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Case Study
Resolution of Psoriasis Secondary to Chiropractic Using The
Toftness System Technique: A Case Report
Yoshitaka Tsuji D.C.
Private Practice of Chiropractic,
Kishiwada, Osaka, Japan
Objective: Psoriasis is an immune disorder with dermatological manifestations
whose cause is unknown. For this reason, in the clinical settings of modern
medicine, supportive measures such as drugs are primarily used to address the
problem. However, those symptomatic treatments have been recognized to be
associated with side effects, exacerbation of the disease, or no improvement.
The aim of this study was to examine the efficacy of the Toftness System on
Clinical Features: An 85-year-old male with psoriasis which affected almost his
entire body underwent care using the Toftness System of chiropractic.
Intervention and Outcome: Patient was seen a total of 30 times over a three
month period. Toftness System chiropractic technique was utilized while
reducing vertebral subluxations. Dramatic improvements were observed
Conclusion: Significant improvement of patient’s skin condition was observed,
which confirmed some degree of positive effect of the Toftness System in the
treatment of psoriasis.
Key Words: Toftness System of Chiropractic, Psoriasis, Immune Disorder,
Subluxation, Electromagnetic Energies
Psoriasis is one of the most common conditions of
inflammatory keratosis with no known cause. It is
categorized into five groups depending on the state of the
condition. The groups include plaque psoriasis, guttate
psoriasis, pustular psoriasis, psoriatic erythrodermia, and
psoriatic arthritis.1 Patients with psoriasis develop
patches of skin with dry white, silvery dandruff-like scales.
These scales may be attached to red and slightly raised
skin rashes. There is a clear border between the diseased
patches of skin and healthy skin, although the boundary
appears obscure when it becomes a chronic disease. The
common lodging sites for psoriasis include the scalp,
extensor surfaces of the elbows and knees, areas where
there is a lot of friction, and the lumbosacral region.
A. Vertebral Subluxation Res. May 4, 2011
Psoriasis may develop due to scars or mechanical
irritations, known as Keobner phenomenon. The skin
rashes could spread to the whole body in some cases. In
the initial stage, it starts with one or more small patches,
which grow together to form bigger patches. The skin
rashes are difficult to heal, and often diagnosed as
psoriasis by a dermatologist.2 Patients with extremely
severe skin manifestations are constantly under stress
from the disease, consequently causing serious and
constant distress whenever awake or asleep.
Psoriasis is a typical chronic and refractory disease. Skin
rashes of psoriasis are unique in that when the thick scales
are scraped with a wooden spatula, petechial bleeding
immediately occurs. This is called Auspitz sign.
There are many with psoriasis in Europe and the United
States. In recent years, the number has increased in Japan
as well. It is estimated that there are about 100,000
patients who suffer from psoriasis and other similar
In Japan, many believe that psoriasis is
contagious because it is pronounced “kansen” and means
“infection.” This discrimination and bias have caused many
patients significant psychological damage, eventually
leading to psychological disorders.
Although it is not conclusive, it is said that one’s
constitutional factors (genetic predispositions) combined
with external factors (such as climate change,
psychological stress, fatigue, communicable disease) and
internal factors (such as obesity, hyperlipidemia, diabetes)
might be a cause of psoriasis. It is believed that high fat
intake contributed to the increased number of cases seen
in post-war Japan. Generally speaking, patients are not
given dietary restrictions, but they should be cautious and
avoid diets which may harm one’s general heath because it
may also adversely affect their psoriasis.2
The treatment options are extensive and include
corticosteroids, calcipotriol, tazarotene, methotrexate,
topical and oral retinoid, topical and oral calcineurin
inhibitors, immunosuppressants, immunemodulartory
agents (biologics), and ultraviolet light therapy.3
This case will report on an adult male with psoriasis
undergoing successful chiropractic care utilizing the
Toftness Technique.
Case Report
Patient History
The patient was an 85-year-old male, exhibiting skin
irritations over his entire body. These irritations are seen
in Figure 3 on the face, upper and lower extremities, and
torso. The patient was suffering from extreme skin
itchiness, soreness, and heat sensation. He also had
symptoms suggesting possible prostate cancer. Noticeable
swelling in the lower extremities and abdominal bloating
were observed. The patient was feeling a sense of loss and
stress in his advanced age.
