Chiropractic Proven to Help Acute Back Pain Patients, Debunks 2007 Study

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As a chiropractor, I am happy to find research from non-chiropractors that supports results that I see and I am sure many other chiropractors see in their practices. Back pain can be complex and very individualized. I like to start by trying to find the primary cause of their pain whether it is joint pain, muscle pain or nerve pain. Non-arthritic joint pain (pain from a misaligned bone, dynamic joint motion restriction or subluxation) and muscle pain are directly related so I focus more on the chiropractic adjustment or muscle pain with Graston Technique or massage depending on the primary source of pain. What others label "nerve pain" can be sclerotogenous (nociceptive) pain like a trigger point, pain from cancer or typical arthritic pain while dermatomal pain is pain resulting from a disc herniation or an arthritic foraminal nerve compression. "Nerve pain" is therefore more complicated and can mimic simple acute back pain. Sometimes, the "pinched nerve" diagnosis is overused or abused especially with x-rays but that is another issue for another time. The point is when I see a research journal saying that chiropractic spinal adjustments are not effective, I wonder how does one make a judgement that a chiropractic adjustment is not effective when they themselves are not manual therapists who perform regular spinal adjustments. I have even read that a cervical adjustment is equivalent to a whiplash from a car accident. There are many different techniques or styles of chiropractic adjustments including the more gentle chiropractic adjustments. Forgive my little rant. On with the study...

The December issue of the Spine Journal outlines a single-blind randomized study where 92 patients were recruited to either have medical or chiropractic care. Their progress was measured by a standard developed by the Quebec Task Force or the Roland-Morris Disability Questionnaire. Patients who were not treated by chiropractic spinal manipulation were called the "usual care" group or UC. The UC patients were treated with various therapists ranging from "a variety of professionals including family physicians, massage therapists, kinesiologists, and/or physiotherapists." The group who received chiropractic care were called the "study care" or SC group.

 Patients in the SC group received acetaminophen, a "progressive walking program" and up to four weeks of lumbar chiropractic spinal manipulative therapy. The manipulative therapy was provided "using conventional side-posture, high-velocity, low-amplitude techniques" to the lumbar region only, and only by a chiropractor. (Dynamic Chiropractic – March 12, 2011, Vol. 29, Issue 06) 

The study also even included a placebo spinal manipulative therapy performed by a physical therapist or physiotherapist in additional to NSAIDS and for some even narcotic pain killers. Their main criticism for the 2007 study was that the outcome was based on therapy provided by non-chiropractors. Another interesting note was that the chiropractors were only allowed to adjust the lumbar spine (low back not including the pelvis). The UC therapists adjusted the thoracic spine, lumbar spine, pelvis, sacroiliac joints and hips.

I hope there will be more studies like this that are well designed and fair to all types of therapy. In the end, I hope it promotes more cooperation between chiropractors and all other professions. Every profession has their own unique perspective and in it has their own strengths and weaknesses. The patient benefits in the end with more cooperation. When more patients get better, we may even potentially benefit from lower health costs. Something to think about.

ChiroWorks Care Center
Anthony Tsai, D.C.
Chiropractor in San Jose, CA
ChiroWorksCareCenter.com
Graston Technique Certified
FAKTR-PM Completed

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References:
http://www.ncbi.nlm.nih.gov/pubmed/20889389
http://www.ncbi.nlm.nih.gov/pubmed/17993364
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55150
http://www.thespinejournalonline.com/
http://www.dynamicchiropractic.com/