Opioid Use and Chiropractic
Studies have found that an increase in chiropractic therapy resulted in a reduction of opioid use in younger disabled Medicare beneficiaries.
Weeks WB, Geortz CM. Cross-Sectional Analysis of Per Capita Supply of doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries. J Manipulative Physiol Ther 2016;39(4):263-266. https://www.ncbi.nlm.nih.gov/pubmed/27034107
Low Back Pain
Treating low back pain with non-pharmalogical therapy like chiropractic is effective in acute and chronic low back pain patients
Chou R, Deyo R, Friedly J et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for am American College of Physicians Clinical Practice Guidelines. Ann Intern Med 2017;166(7):493-505. https://www.ncbi.nlm.nih.gov/pubmed/28192793
Among patients with acute low back pain, spinal manipulative therapy (chiropractic) was associated with modest improvements in pain and function at up to 6 weeks, with transient minor musculoskeletal harms.
Paige NM, Miake-Lye IM, Booth MS et al. Association of Spinal Manipulative therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA 2017;317(14):1451-1460. https://www.ncbi.nlm.nih.gov/pubmed/28399251
Patients with leg pain relating to the back, chiropractic and home exercise were more effective than home exercise alone after 12 weeks and sustained for a year with some minor secondary outcomes.
Bronfort G, Hondras MA, Schulz CA, et al. Spinal Manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trail with adaptive allocation. Ann Intern Med 2014;161(6):381-391. https://www.ncbi.nlm.nih.gov/pubmed/25222385
The results of this study suggest that chiropractic in conjunction with standard medical care offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP.
Goertz CM, Long CR, Hondras MA, Petri R, Delgado R, Lawrence DJ, Owen EF, Meeker WC. Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain. Spine 2013;38(8):627-634. https://www.ncbi.nlm.nih.gov/pubmed/23060056
Chiropractic is modestly effective on patients with chronic low back pain outcomes with favorable results around 12 visits. Though people will not always get better by this time period we should be seeing improvements by then.
Haas M. Vavrek D, Peterson D, Polissar N, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trail. Spinal J 2014;14(7):1106-1116. https://www.ncbi.nlm.nih.gov/pubmed/24139233
This articles shows what we screen for as doctors of chiropractic when you come in with low back pain and the strength in evidence behind it.
Vining R, Potocki E, Seidman M, Morgenthal AP. An evidence-based diagnostic classification system for low back pain. J Can Chiropr Assoc 2013;57(3):189-204. https://www.ncbi.nlm.nih.gov/pubmed/23997245
Neck Adjustment and Strokes
Over 240 articles of research, there was no convincing evidence to support a causal between chiropractic manipulation and cervical artery dissection that led to strokes. Majority of the time its when someone is having a stroke either before coming to the office or during and a chiropractor doesn’t catch it and adjust anyway, thus leading for someone people to believe when they find out they had a stroke they will like it to their recent chiropractic visit. Most chiropractors are trained to look for signs of stroke and send people to the appropriate facility.
Church EW, Sieg EP, Zalatimo O, et al. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus 8(2):e498. https://www.ncbi.nlm.nih.gov/pubmed/27014532
Cost of Chiropractic Care
Complimentary and alternative medicine (chiropractic included) did not add to the overall national medical spending representation of neck and back problems. In other studies that I have seen, chiropractic even reduces the amount spent.
Martin BI, Gerkovich MM, Deyo RA, Sherman KJ, Cherkin DC, Lind BK, Goertz CM, Lafferty WE. The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems. Med Care 2012;50(12):1029-1036. https://www.ncbi.nlm.nih.gov/pubmed/23132198
Mobilization, manipulation, and clinical massage are effective interventions for the management of neck pain
Meeker WC, Haldeman S. Chiropractic: A profession at the Crossroads of Mainstream and Alternative Medicine. Ann Intern Med 2002;136(3):216-227. https://www.ncbi.nlm.nih.gov/pubmed/11827498
The findings from this study suggest that chiropractic use in episodes of care for uncomplicated back conditions has protective effects against declines in ADLs, instrumental ADLs, and self-rated health for older Medicare beneficiaries over a 2-year period. Meaning that older adults benefit from chiropractic to have better quality of life that have low back pain.
Weigel PA, Hockenberry J, Bentler SE, Wolinsky FD. The comparative effect of episodes of chiropractic and medical treatment on the health of older adults. J Manipulative Physiol Ther 2014:37(3):143-154. https://www.ncbi.nlm.nih.gov/pubmed/24636108
Talks a little bit about the history of chiropractic and its integration with mainstream medicine and alternative medicine. Also how chiropractic has taken strides before 2002 to become more professional in education and licensure.
Wong JJ, Shearer HM, Mior S et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMA collaboration. Spine J 2016;16(12):1598-1630. https://www.ncbi.nlm.nih.gov/pubmed/26707074