Chiropractic Science and Research
March 24, 2009
Over 100 years ago, chiropractic health care was founded by Dr. D.D. Palmer. He had a simple theory: that good health can be sustained naturally, without the use of drugs or surgery, by removing vertebral subluxations and allowing the nervous system to function properly.
His theory has stood the test of time. This section will briefly explain how the theory was proven by taking you “behind the scenes,” into the field of chiropractic research.
1895–Present: Scientifically Proven
Since the first chiropractic adjustment in 1895, the chiropractic profession has rapidly grown to be the third-largest field of health care behind medicine and dentistry. The reason for the growth of chiropractic is simple: chiropractic is based on sound, scientific principles that have been proven with thorough research.
Investigations and inquiries have been conducted worldwide by government agencies, universities, health-care facilities, and private- and public-sector research organizations. The following paragraphs summarize some of the landmark research studies that have resulted in widespread recognition of chiropractic as a sound health-care choice.
Government of New Zealand. The New Zealand Commission Report was published in 1979 and was the culmination of two years of interviews from health-care experts on the efficacy and safety of chiropractic. The government of New Zealand funded the study, which concluded that modern chiropractic is a “soundly-based and valuable branch of health care in a specialized area.”
Wilk, et al, vs. American Medical Association (AMA) Lawsuit. Another inquiry that further validated chiropractic came about in 1987 through an antitrust suit filed by four doctors of chiropractic against the AMA. A federal appellate court judge ruled that the AMA had engaged in a “lengthy, systematic, successful, and unlawful boycott” of chiropractic.
During the legal proceedings, studies comparing chiropractic care to medical care were presented that showed how chiropractors were “twice as effective as medical physicians, for comparable injuries, in returning injured workers to work at every level of injury severity.”
Since the court findings and conclusions were released, a growing number of medical practices, hospitals, and health-care organizations in the United States now include the services of chiropractors.
Ontario Ministry of Health. In 1993, the Ontario Ministry of Health published the Manga Report, which was a review of literature on the most effective and cost-effective treatments for of low-back pain. After reviewing all available international evidence, the researchers concluded that chiropractic is “greatly superior to medical treatment in terms of scientific validity, safety, cost-effectiveness, and patient satisfaction.”
The Agency for Health Care Policy and Research (AHCPR). In 1994, the AHCPR of the United States Department of Health and Human Services released guidelines for the management of lower-back pain.
The guidelines, which were intended to assist primary-care physicians, were developed by a panel of 23 professionals, including medical doctors, chiropractic doctors, nurses, experts in spinal research, and physical therapists. The panel concluded, among other things, that chiropractic treatment (specifically, spinal manipulation) is recommended for acute low-back problems in adults and should be pursued (in most cases) before pharmaceutical or surgical treatments.
Present-Future: Ongoing Research
Health-care practitioners in all fields rely heavily upon data made available as a result of clinical research. As the chiropractic profession continues to grow, so does our need to conduct research. The acceptance of and the increase in the utilization of chiropractic care depends largely upon research addressing questions of effectiveness, safety, practicality, and cost-effectiveness.
Who does the research?
The following is just a sampling of organizations, publications, and private and public institutions where chiropractic research may be conducted.
There are entire organizations devoted to chiropractic research (e.g., the Foundation for Chiropractic Education and Research, the Consortial Center of Chiropractic Research), as well as journals (e.g., the Chiropractic Research Journal, the Journal of Vertebral Subluxation Research).
In addition, there are research departments associated with each of the 23 chiropractic colleges around the world (e.g., the Palmer Center for Chiropractic Research, the National University of Health Sciences). Professionals from different organizations commonly collaborate on research projects.
Research has also been conducted around the world by governmental organizations (e.g., the United States Department of Health and Human Services, the Ontario Ministry of Health), academic institutions (e.g., University of Pittsburgh Medical Center, Welsh National School of Medicine), medical journals (e.g., the British Medical Journal, the Journal of Family Practice), and private research organizations (e.g., RAND, the Gallup Organization).
