Chiropractic Care

Chiropractic care is most commonly associated with manipulation of the spine. Manipulation is one of the most widely researched and clinically proven forms of physical therapy for low back pain and neck pain. Manipulation has been used as a treatment for musculoskeletal complaints for centuries. However, it was not until the last few years that its effectiveness has been proven through scientific research. In fact, for many years manipulation was thought to be an unorthodox form of medical care because of its relationship to the chiropractic profession. Today, this treatment is commonly accepted and its validity and efficacy have been proven for low back and neck pain.

Manipulation typically is recommended for low back pain without associated symptoms traveling beyond the knee; and neck pain with symptoms not traveling beyond the shoulder region. Symptoms including pain, numbness, and tingling that travel beyond the knee or shoulder region can be related to a pinched nerve and manipulation needs to be used with caution, if at all in these types of cases.

Manipulation has also recently been studied and compared to other forms of usual therapeutic interventions for chronic low back pain including individualized physical therapy and back school. The research performed has supported better short and long-term functional improvement and pain relief with spinal manipulation vs. individual physical therapy or back school.

Therapeutic Benefits (As Evidenced Through Clinical Research):

1) Improving Range of Motion

Research Links:
http://www.ncbi.nlm.nih.gov/pubmed/20350671
http://www.ncbi.nlm.nih.gov/pubmed/17509440
http://www.ncbi.nlm.nih.gov/pubmed/19119394
http://www.ncbi.nlm.nih.gov/pubmed/11753327

2) Reducing Pain

Research Links:
http://www.ncbi.nlm.nih.gov/pubmed/19797305
http://www.ncbi.nlm.nih.gov/pubmed/18267029
http://www.ncbi.nlm.nih.gov/pubmed/11514817
http://www.ncbi.nlm.nih.gov/pubmed/18328937
http://www.ncbi.nlm.nih.gov/pubmed/17612359
http://www.ncbi.nlm.nih.gov/pubmed/18328937

3) Decreasing muscle tension/spasm

Research Links:
http://www.ncbi.nlm.nih.gov/pubmed/11013505
http://www.ncbi.nlm.nih.gov/pubmed/12072852

4) Improved contractility of spine stabilizing musculature (core muscles)

Research Links:
http://www.ncbi.nlm.nih.gov/pubmed/17970408
http://www.ncbi.nlm.nih.gov/pubmed/17877283

As a result of the above clinically known effects of manipulation, it is one of the most effective forms of care for low back and neck pain. We certainly do not expect you to understand all of the above noted literature, however we want you to understand that our practice is to the highest medical standards and that the interventions we utilize and perform are well researched and supported by clinical evidence and research. Evidence-based care is extremely important as it significantly improves the likelihood of a positive response to your treatment. In fact, many recent research studies performed support spinal manipulation as the only effective form of physical intervention for acute low back pain (pain present for 3 months or less). The abstracts to these studies can be found at:

http://www.ncbi.nlm.nih.gov/pubmed/20494814
http://www.ncbi.nlm.nih.gov/pubmed/17909210

Manipulation has recently been shown to be significantly more effective than usual family physician directed care (medication, referral for physical therapy, etc.) for new onset low back pain associated to a musculoskeletal cause. This study was performed in a hospital-based setting and all outcomes including pain level and activities of daily living were significantly better in the patients treated with spinal manipulation compared to those who were treated by usual family physician care. This study was published in the October 2010 issue of The Spine Journal and can be found at: http://www.ncbi.nlm.nih.gov/pubmed/20889389

Manipulation has also recently been studied and compared to other forms of usual therapeutic interventions for chronic low back pain including individualized physical therapy and back school. The research performed has supported better short and long-term functional improvement and pain relief with spinal manipulation vs. individual physical therapy or back school. The abstract for this study can be found at:

http://www.ncbi.nlm.nih.gov/pubmed/20053720

In addition, another study found spinal manipulation to be better than general exercise and just as effective as stability exercises for the low back in the short-term. The abstract for this article can be found at:

http://www.ncbi.nlm.nih.gov/pubmed/17250965

It has also been mentioned in the medical community that manipulation of the neck is a high risk procedure, as it can result in stroke. However, the most recent literature on this topic dismisses this argument and relays that this correlation is not valid. Numerous recent articles all written in peer reviewed journals have supported these findings. The abstracts for these article can be found at:

http://www.ncbi.nlm.nih.gov/pubmed/18204390
http://www.ncbi.nlm.nih.gov/pubmed/20709591
http://www.ncbi.nlm.nih.gov/pubmed/20538226

Ultimately, when determining the best evidenced care for any condition the benefit to risk ratio must be determined, as noted above the therapeutic benefit of spinal manipulation for low back and neck pain is strongly supported and well documented, while the risks and arguments against its use have not been supported. As a result, spinal manipulation should always be considered as a first line of therapy in most cases of localized low back and neck pain. In fact, the risks associated with many other forms of accepted therapies are much greater including the use of acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve), and while the benefit of these medications only treats the symptom and not the true cause of the pain, we use these medications routinely for pain. Spinal Manipulation helps to treat the cause of the pain as explained in the above noted literature and as a result has a much greater benefit to risk ratio than most conventional treatment available today for neck and low back pain. In addition, chiropractors are the most highly trained professionals in this form of therapy and as a result should be your therapist of choice when this form of therapy is indicated for your care.