August 29, 2018
An estimated 60-80% of people will suffer from low-back pain at least once in their lifetime. However, the treatment of chronic lower back pain is complex, and the outcome remains unpredictable. Doctors are advised to recommend that patients follow a program of active exercise to alleviate their symptoms. However, patients may be reluctant to do so because of their pain.
A recent study compared the effects of chiropractic treatment followed by exercise versus a placebo or 'sham' treatment followed by the same exercise. The researchers hypothesize that chiropractic adjustments which are believed to induce an immediate analgesic effect may enhance the benefits of exercise for patients with lower back pain.
The study involved patients with chronic, non-specific lower back pain. The first group received spinal adjustments plus active exercise therapy. The second group received a detuned ultrasound 'sham' treatment followed by active exercise. Both groups underwent eight treatment sessions over 4 to 8 weeks.
The analgesic effect of spinal adjustments were measured by evaluating pain intensity both before and immediately after each therapeutic session. Periodically, researchers also evaluated participants' disability, fear-avoidance beliefs, and erector spinae and abdominal muscle endurance (measured with Sorensen and Shirado tests).
The participants who received spinal adjustments experienced a better immediate analgesic effect, along with lower disability and a trend toward lower pain levels. The researchers concluded that manual therapy, immediately followed by active exercise, tends to induce a more significant decrease in pain reduction in patients with chronic lower back pain. These results confirm that chiropractic is an appropriate treatment for chronic low-back pain.
While exercise has long been a crucial component of chiropractic care, this study provides further evidence of the efficacy of combining exercise with chiropractic adjustments for relieving chronic pain.
Balthazard P, et al. Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial. BMC Musculoskeletal Disorders 2012; 13: 162. doi:10.1186/1471-2474-13-162.
August 28, 2018
An estimated 11-28% of adults suffer from chronic dizziness --a never-ending feeling of spinning, unsteadiness, and disorientation. These symptoms are common in patients with headache, neck pain, and whiplash-associated disorders.
Fortunately, a growing body of research suggests that manual therapies like chiropractic can reduce cervicogenic dizziness.
This specific type of dizziness is believed to originate in the cervical spine or neck. The neck plays an important role in the body's postural control: your neck is full of muscle spindles that act as sensory receptors working with a variety of reflexes to stabilize the head, eyes, and posture. Injury or disorders in the neck may disrupt the body's sensory system, resulting in cervical vertigo. Treating disorders in the neck can help restore the body's sensory capabilities to reduce symptoms of dizziness.
A recent literature review analyzes the available research on the efficacy of spinal adjustments, soft-tissue mobilization, and other manual therapies for treating dizziness.1
In a 2008 study, researchers compared a specific type of spinal mobilization to a placebo.2Although placebo patients did improve, the patients receiving spinal mobilization experienced additional improvements in decreased dizziness frequency. They also had significantly reduced dizziness severity, disability, and neck pain at both the 6 and 12-week follow-ups.
The literature review also showed that other manual therapies, notably spinal adjustments and soft-tissue mobilization, produced similar improvements in several studies.
In addition to minimizing dizziness symptoms, two studies showed that spinal adjustments were found to improve blood flow in the arteries of the neck, which is believed to produce therapeutic effects.3-4 Another two studies found that spinal adjustments led to measurable improvements in balance.5-6
Some case studies suggested that combining manual therapies with vestibular rehabilitation could prove to be more superior than manual therapy alone. Vestibular rehabilitation can include a variety of mental and physical exercises, occupational therapy, restoring balance sense, and eye training. While cases studies point to promising results with combined treatment, there are still no experimental or observational studies on the combined effects of manual therapies and rehabilitation. The authors recommended that future research examine the potential benefits of combined treatment, and determine the dose requirements of manual therapies for dizziness.
This literature review confirms that chiropractic and other manual therapies can reduce cervicogenic dizziness for many patients. Chiropractors can also provide natural treatment for related symptoms of cervicogenic headache and migraine.
1. Lystad RP, Bell G, et al. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropractic and Manual Therapies 2011;19(1):21. doi: 10.1186/2045-709X-19-21.
2. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Manual Therapy 2008;13(4):357366. doi: 10.1016/j.math.2007.03.006.
3. Kang F, Wang Q-C, Ye Y-G. A randomized controlled trial of rotatory reduction manipulation and acupoint massage in the treatment of younger cervical vertigo. Chinese Journal of Orthopedics & Trauma 2008;21(4):270272.
4. Du H, Wei H, Huang M-Z, Jiang Z, Ye S-L, Song H-Q, Yu J-W, Ning X-T. Randomized controlled trial on manipulation for the treatment of cervical vertigo of high flow velocity type. Chinese Journal of Orthopedics & Trauma 2010;23(3):212215.
5. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Manual Therapy 2008;13(4):357366. doi: 10.1016/j.math.2007.03.006.
6. Karlberg M, Magnusson M, Malmström E-M, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Archives of Physical Medicine and Rehabilitation 1996;77(9):874882. doi: 10.1016/S0003-9993(96)90273-7.
August 23, 2018
Many people are aware that chiropractic is an effective way to relieve a number pain conditions, but a growing body of research suggests it can also improve immunity.
have shown that spinal adjustments can affect specific immune responses in both healthy participants and back-pain patients. However there have been no major literature reviews of the overall effect of chiropractic on immunity. In a recent presentation
at the 9th Chiropractic, Osteopathy, and Physiotherapy Annual Conference in the UK, Jack Neil of the Anglo-European College of Chiropractic analyzed the existing literature on spinal manipulative therapy (SMT) and immune responses.
After reviewing the research up to January 2012, Neil confirmed that spinal adjustments are associated with a central anti-inflammatory response. Research suggests that SMT may lead to a down regulating of pro-inflammatory cytokines and an increase in antibodies involved in the immune response. At the same time, SMT may increase the production of tiny cells called leukocytes which support the white blood cells in fighting off a threat. SMT may also affect Natural Killer cells, interleukin-2 activity, TNF-a levels, cortisol, and b-endorphin levels.
The mechanisms behind these processes are still unclear however. There is not enough research yet to know whether these inflammatory changes correlate with an improvement in symptoms."Most research to date has focused on asymptomatic patients with short-term improvements. The challenge now is to clinically observe long-term health benefits in symptomatic patients," Neil concluded.
Although more research is needed, current evidence suggests that chiropractic adjustments can produce positive changes in the immune system. These immunological changes may explain why chiropractic can reduce inflammation and pain while supporting overall wellness.
At Charlotte Natural Healing, we carry a variety of herbs and Whole Food Supplements to support your immune system.
Neil J. Manipulative therapy and immune response: A literature review of the chiropractic and osteopathic evidence. Clinical Chiropractic 2012;15(3):186.
August 21, 2018
Many headaches arise from cervical musculoskeletal disorders. Often, conservative therapies are recommended as the first treatment for cervicogenic headache, but it was previously unclear which treatments were the most effective. Should patients be prescribed a set of exercises and physical therapy sessions, chiropractic adjustments, or both? Will one lead to better outcomes?
A 2002 study sought to answer these questions by examining the effectiveness of a combination treatment involving both chiropractic adjustments and an exercise program. Two-hundred participants with chronic, moderate intensity cervicogenic headaches were assigned to one of four groups: spinal adjustments, exercise therapy, combined therapy, and a control group. Over six weeks of treatment, they reported their headache frequency, intensity, duration, pain, medication intake, and satisfaction with treatment. Researchers also measured physical outcomes such as pain on neck movement and a photographic measure of posture.
The study showed that all three active treatments (chiropractic adjustments, exercise, and a combination of both) were effective for improving the symptoms of cervicogenic headache, with benefits maintained at least 12 months following treatment. There was no statistical evidence of an additive effect when both chiropractic manipulation and exercise therapy were used simultaneously. Despite patients receiving combined treatments experienced the same clinical benefits as patients in the stand-alone treatment groups, a greater proportion of participants in the combined treatment group experienced good or excellent outcomes. This supports the use of combined treatments for the management of cervicogenic headaches.
