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Quality of Life Improvement in Patients With Chronic Fatigue Syndrome Following Upper Cervical Chiropractic Care


H. Charles Woodfield, BS Pharmacy, D.C. Bio & Marshall Dickholtz, Sr., D.C., FICA Bio


Journal of Upper Cervical Chiropractic Research ~ December 11, 2012 ~ Pages 92-99 



Introduction: Chronic Fatigue Syndrome (CFS) has an elusive diagnosis and etiology.  Treatment

focuses on alleviation of symptoms and improving a patient’s quality of life. The primary

objective was to observe and record changes in health related quality of life (HRQoL), before

and after a National Upper Cervical Chiropractic Association (NUCCA) Atlas correction, using

the SF 36-Item Health Survey (SF-36).


Methods: Nineteen subjects diagnosed as having CFS according to the 1994 Center of Disease

Control (CDC) diagnostic criteria were studied.  Patients who were fatigued six (6) or more

months and who met four (4) or more diagnostic criteria were evaluated for study inclusion. Data

and study administration were conducted using a practice based research  protocol. Patients

were monitored for a period of six months to insure Atlas alignment was maintained and then

retested with the outcomes measures.


Results: SF-36 results at the end of the study by a paired t-test of SF-36 data (n=19) revealed a

significant increase in the General Health component, from 30.3 pre to 55.6 post (p<0.001) and

Mental Health, from 46.4 to 68.6 (p<0.01). The overall PSQI score decreased from 12.1 to

6.1 (p < 0.05).


Conclusion:  This chiropractic procedure may contribute to an improved quality of life in some

subjects with CFS as demonstrated in improved SF-36. If correction of Atlas misalignment in

clinically diagnosed CFS patients could be the single variable that appears responsible for

self-reported improvement of functional and mental health status, further study is warranted to

determine the utility of this intervention in patient care.  The study was limited by the lack of a

control group and that care was provided by only one practitioner. 


Key Words:  Fatigue Syndrome, Chronic /therapy, Chiropractic /methods, Health Status,

Quality of Life, Questionnaires, Sleep/physiology, vertebral subluxation, NUCCA