What do they study?
Topics of research vary widely and include anatomy, neurology, biomechanics, neurophysiology, instrumentation, public health, geriatrics, and human performance. The fundamental goals of the researchers are to promote and further chiropractic education and health care.
In conclusion
The purpose of chiropractic research has been (and still is) to provide information needed to document and improve chiropractic health care worldwide. Our profession has seen advances once thought impossible due to the impact of scientific research.
For example, federal grants for chiropractic research are now a reality. The Department of Defense formed a committee to introduce chiropractic services into the United States military. Several managed-care organizations now recognize us as qualified primary-care providers. And there is an ever-growing public awareness of the benefits of chiropractic care.
Feel free to do your own research— at work, at school, at your health club or rec center. Ask around. You will hear countless success stories on how chiropractic has helped people recover from an accident, an injury, a tense period in their life, etc., or how chiropractic has helped them develop new, healthier lifestyle habits.
Collect more data by making an appointment with us today. You will be pleased with the results.
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Effectiveness of Chiropractic Treatments
March 24, 2009
Chiropractic is now firmly established as a primary health-care profession where, according to the American Chiropractic Association, approximately 7 to 16 percent of people in the United Stated seek treatment each year. Our profession has earned recognition for its remarkable effectiveness and its focus on natural, drug-free, non-invasive methods of treatment. This section summarizes the effectiveness of chiropractic for some of the conditions we treat.
General Lower-Back Pain
Approximately 25% of our patients come to us with a chief complaint of low-back/pelvic pain or discomfort. This pain can be brought on by an accident, overuse, repetitive stress, emotional stress, or just everyday living.
Several studies have been conducted to determine the efficacy of spinal manipulation as a treatment for lower-back pain in general. One of these involved three chiropractic colleges in California, where researchers reported that “the trend for spinal manipulation to produce better results than any form of treatment to which it was compared was consistent and strong.” For 86% of the outcomes, spinal manipulation was more effective than any other treatment rendered for lower-back pain.
Additional studies conducted both in and out of the United States yielded similar results, where patients reportedly recovered at a more rapid rate, had fewer relapses, and gained a new sense of confidence in their movement. Still more investigations have been conducted on the effectiveness of chiropractic treatment for two sub-categories of lower-back pain: acute and chronic.
Acute Lower-Back Pain
A report published in 1994 by the Agency for Health Care Policy and Research on acute low-back pain concluded that spinal adjustment is one of the most effective treatments for this condition. In another study published in 1994 by the University of Pittsburgh Medical Center and the Jefferson County (Missouri) Rehabilitation Center, it was concluded that greater and more rapid improvement occurred when treated using exercises and spinal adjustment for acute low-back pain.
A third study conducted by the Los Angeles College of Chiropractic and the University of Vermont was published in 1992. These researchers reported that spinal adjustment, when compared to other methods of treatment for acute lower-back pain (massage, corset, and TMS), proved to be a “superior,” more effective treatment after three weeks of care.
Chronic Lower-Back Pain
In 1997, the Dutch Health Insurance Board funded an investigation that summarized the results of 48 separate studies on the effectiveness of chiropractic treatment for chronic lower-back pain. The investigation determined that spinal adjustment is more effective than treatments suggested by general practitioners (bed rest, analgesics, and massage).
Two similar studies conducted in Canada in 1985 (University Hospital in Saskatoon) and 1991 (University of Calgary), plus a third study conducted in Poland in 1986 (Silesian Medical School), produced results similar to the Dutch investigation.
Neck Pain
Approximately 19% of our patients come to us with complaints of neck pain or discomfort. This pain can be caused by a variety of factors, such as an accident, injury, overuse, etc. The most common neck condition we address is whiplash.
The efficacy of chiropractic for neck pain has been well documented in numerous studies conducted in the United States, Canada, Wales, and the Netherlands. In a joint U.S./Canadian study published in 1996, researchers from UCLA, the West LA Veterans Affairs Medical Center, and two chiropractic colleges found that for some patients with sub-acute or chronic neck pain, spinal adjustment proved to be a more effective treatment than mobilization or physical therapy.
