Primarily, chiropractic focuses on the diagnosis and treatment of neuromuscular disorders with an emphasis on treatment utilizing manual adjustments and other types of manipulation and/or mobilization of the spine. Chiropractic is classified as a form of primary care, as anyone can choose to see a doctor of chiropractic without a referral.
A 2010 meta analysis reviewed a number of published studies to determine the strength of scientific evidence regarding the effectiveness of manual treatment for both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) conditions.
Lead author Dr. Gert Bronfort reviewed 49 relevant systematic reviews and 16 evidence-based clinical guidelines and concluded that he and the other authors of the analysis found SMT/mobilization to be effective in adults for the following: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; and several extremity joint conditions. Interestingly, Dr. Bronfort and his team noted thoracic manipulation/mobilization as effective for acute and subacute neck pain, but the evidence available at the time was inconclusive for cervical manipulation/mobilization alone for neck pain of any duration.
The evidence was also inconclusive for SMT/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Additionally, they found SMT/mobilization was not effective for asthma, dysmenorrhea (when compared to sham SMT), or stage 1 hypertension when added to an antihypertensive diet. In children, the evidence was inconclusive regarding the effectiveness of SMT/mobilization for otitis media and enuresis, and they also noted SMT/mobilization was not effective for infantile colic and asthma when compared with sham SMT.
In a 2014 follow-up study, lead author Dr. Christine Clar confirmed most of the previously “inconclusive” or “moderate” evidence ratings of the 2010 evidence report. However, the availability of new research motivated Dr. Clar to note moderate evidence for these conditions: manipulation/mobilization (with exercise) for rotator cuff disorders, spinal mobilization for cervicogenic headache, and mobilization for miscellaneous headache.
These two meta-analyses are significantly helpful for those considering chiropractic care for specific conditions. Reviews like this are planned for the future, and the list of conditions that respond well to chiropractic care should expand as areas that need further study are determined and more research is published.
Harvard Study: Low Back Pain Patients Significantly More Satisfied with Chiropractic Than Conventional Medical Care.
In 2002, at the 17th annual North American Spine Society meeting, three medical doctors defended chiropractic by citing a Harvard study that found low back pain patients were significantly more satisfied with Chiropractic treatments compared to conventional medical care.
After researching “myths,” co-author , Dr. Jack Zigler, MD found chiropractic education is more similar to medical education than it is dissimilar.
Dr. Zigler had integrated chiropractors into his multi-disciplinary spine center where the chiropractors screen patients for surgical versus non-surgical care.
Another co-author, Dr. Andrew Cole, MD, stated, “overall, manipulation* has the advantage of reducing pain, decreasing medication, rapidly advancing physical therapy and requiring fewer passive modalities.” (*Manipulation is one of the primary treatment techniques used by Doctors of Chiropractic.)
He also recommends spine surgeons refer their patients to chiropractors.
Our goal is to give you, your friends, you co-workers, and your family the best treatment possible.
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Haldeman S, Chapman-Smith D, Petersen DM Jr. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today February 2003:23(2), pp14-15.
Haldeman S, Cole A, Zigler J, et al. Spinal manipulation in spine care: who? why? when? Presented at the North American Spine Society 17th Annual Meeting, Oct. 29-Nov. 2, 2002, Montreal.
The mission of chiropractic is to help sick people get well, as well as to help healthy people function better in the absence of drugs or surgery.
When people are asked, “…what do chiropractors do?” the frequent response is, “…they crack your neck and/or back.”
Chiropractic spinal manipulation (frequently called an adjustment) often produces an audible popping or cracking noise.
This sound is known as joint cavitation and it is reported to be caused by the release of pressure created by gases (nitrogen, oxygen, and carbon dioxide) within the joint.
It is the same noise produced when one cracks their knuckles. One common myth is that cracking or cavitating a joint will produce arthritis in the joint—this is simply not true.
Several scientific studies of joint cavitation dispel this old wives tale. In fact, studies demonstrate that joint manipulation actually benefits patients with arthritis of the spine.
There have been a number of studies published on the topic of unwanted reactions to spinal manipulation.
In general, side effects, if any, are mild and transient.
When they do occur, they typically happen shortly after the first or second session of spinal manipulation, similar to the post-exercise soreness that occurs when first introducing a new sport or activity.
Unpleasant side effects such as this may occur in between 10% and 30% of patients. They occur more often in women than men, and as previously stated, they seem to occur more often after the first session of spinal manipulation.
The most commonly reported unpleasant reaction is temporary and transient increased pain or stiffness. This reaction usually resolves in 24 hours or less.
More rare reports of tiredness, light headedness, and occasional nausea have been infrequently reported.
The type and nature of these reactions may be associated with the severity and nature of the condition being treated.
It seems self evident that more severe problems have the potential to produce short-term increases in symptoms. The use of ice, ultrasound and or other modalities can help to minimize any irritation that may occur due to spinal manipulative treatment.
