I have a confession. Even after many years of using and working with natural medicine, I still have an underlying fear of chiropractors. Not the men and women who are part of the appeal. But the actual process of getting an adjustment. I’ve just never gotten used to the cracking and popping sound achieved by manual adjustments. But my concerns are often at odds with some of the positive evidence that exists about this widely used holistic techniques. The most recent figures published by the National Center for Complementary and Alternative Medicine estimate that more than $ 4 billion per year is spent on “chiropractic or osteopathic manipulation” in the U.S. alone. It appears that many health-conscious consumers do not share my reservations about visiting their friendly neighborhood chiropractor.
Two recent publications shine a positive light on the efficacy and safety of chiropractic care. The first of the two is presented in the March 2010 edition of the Journal of the Canadian Chiropractic Association. This was a systematic review of chiropractic care in patients with asthma. I chose to focus on this study because, for good or for evil, spinal manipulation is primarily associated with providing relief in circumstances that physical pain or decreased mobility involved. A total of 8 studies were included in this specific evaluation, but no randomized, placebo-controlled studies – the preferred form of data for scientists. Most researchers believe that this variety of the test model provides the most accurate and reliable evidence. But in this case the researchers from the Canadian Memorial Chiropractic College uses the best, peer-reviewed papers they could find. Their conclusion was that chiropractic care usually leads to improvement in subjective measures of asthma severity, such as the number of asthma attacks and a reduced need for medication. Objective changes in asthma symptoms were less visible but still present. Finally, the authors state that “Despite a lack of evidence the successful treatment of patients with asthma chiropractic care support, and despite the evidence that does exist is heterogeneous with respect to the quality of power, there is nevertheless an indication that patients experienced a positive subjective and objective results, sometimes positive while under chiropractic care. ” (1,2)
A study appearing in the February 2010 issue of The Spine Journal, assessing the relative benefits of spinal manipulation therapy (SMT) vs. light massage in patients with cervicogenic headache (CGH), a disorder characterized by chronic pain on one side of the head , which is called from the neck region. 80 patients living with CGH enrolled in a 24-week evaluation period. Researchers from the Western States Chiropractic College in Portland, Oregon assessed pain scores using a modified Von Korff Pain and Disability Scale and noted the number of headaches experienced by the participants. The study volunteers were randomized into four treatment groups, that 8 or 16 chiropractic adjustments or equal amounts of light received massage therapy. The respective sessions were once or twice a week for 8 weeks provided. The participants receiving chiropractic care exhibited more significant reduction in pain intensity. Those in the “higher dose” group (16 treatments) found a greater advantage over the lower dose (8 treatments) and massage interventions. On average, the incidence of CGH “was reduced by half” and / or produced a “50% improvement in pain scale” in the spinal manipulation subjects. (3)
Common reasons for seeking chiropractic care
Source: J Can Assoc Chiropr. August 2008-52 (3): 175-184. (A)
In a recent column, Dr. Andrew Weil the issue of a “kinder, gentler” form of chiropractic. He suggests looking for chiropractors that a “reliable and safe” modality known as an activator (pictured above) instead of conventional “dynamic thrust” adjustments to use. Dr. Weil describes an activator in the follower way: “a low power, handheld device with a spring and piston speed low-power pulse produces high speed”. In short, no pain or running application, and no cracking and popping sounds. Recent studies have shown that the positive results using activators in conditions such as temporomandibular disorder (TMJ) and low back pain. The number of studies of “mechanical force, manually assisted chiropractic” devices is somewhat due to the relatively recent introduction in the medical care is limited. However, until now the evidence that exists does tend to support its efficacy and safety. (4,5,6,7,8)
Many years ago I wrote a few months studying at a holistic clinic in Arizona. The majority of health professionals on staff were chiropractors. At that moment I felt somewhat uncomfortable with the broad application of this therapeutic modality. It seemed almost every conceivable state of fear of incontinence heartburn dizziness was addressed through spinal manipulation therapy. The fundamental idea behind this approach was that structural changes would not directly cure these conditions, but can possibly help with general healing. You see in the chiropractic are misalignments or subluxations of the spine thought to the proper functioning of the nervous system, which is alternately described as the “flow of energy needed for the health support” affect. Reservations aside, I am grateful that modern science helps me to my own view about what chiropractic is actually capable of accomplishing expand. (9)
Update: December 2010 – If you ever been to a chiropractor who seems to believe that he or she can almost every disease known to man to heal quickly run and run far away. Past and present studies show that chiropractic may play an important role in modern medical care to serve the judicious use. But it is not a panacea and is not suitable in some cases. Three current publications in the medical literature confirm this view. The first provides a positive assessment of the use of a chiropractor (DC) vs. a doctor (MD) for lower back pain. An analysis by an insurer determined that patients receiving care initiated with a DC summed up health care costs about 20% less than MD care started. More positive results were published in the October 2010 issue of the Journal of manipulative and Physiological Therapeutics. In that study, “Sixty percent of patients with sciatica who had failed other medical treatment benefit from spinal manipulation to the same extent as if they underwent surgery.” Unfortunately, the latest study, presented in the September issue of the Archives of physical medicine and rehabilitation, no benefit from chiropractic neck manipulation versus mobilization therapy in men and women with non-specific neck pain to find. The findings of the randomized, controlled study states that “The use of neck manipulation, can not be justified on the basis of superior efficacy.” (10,11,12)