In a study conducted by the Canadian Memorial Chiropractic College in Toronto in 1997, researchers found spinal adjustments to improve neck mobility and decrease neck pain. An additional Canadian investigation published in 1997 by the University of Calgary found spinal adjustments to improve neck mobility and decrease neck pain in patients having back and/or neck complaints.
General practitioners in private practice at the Welsh National School of Medicine conducted a study of the efficacy of spinal adjustment in alleviating neck and shoulder pain. The results, published in 1983, indicated that pain and discomfort improved significantly after adjustment, as well as range of motion and flexibility of the affected areas.
A 1992 Netherlands study conducted by doctors of medicine and other professionals investigated different methods of treatment for patients with chronic back and neck pain. After 12 weeks of care, manual therapy (which consisted of adjustment and mobilization of the spine) had showed a “faster and larger improvement in physical functioning” relative to the other types of treatment such as massage, exercises, and physical therapy.
Head Pain
Headaches, both tension and migraine, are the chief complaint for approximately 13% of our patients. Before you reach for your pain-reliever of choice the next time a headache or migraine sneaks up on you, consider the following information on the efficacy of chiropractic care for head pain.
In a 1995 study conducted in Minnesota, the effectiveness of spinal adjustment relative to the administration of an antidepressant drug (amitriptyline) for patients with chronic tension-type headaches was investigated. The researchers included doctors of chiropractic, a doctor of medicine, and another professionals from Northwestern College of Chiropractic and the Pain Assessment and Rehabilitation Center, Ltd. They determined that, after four weeks of treatment, patients receiving spinal adjustment therapy experienced a continued lack of symptoms, whereas patients taking the medication returned to original, baseline conditions.
Another study, published in 1997 by doctors of medicine and doctors of chiropractic at the University of Odense and the Nordic Institute of Chiropractic and Clinical Biomechanics in Denmark, compared spinal adjustment and soft tissue therapy for the treatment of benign, chronic headaches. They found that both methods of therapy allowed for significant improvement, and there were no side effects or signs of worsening associated with either method.
Carpal Tunnel Syndrome (CTS)
With a large percentage of the population using keyboards either at work or at home, CTS is becoming increasingly common. CTS is a condition where there is a disturbance of nerve function in the wrist. Because it is a neurological issue, we are treating more and more patients of all ages suffering from this malady.
One study, published in 1998 and conducted by researchers from the Northwestern College of Chiropractic in Minnesota, compared chiropractic treatment of CTS to conservative medical treatment. The chiropractic treatment included manipulation, ultrasound treatment, and wrist supports, while the medical group received an anti-inflammatory drug (ibuprofen) and wore wrist supports. They found that both methods of treatment proved to be equally effective and recommended that patients with CTS who are sensitive to medical side effects pursue chiropractic for treatment.
Fibromyalgia
Fibromyalgia is a syndrome characterized by chronic pain in the muscles and soft tissues surrounding joints, fatigue, and tenderness at specific sites in the body. While the cause is unknown, an estimated 3 million people are affected in the United States. Because we offer a conservative, hands-on approach to health care, some patients suffering from fibromyalgia are supplementing their medical care with chiropractic care.
In 1997, a study was conducted by three Canadian chiropractors on the effectiveness of chiropractic care for patients with fibromyalgia. They reported significant improvement in flexibility and reduction of pain levels and recommended that this type of treatment be included along with medical treatments for this condition.
Infantile Colic
Colic is a condition that occurs in early infancy and is characterized by episodes of loud crying, apparent abdominal pain, and irritability. Unfortunately, it is a common condition that affects approximately 10% of babies in the United States and lasts from about 2-3 weeks of age until 3-4 months. While the causes of colic are not always known or understood, parents of children exhibiting symptoms of colic are seeking help from chiropractors because of its effectiveness in reducing the severity of the symptoms.
