Chiropractic Care Not Just for Back and Neck Pain

April 8, 2014 - Miller_Chris

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Many people unfamiliar to the benefits of Chiropractic believe Chiropractic it is just for back and neck pain. Also, people who are familiar with Chiropractic might not even know the range of conditions that Chiropractic can potentially benefit. Chiropractic works great for neck pain and headaches, however it can do so much more.

Chiropractic affects the neurological system through the musculoskeletal system through our High Velocity Low Amplitude adjustments. Additionally, Chiropractors use other forms of treatment to better our patient care besides adjustments including soft tissue manual therapy, rehabilitation exercise, diet/nutrition advice, physical therapy modalities, and acupuncture, to name a few.

When reviewing and organizing my research I came across this metanalysis of 179 papers, which cover 50 different nonmusculoskeletal conditions in which Chiropractic can benefit. This paper is by Hawk et al, published in 2007 in the Journal of Alternative and Complementary Medicine. It is titled, “Chiropractic Care for Nonmusculoskeletal Conditions: A Systematic Review with Implications for Whole Systems Research.”

Let me start with the conclusions:

  1. Adverse effects of spinal manipulation that were reported for all ages and conditions were rare, transient and not severe.
  2. Evidence from controlled studies and usual practice supports chiropractic care as providing benefit to patients with asthma, cervicogenic vertigo and infantile colic.
  3. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia.

Like I said this paper analyzed 179 papers on 50 different nonmusculoskeletal conditions which included 122 case reports, 47 experimental designs, 14 Randomized Controlled Trials (RCT), 9 systematic reviews and 1 large Cohort study.  The 14 RCT covered 10 difference conditions. The following table summarizes the amount of research for each condition.

hawk et al table

I am going to just summarize some of the findings of the studies for some common conditions which you might not think Chiropractic can benefit.

Asthma

  • No adverse effects of Chiropractic manipulation
  • Peak expiratory volume improved between treatment and control group in 140 patients
  • Thoracic excursion significantly increased
  • Voluntary reduction and/or elimination of medication
    • One study included stopped use of inhaler
  • Peak flow meter reading improved
  • Reduction of symptoms, episodes, medication after 2 year follow up
  • Improvement in health status

Hypertension

  • No adverse effects related to manipulation
  • Significant decrease in systolic and diastolic blood pressure immediately post treatment in 21 patients
  • Small decrease in blood pressure with manipulation, physical modalities and diet intervention by Chiropractor vs a dietician in 140 patients
  • Significant drop in serum aldosterone
  • 80% of hypertensives had persistent pattern of spinal dysfunction
  • Reduced medication and after 7 treatments discontinued all medications by primary care physician

Vertigo

  • No adverse effect of spinal manipulation
  • Less postural sway, frequency and intensity of dizziness
  • 77% improvement in vertigo symptoms in the spinal manipulations group vs 26% improvement in the physical therapy group
  • Greater improvement in head repositioning (cervical kinesthesia)
  • 101/112 symptom free after cervical spine manipulation, 11 decrease vertigo and 5 no change

Menstrual Type Symptoms

  • Dysmonorrhea
    • Improvement in symptoms
    • Decrease prostaglandins 1 hour post treatment
  • PMS
    • PMS patients had higher prevalence of spinal clinical findings
    • Improvement in menstrual distress

Infantile Colic

  • Parent reported improvement in crying time
  • Crying decreased 50% in 1 treatment in 6 week old
  • Remission of symptoms after each treatment (3x over 2 week intervals in 1 patient) and at 6 months after 2x for 4 weeks (1 patient)

Otitis Media

  • Significantly fewer episodes of acute otitis media in 57 patients vs control group over 6 months
  • Normal otoscopic exam at 1 week after 4-6 treatments

Pneumonia

  • In hospitalized patients 60 and older, hospital stays and courses of intravenous antibiotics were shorter in the treatment group than the control group

This is only scratching the surface on what types of conditions Chiropractic can benefit. Compared to other disciplines, Chiropractic contains less research in terms of the type, patient size and quality. Chiropractic research is also very hard to publish because resources are limited and intervention designs are difficult to validate. This study was done in 2007, and since then Chiropractic research has exploded. I hope there is a follow up to this metanalysis in the near future.

I hope some of you who are unfamiliar to Chiropractic consider the benefits of Chiropractic care for conditions other than back and neck pain, and for those of you familiar to Chiropractic can take some of the results and apply them to better our profession.

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Miller_Chris