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Chiropractic More Effective Than Drugs for Back Pain, Study Shows

​Got an achy back? You're better off  going to a chiropractor than popping another pain pill, suggests the results of a new study.

The study, published in the medical journal Spine, shows that that chiropractic adjustments are more effective than a drug for easing back pain.

To compare the efficacy of drugs and chiropractic, researchers tested the effects of spinal adjustments and a non-steroidal anti-inflammatory drug called diclofenac. They divided 38 patients with acute back pain into three treatment groups. One group received spinal adjustments and a placebo drug; the second group received sham adjustments and real diclofenac; and the control group received sham adjustments and a placebo drug.

While both the active treatment groups improved, patients receiving spinal adjustments were significantly better off than patients taking diclofenac. They experienced greater improvements in physical disability, function, time off work, and rescue medication.

This led researchers to conclude that "spinal manipulation was significantly better than non-steroidal anti-inflammatory drug diclofenac and clinically superior to placebo."

These findings add to the growing body of research showing that chiropractic is more effective than drugs for back pain and sciatica. And it's easy to see why. While drugs temporarily dull the pain, they do little to treat the root of the problem. Instead, chiropractic can relieve symptoms while addressing the underlying cause of pain.

Reference

von Heymann, et al. Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparision with diclofenac and placebo. Spine 2013; 38 (7): 540-48. doi: 10.1097/BRS.0b013e318275d09c.

 

Chiropractic Best Option for Sacroiliac Joint Pain

Dysfunction in the sacroiliac joint (SIJ), located in the pelvis, is thought to be a possible cause of sciatica, resulting in back pain that radiates down the leg and below the knee.

Scientists have questioned what the best treatment option is for patients with SIJ-related leg pain. In a recent study, researchers compared three treatment options: physical therapy, chiropractic manual therapy, and intra-articular injections of corticosteroids. Patients included 51 adults with leg pain associated with the sacroiliac joint. Researchers analyzed the effectiveness of each method after 6 weeks of selected treatments, and again after 12 weeks. The results for each patient was categorized as either a success or failure, based on relief or worsening of symptoms and average pain scores.

The study's findings revealed that manual therapy is the superior choice for treating leg pain associated with the SIJ. The success rate for chiropractic manual therapy was 72%, compared to just 20% for physiotherapy and 50% for corticosteroid injections. Researchers also found that neither physical therapy nor injections resulted in significant pain relief, whereas manual therapy resulted in a significant improvement on pain scores.

Due to the success rate and pain reduction of manual therapy, the study authors concluded that chiropractic should be the first treatment of choice in patients with SIJ-related leg pain. They hoped that their findings would be confirmed by further research with a larger sample size.

Additional research has highlighted the efficacy of chiropractic for sciatica, even after surgery has failed.

Reference

Visser L, Woudenberg N, et al. Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial. European Spine Journal 2013 [online]. doi: 10.1007/s00586-013-2833-2.

 

Chiropractic Cuts Headache Pain By 71%

Trigger point therapy reduced cervicogenic headache pain by 71% for patients in a new study. The patients also experienced a 59% reduction in neck pain symptoms, as well as improved range of motion and muscle function.

Trigger point therapy is a treatment commonly used by chiropractors to relieve trigger points (TrPs), or hyperirritable spots of pain located in taut bands of skeletal muscles. Earlier research has shown that chiropractic spinal adjustments are effective for cervicogenic headache, but few studies have tested the efficacy of trigger point therapy for the condition.

In a new preliminary study, researchers tested the effects of trigger point therapy for the treatment of cervicogenic headache. Twenty patients were randomly assigned to receive either trigger point therapy (TrP therapy) or a sham treatment for three sessions during a one week period. The treatments were applied to active trigger points located in the neck.

Patients receiving TrP therapy experienced markedly better outcomes than the sham group. TrP therapy patients had significantly improved neck range of motion and increased functioning of the deep cervical flexor muscles. They also had substantially reduced pain sensitivity, neck pain, and headache. On average, patients' headache pain scores dropped from a 7.6 out of 10 to a 2.2, or about a 71.1% reduction. Their neck pain scores also decreased from a 7.4 to a 3.0 after treatment, or about a 59.5% reduction.

More research is needed to understand why TrP manual therapy lead to these improvements. It has been hypothesized that trigger points play a role in the development of headache, since earlier studies have reported trigger points present in patients with tension headache, cluster headache, and migraine. However this is one of the first studies to confirm the presence of trigger points in people with cervicogenic headache, and to suggest that trigger point therapy can help.

Chiropractors frequently use trigger point therapy in conjunction with spinal adjustments, spinal mobilization, and exercise rehabilitation. This study adds further evidence of the efficacy of chiropractic care for cervicogenic headache.

Reference

Bodes-Pardo G, et al. Manual treatment for cervicogenic headache and active trigger point in the sternocleidomastoid muscle: a pilot randomized clinical trial. Journal of Manipulative and Physiological Therapeutics 2013; doi 10.1016/j.jmpt.2013.05.022.