SPINAL MANIPULATION HAS BEEN FOUND TO BE SAFE AND EFFECTIVE FOR UNCOMPLICATED SPINAL PAIN SYNDROMES. MORE IMPORTANTLY, IT MAY ALSO BE A VIABLE ALTERNATIVE TO SURGERY FOR LUMBAR OR CERVICAL DISK HERNIATIONS.
There are many reports on both sides of this subject, with some stating spinal manipulation can increase compression of the spinal nerves in patients with disk herniations as well as the opposite—that it reduces nerve root pressure.
The good news is that the rate of occurrence is only about 1 in 1- 3 million cases, making spinal manipulation for disk problems an extremely safe treatment option for patient with herniated disks.
Chiropractors will often use low-force manipulation methods for treating herniated disks that do not require a standard type of manipulation thrust.
These spinal methods are sometimes preferred over traditional manipulative techniques for the treatment of herniated spinal disks, but this is case dependent.
To make an educated decision about any type of care you may be considering, you must consider “relative risks”. Simply put, relative risks compare the risk of one procedure with the risk of a second procedure for the same condition.
For example, if you are taking medications to relieve your pain, how do the risks of the medications compare with the risks of an alternative treatment, like chiropractic care?
An example is chiropractic treatment versus drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin, naproxen, and ibuprofen.
THE RISK FOR SERIOUS SIDE EFFECTS FROM ANTI-INFLAMMATORY DRUG IS FROM 6000-9000 TIMES GREATER THAN THE RISK FOR SERIOUS SIDE EFFECTS FROM SPINAL MANIPULATION, MEANING THAT CHIROPRACTIC CARE IS A MUCH SAFER ALTERNATIVE THAN ASPIRIN OR OTHER NSAID DRUGS FOR TREATING INFLAMMATORY BACK OR NECK PAIN.
Interestingly, studies have reported that patients receiving chiropractic care were able to reduce their intake of drugs, thus, reducing the risks of drug reactions/interactions.
If you are trying to avoid surgery for a spine-related problem, your condition is more serious and potential side effects of surgery should be compared with chiropractic.
You should understand any patient who is a potential candidate for spine surgery has a serious medical condition. There is pressure on a nerve and the potential for permanent damage to that nerve exists. Studies show that chiropractic care often can reduce the pressure on a compressed nerve in the lower back or neck, without surgery.
The following references were utilized in the preparation of this information.
The audible release associated with joint manipulation. JMPT. 1995 Mar-Apr;18(3):155-64.
Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum. 1998 May;41(5):949-50.
Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. JMPT 2006 Feb;29(2):107-14.
Comparison of human lumbar facet joint capsule strains during simulated high velocity, low-amplitude spinal manipulation versus physiological motions. Spine J. 2005 May-Jun;5(3):277-90.
Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment JMPT. 2004 Mar-Apr;27(3):197-210.
Side posture manipulation for lumbar intervertebral disk herniation. JMPT. 1993 Feb;16(2):96-103.
Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. JMPT 1996 Nov-Dec;19 (9):597-606.
Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage. 2001 Mar;21(3):238-42.
Risks associated with spinal manipulation. Am J Med. 2002 May;112(7):566-71.
A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. JMPT 1995 Oct;18(8):530-6.
J Side effects of chiropractic treatment: a prospective study. JMPT. 1997 Oct;20(8):511-5.
Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005 Jul 1;30(13):1477-84.
Complications of spinal manipulation: a comprehensive review of the literature. J Fam Pract. 1996 May;42(5):475-80.
Dissection of cervical arteries Presse Med 2001 Dec 15;30(38):1882-9
Vertebral artery occlusion after acute cervical spine trauma. Spine. 2000 May 1;25(9):1171-7.18. Spine Journal
Internal forces sustained by the vertebral artery during spinal manipulative therapy. JMPT 2002 Oct;25(8):504-10
How Can Chiropractic Benefit Someone with Fibromyalgia?
A new study from Egypt reports that chiropractic care can be an effective treatment strategy for fibromyalgia treatment with chiropractic care.1 The study involved 120 people between the ages of 40 and 65 who had suffered with severe fibromyalgia for four years or more. Each person rated their pain as a 4 or higher on a pain scale and also had limited movement in their cervical (neck area) spine, specifically in their C1-C2 area. All of the individuals participating in this study engaged in 12 weeks of therapy which included:
• An education program (one two-hour session per week) designed to provide the participant with more information about fibromyalgia and care options;
• Cognitive behavioral therapy (one two-hour session per week) which involved discussion regarding pain management via relaxation exercises, challenging treatment-prohibitive beliefs about fibromyalgia, and positive reinforcement about what types of actions can be taken to ease fibromyalgia symptoms; and
• An exercise program (three one-hour sessions per week plus 20-minute session twice daily at home) which included relaxation techniques, as well as active and passive stretches.
One half of the individuals were randomly assigned to a chiropractic group, which meant that they also received chiropractic adjustments three times per week for the first month. This was then reduced to once a week sessions for the remaining eight weeks.
