Long-Term, Multimodal Chiropractic Care and Outcome Tracking in a Competitive Endurance Athlete With Chronic Neck and Low Back Pain: A Case Report

A 51-year-old male IT executive and competitive endurance athlete (cyclist and half-Ironman competitor) presented with a six-month history of daily chronic neck pain associated with restricted cervical range of motion and episodic low back pain described as a compression sensation.Symptoms had a gradual onset, with no identifiable inciting injury.Postural examination revealed forward head posture, a left-high shoulder, upper thoracic kyphosis, and anterior pelvic tilt.Full-spine radiographs demonstrated loss of normal cervical lordosis, small osteophytes at multiple levels, and mild thoracolumbar scoliosis with degenerative facet changes.No medical diagnosis was established, as the patient was assessed and managed exclusively within a chiropractic setting.The chiropractic working impression was vertebral subluxation complex (VSC) involving the cervical, thoracic, and lumbosacral spine.The patient received chiropractic spinal adjustments, initially twice weekly and gradually tapered to approximately once weekly, over an intensive care phase of 30 visits, followed by a further course of lowerfrequency maintenance care (40 cumulative visits at the last formal review, with care ongoing).Patient-rated global-change scores for neck pain, low back pain, and overall mobility indicated sustained improvement relative to the pre-care baseline, beginning at the first checkpoint and continuing through 40 visits, although some fluctuations were observed.Paraspinal thermography showed reduced cervical asymmetry at the 30-visit review, with a broadly similar lumbar pattern.In contrast, heart rate variability (HRV) parameters were paradoxically lower at the 30-visit review than at baseline, coinciding with a self-reported period of acute occupational stress preceding that recording.This case report describes patient-perceived improvement, together with qualitatively assessed improvements in range of motion, during a structured, long-term course of chiropractic care in a highly active patient exposed to cumulative mechanical loading.It also highlights the limitations of interpreting adjunctive autonomic and thermal measures in isolation from concurrent lifestyle stressors and patient-rated outcomes.