 

Chiropractic Reduces Health Care Costs

Recent data suggests that expanding insurance coverage of alternative therapies like chiropractic could drive down overall health-care costs. A new study, published in the January 2013 issue of Health Affairs, provides further information into expenditure patterns and utilization of complementary alternative medicine (CAM). Since chiropractic is the predominant source of CAM utilization, the study sheds light on how chiropractic can contribute to patient savings.

According to the study, between 2002 and 2008 the use and spending on CAM services, which had previously been rising, largely plateaued. This suggests that “Any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best." According to the authors, cutting coverage for CAM and chiropractic services could even have the opposite effect, since excluding services currently covered by private and public insurance could “trigger increased spending.”

The analysis of the Medical Expenditure Panel Survey revealed a trend towards increased usage of CAM services, up 6% from 2002 to 2008. In 2002, there were an estimated 15.2 million adult users; this increased to 16.1 million in 2008. The number of chiropractic patients increased from 11.5 million in 2002 to 11.9 million in 2008, while acupuncture saw a 16% increase in adult visits.

Despite the increasing number of patients, total visits to chiropractors and other CAM providers decreased. Chiropractic visits decreased by 3%, from 98.6 million visits in 2002 to 96.1 million in 2008. Acupuncture visits decreased 16% over the same time period, from 6.4 million to 5.4 million. According to the study authors, “The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth.”

The study also investigated the costs associated with chiropractic and other CAM services. Expenditures on chiropractic care increased from $6.2 billion in 2002 to $6.9 billion in 2008. Meanwhile, expenditures on acupuncture, massage, and other CAM treatments remained stable.

This data has important implications for national health-care policy. In their attempt to reduce waste, health-care policy makers often target complementary and alternative medicine services for exclusion. However, this tactic would, at best, result in only a small cost savings. Since CAM appears to be relatively inexpensive when compared with allopathic treatments, if medical providers are able to collaborate with local CAM providers, offering alternative and complementary medicine services could help health-care policy makers achieve their goals of cost savings.

The researchers conclude that health-care policy makers should consider the potential offset effect, in which patients substitute the excluded services with other services, which are covered by their health insurance, at an increased cost.

This study comes at the heels of another recent study suggesting that chiropractic patients have lower annual medical costs than patients in traditional care.

Reference

Davis MA, et al. U.S. spending on complementary and alternative medicine during 2002-2008 plateaued, suggesting role in reformed health system. Health Affairs 2013;32(1):45-52.

 

 

Asthma Patients Find Relief With Chiropractic Care

An estimated 300 million people worldwide suffer from asthma. With 180,000 deaths attributed to the disease, asthma treatment has a significant financial burden. In the United States alone, asthma medication is estimated to cost between $1 billion and $6 billion per year. While often treated with medication, there are other natural treatments available, such as chiropractic care.

In recent years, manipulative therapy has been used in addition to medication for managing respiratory diseases in adults and children. While many chiropractors report success with such treatments, few studies have examined the overall effectiveness of using manual therapies for respiratory disease treatment.

A recent literature review sought to examine the efficacy of chiropractic care for patients with asthma. The study involved randomized controlled trials, case reports, case series, cohort studies, survey studies, commentaries, and systematic reviews. The researchers concluded that chiropractic care may offer an alternative care approach for patients with asthma. However, the authors concluded further randomized controlled clinical trials should be conducted for future investigation of this approach.

Another new literature review focused on the use of manual therapy to treat childhood respiratory disease. That study involved eight clinical trials on the effects of manual therapy on children and teens with respiratory diseases. Five of the studies involved children with asthma, while the others focused on the treatment of children with other respiratory conditions, including recurrent respiratory infections, cystic fibrosis, and bronchiolitis.

Six of the eight studies identified positive results of manual therapy, including reduced anxiety, better lung function, and improved levels of salivary cortisol. The use of manual techniques such as chiropractic, osteopathic medicine, and massage appear to be beneficial for children with respiratory disease.While more research is needed to confirm the results of these initial studies, the findings offer promise for families searching for natural relief of asthma.

A recent case study highlights the impact that chiropractic can have for children with asthma. The case study involved a ten-year old boy who found relief from headache and respiratory symptoms under the care of chiropractor.

 

References

Alcantara J, et al. The chiropractic care of patients with asthma: a systematic review of the literature to inform clinical practice. Clinical Chiropractic 2012; 15: 23-30.

Pepinoa VC, et al. Manual therapy for childhood respiratory disease: A systematic review. Journal of Manipulative and Physiological Therapeutics 2013; 36(1): 57-65.

 

Chiropractic Best Conservative Treatment for Back Pain

When treating persistent back pain, it can be difficult to accurately predict how well a patient will recover from symptoms resulting from non-specific pain. Will the patient be plagued with a lifetime of back pain or can the symptoms be resolved in a matter of months? Although several factors influence the prognosis of back pain, studies suggest that prognosis may differ depending on which treatments patients receive. The identification of which patients are more likely to respond to specific treatments would have valuable clinical implications, yet little research has been done in this area.

