provided as palliative care in the context of testicular cancer. His back pain temporarily improved after chiropractic treatment.