At the beginning of the study, the conclusion of the study, and at one year post-study, each participant was asked to complete various questionnaires to help the researchers determine what effect, if any, that chiropractic had on easing fibromyalgia symptoms and reducing its impact on their lifestyle. Specifically, questions were asked regarding physical function abilities, work days missed due to fibromyalgia symptoms, sleep disturbances, level of pain, fatigue, depression, and anxiety.
What Were The Results of the Fibromyalgia Study?
The individuals who participated in the chiropractic care group showed more improvement and better results than the control group who had no chiropractic intervention. This was validated by questionnaire scores that improved by 15 or more percent.
1. Moustafa IM, Diab AA. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial. Rheumatology International 2015;35(7):1163-1174.
What Is Benign Prostatic Hypertrophy?
Swelling of the prostate gland and elevated prostate specific antigen (PSA) are the latest conditions targeted by the pharmaceutical industry in their media blitz advertising campaign. Their goal is clearly to reach the millions of men suffering the discomfort and dysfunction of benign prostate diseases and to mobilize anxiety about the 30,000 men who die annually from prostate cancer. The awareness of the problem is good… but are drugs and surgery our only or our wisest choices?
Benign (non-cancerous) Prostate Hyper-trophy (BPH) alone contributes to over one billion dollars spent annually in pursuit of relief for symptoms of:
• Awakening from sleep to urinate a number of times per night.
• Feeling the bladder is not empty and frequent urination.
• Difficulty beginning urination.
While these symptoms are inconvenient, embarrassing and uncomfortable they are not immediately life threatening like heart attack or stroke.
Benign Prostate Hypertrophy (BPH) is simply prostate gland swelling which is commonly related to an inflammation and/or infection of the lower urinary tract and prostate. This swelling leads to incomplete emptying of the bladder while increasing the risk of urinary tract infection. This vicious cycle of swelling, urinary retention, and infection causes a worsening of symptoms, sometimes even leading to prostate cancer.
What Is The PSA Test and How Important Is It?
Prostate Specific Antigen (PSA) is a protein that increases in the blood of men with various conditions of the prostate, including hypertrophy, inflammation, infection and cancer. It is NOT a specific indicator of cancer, merely an indicator of prostate tissue stress. Fueled by media frenzy and fear of prostate cancer, men often are counseled to aggressively pursue diagnostic studies and treatment of elevated PSA. But research shows that 85% of the time a man has an increase in PSA it is due to inflammation and infections of the prostate gland that have gone untreated and unsupported by healthful choices… not cancer!
How Does Lifestyle Affect The Incidence of BPH?
Research in China shows that men in rural areas have very low rates of clinical BPH, while men living in cities adopting a western lifestyle have a skyrocketing incidence of this condition (though it is still below rates seen in the West). Men who lead a western lifestyle have a much higher incidence of symptomatic BPH than men who lead a traditional or rural lifestyle.
What Causes Benign Prostatic Hypertrophy?
It is agreed by most experts that BPH is the result of 3 causes.
3. Autoimmune disease
Unhealthful lifestyle choices lead to impaired immune function that can lead to inflammation and decreased resistance to infection. Incomplete bladder emptying and sexual activity both may lead to bacterial concentrations causing infection of the urinary tract. Over months and years, bladder and prostate tissues stressed in this way could become damaged and result in autoimmune disease. When the protein component of an injured tissue enters the bloodstream, an antibody-antigen reaction develops against that tissue. If the injured tissue is from the prostate, one may suffer autoimmune attack on the prostate.
What Lifestyle Changes Can Help the Prostate Gland?
Take these steps for increasing prostate health:
• Eliminate processed foods and sugars
• Reduce or eliminate toxins in food, air and water
• Increase whole foods rich in antioxidants
• Increase whole foods rich in trace minerals such as selenium, zinc and iodine
• Increase healthful Vitamin D from brief periods of daily sunshine and whole food supplements
• Increase water consumption to frequently flush bacteria and toxins from the urinary tract
• Increase exercise
What About Supplements and BPH?
Some of the oldest nutritional support for BPH is the vitamin that used to be known as Vitamin F (Still available today as Cataplex F from Standard Process) If contains fatty acids, prostate extract and iodine. Research from the 1940’s showed the benefit of this combination is supporting BPH.1
Vitamin D3 is vital for a healthy prostate gland and normal calcium metabolism which is necessary for the prostate. Used by doctors since 1953 prostate tissue extracts called PMGs or protomorphogens have been used to support the health and repair of the prostate. (Prostate PMG)
Also successfully used to shrink prostate swelling and support the prostate have been saw palmetto berry, prostate tissue extract, stinging nettle root extract, pygeum, zinc land tomato fruit powder (Available today as Palmettoplex from Standard Process).2
1. Hart JP, Cooper WL. Vitamin F in the treatment of prostatic hypertrophy. Report Number 1, Lee Foundation for Nutritional Research, Milwaukee, Wisconsin, 1941
2. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998 Nov 11; 280(18):1604-9.