A team of researchers recently sought to identify predictors of response to three conservative treatments for low back pain: spinal manipulation (SM), individual physiotherapy (IP), or back school (BS). The research involved 210 patients with chronic, non-specific low back pain. Each was randomly assigned to one of the treatment groups.

Significant improvement was found following all three intervention types. However spinal manipulation provided more functional recovery and pain relief than either of the other interventions studied.  Overall 34% of the patients did not respond to treatment but spinal manipulation showed the lowest rate of non-responders.

The researchers then sought to identify specific patterns of response to treatment in order to identify predictors of outcome. They found that age, quality of life, work status, pain duration, patients' beliefs, and other variables studied did not predict response to treatment. Patients were more likely to benefit from spinal manipulation than from back school or physiotherapy, regardless of their baseline disability score and other clinical characteristics.

A lower initial disability score predicted poor outcome for back school and for individual physiotherapy, but not for patients treated with spinal manipulation. The researchers concluded that patients with chronic lower back pain and related disability should first consider spinal manipulation before other conservative treatments.

Other research has shown that combining chiropractic adjustments with exercise therapies can enhance back-pain treatment.

Reference

Cecchi F, et al. Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation. European Journal of Physical and Rehabilitation Medicine 2012; 48: 371-8.

 

 

 

Chiropractic is Great for Kids

Many parents of children with chronic-health conditions struggle to help their child manage ongoing pain and symptoms. They also worry about the potential effects certain medical treatments and drugs can have on their child's health. That could be why more parents are now seeking natural treatment options like chiropractic.

In a recent study, chiropractic was one of the most commonly-used alternative therapies for children with chronic-health problems.

The study included more than 900 parents of children being treated at cardiology, gastroenterology, neurology, oncology, and respiratory clinics in Canada. Parents were asked about their child's use of alternative therapies and products.

Nearly half of parents said their child used an alternative therapy in addition to receiving conventional treatments. Almost 10% of parents said they'd pursue complementary and alternative medicine (CAM) prior to conventional treatments, and 5% said they used alternative medicine in place of traditional care.

Of the two hospitals included in the survey, at one hospital, 71% of children had received CAM therapies, while 42% had used CAM therapies at the other. The most common CAM therapies were massage, chiropractic, relaxation, and aromatherapy.

Several parents also said their child took multivitamins and minerals and had used herbal supplements and homeopathic remedies in the past. However, parents did not always communicate with primary-care physicians about their child's use of herbal supplements and minerals, which had some observers worried.

Herbal and dietary supplements can change how the body reacts to certain drugs, warned Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, who commented on the issue in recent article from The Huffington Post. She encouraged patients to talk with physicians about their herbal and dietary supplement use, and reminded physicians to take the time to ask.

The study suggests that the use of CAM therapies like chiropractic among children is on the rise. Studies show that chiropractic care is a safe, effective treatment for children with musculoskeletal complaints, headache, and more.

Adams D, et al. Complementary and alternative medicine use by pediatric specialty outpatients. Pediatrics 2013; doi: 10.1542/peds.2012-1220.

 

 

Chiropractic Patients Have 90% Reduction in Migraine Frequency

Many patients rely on pain medications to manage migraines but did you know those medications may actually be causing you more headaches? A recent study found that medication overuse causes daily headaches in 1 in 50 people.  Fortunately, there are natural treatment options that don't put you at risk for worsening head pain.

Cases studies have suggested that chiropractic is beneficial for migraine treatment in pregnant women and children but a 2000 study was one of the the first randomized, controlled trials assessing the efficacy of chiropractic for migraine.

The study involved 127 participants between the ages of 10 and 70. All had been diagnosed with migraines, and had a minimum of at least one migraine per month. Half of the patients received chiropractic treatments, while the other half served as a control group. Treatment consisted of two months of chiropractic spinal manipulations, with a maximum of 16 treatments. Over the course of the study, participants completed headache diaries noting the frequency, intensity, duration, disability, associated symptoms, and medication use for each migraine.

The treatment group showed statistically significant improvements in average responses for migraine frequency, duration, disability, and medication use when compared to the control group. Twenty-two percent of participants reported more than a 90% reduction of migraines after the 2 months of treatment. The results of this study support previous information that some people report significant improvement in their migraines after chiropractic spinal manipulation.

Given that a high percentage of people with migraines report stress as a major migraine factor, it appears likely that chiropractic care affects physical conditions related to stress, thereby reducing the effects of the migraine.

A more recent study published in 2012 demonstrated that chiropractic care reduced pain severity in migraine patients by an average of 68%. In other words, chiropractic patients had their pain levels drop from an average of 5 to 0.5 on scale of 1 to 10.

References

Jahangiri JN, Vatankhah N, and Baradaran HR. Reduction of Current Migraine Headache Pain Following Neck Massage and Spinal Manipulation. Journal of Therapeutic Massage and Bodywork. 2012; 5(1): 5–13.

Tuchin P, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 2000; 23 (2)
91-95.