Chiropractic management of a U.S. Veteran with myofascial pain and concurrent distal bimelic amyotrophy (Hirayama disease): a case report.

Background: Distal bimelic amyotrophy (DBMA) also known as Hirayama disease, is a rare, self-limiting motor neuron disease manifesting as atrophy of C7-T1 innervated muscles. We present a case report describing the chiropractic management of neck and thoracic pain in a patient with known DBMA.

Case presentation: A 30 year-old black male U.S. veteran with DBMA presented with myofascial pain of the neck, shoulder, and back. A trial of chiropractic care was undertaken involving spinal manipulation of the thoracic spine and cervicothoracic region, manual and instrument-assisted soft tissue mobilization, and home exercise prescription. The patient reported modest improvement in pain intensity and did not experience any adverse events.

Summary: This case presents the first documentation of chiropractic services in musculoskeletal pain management of a patient with concurrent DBMA. At this time there is no guidance in the existing body of literature for the safety and effectiveness of manual therapy in this population.