A. Vertebral Subluxation Res. May 4, 2011
Within a month of onset, the skin irritations became very
severe and spread over the entire body. He began
exhibiting various symptoms of psoriasis. The symptoms
included severe skin itchiness, soreness, and heat
sensation. He became physically and psychologically
uncomfortable due to lack of sleep and stress.
The patient went to see a specialist. Upon examination
and testing, he was diagnosed with inflammatory
keratinization of the skin, psoriasis.
The patient was
suspected to have prostate cancer with abnormal immune
and hormonal systems, but no specific cause was
identified. Oral medication and ointment (steroids) were
prescribed by the specialist. The patient was told to
monitor his condition.
Unfortunately, his condition
increasingly worsened day by day. At the discretion of the
patient and with the approval of the specialist, the patient
stopped using any of the prescribed medications and
sought out chiropractic care.
The patient received a total of 30 Toftness System
adjustments over a three month period. Locations subject
to care included sacrum, lumbar, thoracic and cervical
regions, occipital and abdomen. The skin conditions of
psoriasis were visually evaluated using a scale from 1-10,
with 10 being the worst. This was recorded each visit.
The Toftness System
Toftness System treatment was developed in Cumberland,
WI by I. N. Toftness D.C., Ph. C., approximately 7 decades
ago. In this technique, a palpation enhancement device
(Figure1) is used to detect negative millimeter-wavelength
electromagnetic waves emitted from the body. The
examiner holds the palpation enhancement device close to
the patient’s body and uses his/her fingers to detect the
electromagnetic energies to determine the location and the
order/sequence of treatment. Also, the doctor monitors
the amount and direction of pressure applied as well as the
duration of treatment.
An applicator similar to a pressure gauge with graduations
(Figure 2) or a finger is used to apply the pressure. The
amount of pressure is low and gentle enough
(approximately 100g) to be used on anyone without
concerns or fear regardless of age.4,5
According to the chiropractic literature, the Toftness
System has been effective in treating those with pain
syndromes and in those with back pain.6-10 Correlations
were seen in electromagnetic field, heart rate variability,
and visual analog recordings.11-14 Other studies have
looked at reliability, subluxation detection, and
thermographic evaluation.15-18 Two other studies looked at
the effect of Toftness on otitis media in children and on
allergic dermatitis in an infant.19, 20
The results from the visual skin evaluation are plotted in
Graph 1. It shows a gradual decline each visit, eventually
reaching 0 by the 11th visit and remaining there for the
remainder of the care plan. Improvement in the condition
of the skin was seen in Figures 3-10, following Toftness
System care. The patient fell asleep during the initial
session and was thereafter able to sleep and rest well at
Dramatic improvement was observed after just one
session. (Figure 4) After the 3rd session, the swelling of the
lower extremities and abdominal bloating have lessened.
(Figure 6) On some days itchiness was felt more than
others; until about the 10th treatment, some itchiness was
felt while sleeping and from the pressure of the
underwear, etc., but it gradually subsided. (Figure 8)
Given the unusually hot and humid summer season, the
patient felt some skin itchiness or soreness especially after
perspiration, but primary symptoms of skin itchiness,
soreness, and heat sensation had improved.
This case demonstrates that the Toftness System of
Chiropractic indeed had some positive effects on a patient
suffering from psoriasis. Toftness System care is believed
to affect the autonomic nervous system and hormonal
system. This in turn improves the innate ability of the
body to heal and defend itself. In this case, the condition of
psoriasis was improved and helped the patient to recover.
This case described an adult male with psoriasis
undergoing successful chiropractic care utilizing the
Toftness Technique. Further research is warranted in this
area to draw conclusions, as this is only a single case study.
I wish to give my sincere thanks to Dr. Choken Yara, David
R. Toftness, DC, Brian J. Snyder, DC, and John Q. Zhang, MD,
PhD for their guidance in the philosophy, science and
technique of the Toftness System of Chiropractic and for
their assistance in preparing this paper. Similarly, I would
like to thank the members of the Japan Association of
Advanced Toftness System for their fellowship and
support. And finally, I would like to pay my compliments
to Youko Smith for her work in providing the English
translation from the original manuscript of this paper.
Shimizu, Hiroshi Textbook of Modern Dermatology.
Nakayama Shoten, 2005: 241.
Psoriasis Web Site; “Fighting and Overcoming
Psoriasis” a forum for information exchange for
psoriasis patients in Japan.
Merck Manuals 18th Edition; Online Medical Library.