Combining chiropractic with exercise can also ease symptoms in patients with neck and back pain.
Jull G, Trott P, Potter H, et al. A randomized controlled trail of exercise and manipulative therapy for cervicogenic headache. Spine 2002; 27(17):1835-1843.
August 20, 2018
Whiplash injuries are an expensive and painful problem in the US. Experts estimate that we spend $29 billion per year in treating the pain and disability that can result from a rear-end collision.
But there are steps you can take to protect yourself from whiplash injury. The key to good whiplash protection is your head restraint. Numerous studies have shown that most people have an improperly adjusted head restraint, commonly called a head rest.
Whiplash injury occurs when your torso moves in one direction while your head moves in another direction. This can put hundreds of pounds of force on the delicate ligaments of your neck.
The key to good head restraint positioning is to eliminate or reduce the amount of space that your head can move. By doing that, it reduces the strain put on your neck. Your head restraint needs to be placed so that the back of your head is level with the middle of the restraint, and your seat needs to be positioned so that your head is very close. You want to have a maximum of 2.5 inches between your head and the restraint.
While car crashes are often out of your control, you can properly adjust your head restraint to reduce the chance of neck injury during a rear-end collision.
If you've already been injured in a crash, it's important to get treatment right away. Research
suggests that chiropractors can provide effective treatments for many patients with whiplash-associated disorders.
Freeman MD, et al. A review and methodologic critique of the literature refuting whiplash syndrome. Spine 1999; 24 (1): 86-96.
Prevent Injury, Adjust your Headrest. CAA South Central Ontario. http://www.caasco.com/insurance/auto-vehicle-insurance/adjust-your-headrest.jsp.
How to Adjust Your Head Restraint. The Royal Society for the Prevention of Accidents. http://www.rospa.com/roadsafety/info/adjust_head_restraints.pdf.
August 14, 2018
Do you ever experience neck stiffness or pain with your headaches? Recent research suggests that neck and head pain are more related than you think.
One study examined whether headaches and cervical spine impairment were linked in patients with head pain. Of the patients evaluated, 90% had cervicogenic headaches, or headaches linked to neck pain. Furthermore, the severity of patients' headaches impacted the range of motion in their necks. This study demonstrates the strong relationship between cervical spine (neck) impairment and cervicogenic headaches.
Visit a chiropractor in your area to determine whether your headaches are related to impairment and pain in your neck.
Hall TM, Briffa K, Hopper D, Robinson KW. The relationship between cervicogenic headache and impairment determined by the flexion-rotation test. Journal of Manipulative Physiological Therapy. 2010 Nov-Dec; 33(9):666-71.
August 10, 2018
In an article written to educate the public about back pain, the Journal of the American Medical Association (JAMA) has suggested that patients seek chiropractic and other conservative back-pain treatment before taking more invasive measures.
The article says that surgery is not usually needed for treating back pain and should only be considered when other conservative methods fail.
This recommendation reinforces what the American Chiropractic Association (ACA) teaches patients, as well. Chiropractic should be the first line of defense against musculoskeletal pain.
The article has been published online on the JAMA patient page titled "Low Back Pain," and discusses the causes, symptoms, diagnosis, treatment options, and prevention of low-back pain. The doctors who wrote the article go on to explain that the back is comprised of bones, nerves, muscles, and soft tissues like ligaments and tendons. Back pain can be a result of problems with any of these structures.
Because chiropractors are neuro-musculoskeletal experts, they are well equipped to manage and prevent low-back pain.
In an interview about the JAMA article, ACA President Keith Overland, DC, said that he and his colleagues at ACA were encouraged to see chiropractic suggested for back-pain treatment. He confirmed that in many cases, back pain can be alleviated without the use of drugs or surgery, "so it makes sense to exhaust conservative options first."
And chiropractic makes sense for reducing health-care costs as well. Dr. Overland went on to say, "Research confirms that the services provided by chiropractic physicians are not only clinically effective but also cost-effective, so taking a more conservative approach at the onset of low back pain can also potentially save both patients and the health care system money down the line."
If you have low-back pain, follow the advice of these reputable medical communities. See a chiropractor first.
