The patient was referred to a regional university medical center and was to receive extracorporeal shock wave lithotripsy scheduled several days after his initial visit. He was given pain medicine for the waiting period and received daily lumbar spine adjustments, which mildly reduced the pain. He eventually received ureteroscopic laser lithotripsy due to failure of the shock wave unit. The fragment analysis showed a calcium oxalate composition, and the patient was advised to lower his intake of oxalates. The patient had become a vegetarian approximately three months before this first stone episode.
Nephrolithiasis is a common condition likely seen in chiropractic practice.
Although usually relatively easy to recognize, the diagnosis can be elusive if the typical historical factors and diagnostic results are absent or altered. The short-term management of nephrolithiasis includes pain management, stone elimination, and the collection of a specimen to identify the composition and underlying metabolic abnormality. Long-term management is to prevent stone recurrence. Conservative comanagement by the chiropractic physician can be implemented through nutritional means. All Rights Reserved, Dynamic Chiropractic, 2001.