Brian J. Snyder, D.C. Thermographic evaluation for
the role of the sensometer: evidence in the Toftenss
System of chiropractic adjusting.
Thomas Turley, D.C. The Toftenss System of
Snyder BJ, Zhang J. Toftness system of chiropractic
adjusting on pain syndromes: a pilot study in a
multicenter setting J Chiropr Med. 2007 Mar;
Sanders GE, Snyder BJ. Evaluation of the Toftness
system of chiropractic adjusting for subjects with
chronic back pain and chronic tension headaches.
Chiropr Tech. 1996.Feb 8(1):3-9.
Gemmell HA, Jacobson BH, Sutton L. Toftness spinal
correction in the treatment of migraine: A case
study. Chiropr Tech. 1994 May 6 (2):57-60.
Gemmell HA. Treatment of chronic low back pain
with low force manipulation. Chiropr J Aust. 1992
Jun 22(2):54-60.
Hawkinson EJ, Sanders GE, Snyder BJ. Evaluation of
the Toftness system of chiropractic adjusting for the
relief of acute pain of musculoskeletal origin.
Chiropr Tech. 1992 May4 (2):57-60.
Snyder BJ, Zhang J. Toftness system of chiropractic
adjusting on back pain and electromagnetic field
and heart rate variability. Poster presentation; the
Association of Chiropractic Colleges' Thirteenth
Annual Conference, 2006. J Chiropr Educ. 2006 Spr;
Snyder BJ, Zhang J. The effect of low force
chiropractic adjustments for 4 weeks on body
surface electromagnetic field J Manipulative Physiol
Ther. 2005 Mar/Apr; 28(3):159-163.
Snyder BJ, Vernor L, Zhang J. The effect of low force
chiropractic adjustments on body surface
electromagnetic field J Can Chiropr Assoc. 2004
Snyder BJ, Toftness D, Nosco D, Balcavage W, Nindl
G, Zhang J. Comparison of a triaxial fluxgate
magnetometer and Toftness sensometer for body
surface EMF measurement. J Can Chiropr Assoc.
2004 Dec;48(4):273-281.
Gemmell HA, Heng BJ. Interexaminer reliability of
the Toftness instrument for determining need and
side of sacral adjustment. Chiropr Tech. 1994 Feb
(6:1) 17-19.
Gemmell HA, Jacobson BH. Association between
level of acute spine pain and level of sustained
pressure used in the Toftness adjustment. Chiropr
Tech. 1993 Nov (5:4) 150-151.
A. Vertebral Subluxation Res. May 4, 2011
17. Gemmell HA, Jacobson BH, Heng BJ. Interexaminer
reliability of the Toftness radiation detector for
determining the presence of upper cervical
subluxation.Chiropr Tech. 1990 Feb (2:1) 10-12.
18. Snyder BJ. Thermographic evaluation for the role of
the sensometer: Evidence in the Toftness system of
chiropractic adjusting. Chiropr Tech. 1999 May
Figure 1. Palpation Enhancement Device
19. Zhang JQ, Snyder BJ. Effect of the Toftness
Chiropractic Adjustments for Children with Acute
Otitis Media. Journal of Vertebral Subluxation Res.
March 29, 2004, pp 1-4.
20. Fujimoto, Takashi Resolution of Allergic Dermatitis
in an Infant Undergoing Toftness Technique.
Journal of Vertebral Subluxation Res. June 21, 2006
Figure 2. Pressure Applicator
Graph 1
Visual evaluation of skin conditions of psoriasis on scale 1-10. Degree of severity, 10 being
the most severe, is displayed on the Y-axis. Treatment number is displayed on the X-axis. There were a
total of 30 visits in approximately 4 months.
A. Vertebral Subluxation Res. May 4, 2011
Figures 3-10: The following figures show improvement on the skin over the course of
Figure 3.
Back and legs during first visit
Figure 4.
Back, legs, and feet during the
second visit
A. Vertebral Subluxation Res. May 4, 2011
Figure 5. Back, legs, and feet during third
A. Vertebral Subluxation Res. May 4, 2011
Figure 6.
Back, legs, and feet during 4th
Figure 7.
Back, legs, and feet during 5th visit
Figure 8.
Back, legs, and feet during 10th
A. Vertebral Subluxation Res. May 4, 2011
Figure 9.
Back, legs, and feet during 20th visit
A. Vertebral Subluxation Res. May 4, 2011
Figure 10.
Back, legs, and feet during 30th visit