One study that documents the efficacy of chiropractic for treating infantile colic was conducted in 1989 by a doctor of medicine and doctors of chiropractic at the Anglo-European College of Chiropractic in Great Britain. Researchers reported that 94% of infants with colic appeared to be helped by spinal manipulation within 14 days of the start of treatment. The babies tended to have both fewer episodes of crying and shorter crying spells.
Another study, this one conducted in 1999 in Denmark, investigated two infant groups: one that was treated with spinal manipulation, and another that was treated with an over-the-counter antacid medication (dimethicone). After two weeks, the group treated with spinal manipulation exhibited a 67% drop in daily hours of crying, while the dimethicone group experienced a 38% drop.
Just a sampling
In summary, the above-referenced studies indicate chiropractic is effective for head, neck, and back pain, as well as carpal tunnel syndrome, fibromyalgia, and infantile colic. It is important to note that the conditions discussed in this section are not the only conditions we treat— this has simply been a sampling of studies that have been conducted to determine the efficacy of chiropractic. Our scope of practice extends well beyond the above maladies, and we will help you determine if chiropractic care will be an effective means of treating your particular condition. Chiropractic care will be an effective means of treating your particular condition.
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Stages of Care
March 24, 2009
It is important to understand the stages of chiropractic care because they are unique relative to those of other health-care disciplines. Because chiropractic addresses core physiological and biomechanical aspects of the body, the process to correct problems without drugs or surgery can take some time. Some conditions can be treated in a few visits, while others may take longer.
The following is a brief summary of the three major phases of chiropractic care.
Relief Care
The majority of patients consult a chiropractor because they have an ache or pain. In the first phase of care, the main objective is to eliminate or reduce your discomfort and stabilize your condition in the shortest amount of time. During this phase, progress is usually rapid.
The number of times you visit a chiropractor during this phase of care varies and is dependent upon your specific condition. It’s hard to say how long it will be until you see relief— it could be as short as a week or up to a month. If you are not responding to chiropractic care during this phase, you may be referred to another health-care provider.
Rehabilitative Care
Once your condition has stabilized, you enter the second phase of care, where the objective is to correct any underlying injury or cause of discomfort, strengthen the muscles, and improve neuromusculoskeletal function. The frequency of office visits is reduced over a period of two to six weeks. Care may be supplemented by rehabilitation exercises, nutrition, and modification of daily habits.
It is important to remember that many of the conditions for which people seek care have developed over many years; therefore, correcting these problems is a true rehabilitative process. It helps to understand that it takes time to correct these conditions.
Once your discomfort has subsided, you may think all is well and choose to abandon your efforts. However, if you end your care before fully healing the muscles and soft tissues, you can invite a relapse. This is a mistake many people make, and it sets them up for recurring health issues.
It’s hard to believe that, after all the time, effort, energy, and money put into correcting a problem, a patient would choose to forgo this relatively easy phase of care! As much as we’d love to see you in our office, we’d much rather assist you in maintaining your health rather than relieving your pain.
Wellness Care
You then “graduate” to the wellness phase, which is designed to maintain your improved health, encourage normal spinal function, prevent the return of the original condition, and catch small problems before they become serious. A personal wellness care program will be designed specifically for you where we teach you how to incorporate good nutrition and exercise habits into your everyday life, thereby promoting vitality, endurance, and the ability to enjoy life at its fullest.
A good way to look at chiropractic is to relate it to dentistry. We all know it takes a long time to develop tooth decay, but with regular maintenance and check-ups, the plaque doesn’t have a chance. Similarly, it often takes a long time to develop a spinal misalignment. But with regular maintenance, the bones will not have a chance to get out of line.
Few things as complicated as your body can be “fixed” and then ignored. Think of your car, your teeth, or your relationships. They take time and effort to maintain, but you know it’s worth it in the long run. That’s why we recommend a regular schedule of chiropractic check-ups.
You can then congratulate yourself on achieving your ultimate goal: optimal health!
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