American Chiropractic Association. JAMA suggests chiropractic for low back pain. Businesswire May 8, 2013. businesswire.com.
Goodman D, Burke A, Livingston E. Low back pain. JAMA Patient Page April 24, 2013; 309(16): 1738. doi:10.1001/jama.2013.3046.
August 9, 2018
Expense of Chronic Back Pain
Lower back pain is incredibly common, and it can be very expensive to treat. According to one estimate, the direct and indirect costs of chronic back pain amount to $100 billion every year in the U.S. alone.
Low-Back Pain Is a Problem
The authors of a new study comment, "One factor explaining these enormous costs is the high rate of recurrence and chronic disability related to low-back disorders." They estimate that ten percent of low-back pain patients account for more than 80 percent of the costs related to back pain.
Study Low-Back Pain Prevention
Because of the huge costs of treating low-back pain, many studies have focused on prevention. One recent study examined the role of chiropractic adjustments in treating chronic lower back pain. The study involved 30 participants whose back pain had lasted at least 6 months. The study began with one treatment-free month, enabling the researchers to observe a 'control period' of untreated back-pain symptoms.
Following this initial period, half of the patients underwent intensive chiropractic adjustments, including 12 treatments in one month, followed by no treatments for the next nine months. The other group received the same initially intensive treatment, along with maintenance chiropractic sessions every 3 weeks for a period of nine months. At the end of this period, researchers examined both groups.
The study authors found that:
Both groups of patients experienced a reduction in pain. Even without follow-up visits, an intensive month of chiropractic treatments reduced pain levels.
Disability levels showed a different response. Patients who received no continuing treatment found that disability levels returned to pre-treatment levels, while those who received maintenance treatments saw continued improvements in their disability scores over the nine-month study period.
The authors conclude that their research appears to confirm the idea that low-back pain and disability are reduced following chiropractic spinal adjustments. They added:
"It also shows the positive effects of preventive chiropractic treatment in maintaining functional capacities and reducing the number and intensity of pain episodes after an acute phase of treatment. Maintenance chiropractic care involving spinal manipulation combined with other treatment modalities (exercises, pain management program) should be investigated. Such combined interventions may have a critical influence on pain, disability, and return to work."
Descarreaux M, Blouin JS, Drolet M, Papadimitriou S, Teasdale N. Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: a preliminary study. Journal of Manipulative and Physiological Therapeutics 2004;27:509-514.
August 8, 2018
August 7, 2018
According to a recent study, patients treated with chiropractic adjustments experienced a 50% reduction in the number of cervicogenic headaches they experienced.
What Are Cervicogenic Headaches?
Cervicogenic headaches are non-throbbing, steady headaches felt at the back of the head, with pain extending downwards through the neck and between the shoulder blades. Some patients also experience dizziness. Such headaches are caused by dysfunction in the cervical spine (the portion of the spine located in the neck).
Previous studies showed that chiropractic treatments can alleviate both the pain and disability resulting from cervicogenic headaches. This study showed that chiropractic treatments can also reduce the frequency of such headaches.
The research involved 80 people with chronic cervicogenic headaches. Patients received either light massage or chiropractic adjustments. Within each group, half received high doses of the treatment, while the other patients received lower doses. The light massage treatments involved several minutes of gentle neck and shoulder massage, while the chiropractic treatments consisted of high-velocity, low-amplitude adjustments of the upper back and neck.
Improvements with Chiropractic
Patients who received chiropractic treatments improved substantially more than those receiving massage. On average, chiropractic patients saw their headaches cut in half. At the conclusion of the study, chiropractic patients required one-third less pain medication than at the start, and reported a 50% reduction in symptoms.
The researchers found no major differences between patients receiving 8 chiropractic treatments and those who received 16 treatments. Those who received more treatments did have slightly more improvements in terms of neck disability. More research is needed to determine the optimum number of chiropractic treatments, but the researchers have concluded that chiropractic adjustments are an effective method of treating cervicogenic headaches. Research shows that chiropractic can also relieve migraine headaches
Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. The Spine Journal 2010; 10: 117-128.