• Chiropractic Treatment: What You Should Know

    What Is Chiropractic Treatment?

    Image for chiropractor article Chiropractic is a medical system founded in 1895 by Canadian Daniel David Palmer. It is based on the theory that many illnesses originate in the spine, and for this reason it focuses on spinal manipulation. Chiropractic physicians may also utilize physical therapy techniques, as well as methods drawn from other branches of alternative medicine, such as herbs and supplements.

    Uses

    Most visits to chiropractor physicians are for back pain, but it is also commonly used to treat:
    • Headaches
    • Neck pain
    • Pain in other areas, such as the shoulders, knees, and jaw
    • Colic

    How It Works

    Chiropractic theory has based itself on “subluxations,” or vertebrae that have shifted position in the spine. These subluxations are said to affect nerve outflow and cause disease in various organs. A chiropractic treatment is supposed to "put back in" these "popped out" vertebrae. For this reason, it is called an “adjustment.”
    However, no real evidence has ever been presented showing that a given chiropractic treatment alters the position of any vertebrae. In addition, there is no real evidence that impairment of nerve outflow is a major contributor to common illnesses, or that spinal manipulation changes nerve outflow in such a way as to affect organ function.
    Other theories suggest that chiropractic manipulation may relieve pain by “loosening” vertebrae that have become relatively immobile rather than by changing their position. In addition, the sudden movements of manipulation may alter the response patterns of nerves in the spine, again relieving pain.

    What Do Studies Show About Chiropractic Treatment?

    Does It Work?

    While many people seek chiropractic treatment for back and neck pain, the current research suggests that chiropractic may offer just a modest benefit. As with most other alternative therapies, more high-quality studies are needed before researchers can come to any definitive conclusions about the effectiveness of chiropractic treatment. The strongest evidence so far seems to be in the treatment of migraine headaches—with chiropractic treatment offering long- and short results (fewer and less severe migraines).
    Chiropractic has also been studied as a treatment for numerous other conditions, like asthma, menstrual pain, colic. Thus far, the results of studies have been inconclusive.

    Is It Safe?

    Chiropractic manipulation appears to be generally safe, rarely causing significant side effects. The most common reaction is local discomfort following therapy, which generally disappears within hours of treatment. Other side effects include temporary headache, tiredness, and discomfort radiating from the site of the adjustment.
    Stroke is a reported rare side effect of chiropractic treatment on the neck. Other rare side effects include:
    • Worsening of disc herniation
    • Increased sensation of nerve pinching
    Because of these rare risks, talk to your doctor before you undergo chiropractic manipulation of your neck.

    If You Decide to Visit A Chiropractor

    A chiropractor must have a four-year Doctor of Chiropractic (DC) degree and also must have a state license. To find a doctor in your area, websites like the American Chiropractic Association offer searchable databases. You can also ask your doctor for a recommendation.

    RESOURCES

    American Chiropractic Association http://www.acatoday.org/

    National Association for Chiropractic Medicine http://www.chiromed.org/

    CANADIAN RESOURCES

    College of Family Physicians Canada http://www.cfpc.ca/Home/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html

    References

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    Astin J, Ernst E. The effectiveness of spinal manipulation for the treatment of headache disorders: a systematic review of randomized clinical trials. Cephalalgia. 2002;22:617–623.

    Aure OF, Hoel Nilsen J, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine . 2003;28:525–531.

    Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors and orthopedic surgeons: the North Carolina back pain project. N Engl J Med. 1995;333(14):913-917.

    Cherkin DC, Deyo RA, Battie M, et al. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. N Engl J Med. 1998;339(15): 1021-1029.

    Chiropractic. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 2011. Accessed August 1, 2011.

    Chiropractors. Occuplational Outlook Handbook website. Available at: http://www.bls.gov/ooh/Healthcare/Chiropractors.htm. Published March 29, 2012. Accessed April 16, 2012.

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    Cooper RA, McKee HJ. Chiropractic in the United States: trends and issues. Milbank Q . 2003;81(1):107-38.

    Coulter ID. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA: Rand Corporation; 1996.

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    Homola S. What a rational chiropractor can do for you. Chirobase website. Available at: http://www.chirobase.org/07Strategy/goodchiro.html . Accessed September 24, 2003.

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    Hufnagel A, Hammers A, Schonle PW, et al. Stroke following chiropractic manipulation of the cervical spine. J Neurol. 1999;246:683-688.

    Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30:1477–84.

    Jarvis WT. Chiropractic: a skeptical view. Chirobase website. Available at: http://www.chirobase.org/01General/skeptic.html . Accessed September 24, 2003.

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