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Chiropractic treatment and Research

Chiropractic Research

Chiropractic first started in 1895 and in the beginning the treatment was based on empirical evidence that it worked. However, it would have been foolish not to try to back up the empirical evidence with research in order to be taken seriously as a profession.

Over the last twenty years more and more research has been done into the treatment and it is now one of the most, if not the most researched complementary medicine discipline. Over the years many good studies have provided the evidence that the treatment is safe, effective and cost effective.

As a result it has become a registered profession in England and many other countries in Europe.

Chiropractic research is such a vast subject that it would be impossible for us to cover everything here. We are initially going to cover safety, effectiveness and cost-effectiveness of the main conditions that we treat.

Safety of chiropractic treatment

It is a subject that is of outmost importance to us as chiropractors. We have all sworn the Hippocratic oath and our foremost aim is ‘to do no harm’.

As with any therapeutic procedure there are possible side effects and risks involved. However, complications from the treatment are very rare. At Avon Chiropractic Healthcare, we have not had any patient with serious side effects since we started in 1993.

Did you know that taking normal painkillers is probably more harmful than receiving chiropractic treatment?

Chiropractic manipulation is a very controlled manoeuvre and side effects from the treatment are very rare. There has been a lot of research into our treatment and patient satisfaction is always reported to be very high.

But as with any therapeutic procedure there are possible side effects and risks involved. So what are the side effects?

What are the side effects?

About half the patients have some form of reaction to the treatment, but fortunately symptoms in the majority (85%) are mild. Local discomfort and tiredness are the most common side effects, which disappear within 24 hours for most (74%). This study done in 1997 included 4712 treatments on 1058 new patients. LINK to research.

A more recent study, published in Spine in 2007, had very similar findings. It included 19,722 patients and 50,276 cervical spine manipulations. The aim of the study was to find out what effects the treatment had and possible side effects of chiropractic manipulation of the cervical spine . The highest risk immediately after treatment was fainting/dizziness/light-headedness in, at worse ≈16 per 1000 treatment consultations. LINK to research.

In both studies above no serious side effects were reported.

Serious side effects

The most serious, but rare risk, is that of a vertebral or carotid artery dissection and stroke following cervical manipulation.

The incidence of stroke in previous studies has ranged between 1 in 100,000 to 1 in 5.85 million treatments. The important thing to remember is that these studies never showed that chiropractic treatment had caused the stroke but that there was an association with the treatment (which mean that the person had been to a chiropractor before the incident).

This should be put in comparison to the rate of spontaneous vertebral artery dissections, ie. without manipulation, which is estimated to be about 2.6 per 100,000 persons. LINK to research.

Those figures suggests that it is more likely to have a stroke from everyday activities such as turning the head reversing the car, looking up at fire works, painting the ceiling, having your hair washed at the hair dressers, and many more common activities.

Research shows no strain on arteries in neck!

Research has shown that the arteries in the neck do not undergo any more strain in chiropractic treatment compared to neck movements in normal daily activities. This probably came as no surprise to most chiropractors as a normal adjustment of the neck rarely involves much more than 45° of rotation and slight extension. This is a position that most people do routinely in normal activities several times every day. LINK to research.

Patients are equally likely to have stroke after seeing their GP!

New research published in January 2008 showed that the incidence of vertebral artery (VBA) stroke is not higher after seeing a chiropractor than a GP!

Family physicians do not manipulate, so why did people suffer stroke after seeing their GP? Well, the explanation is that the people already where in the middle of having a stroke when they contacted their chiropractor or GP. Neck pain and headache are common symptoms of VBA dissection and typically precede VBA stroke and people experiencing headache and neck pain may choose to consult a chiropractor or GP. LINK to research.

In conclusion

Chiropractors are trained in finding out who is at risk to a certain treatment method and can select the method that is going to be most appropriate and safe for you. Chiropractors are trained in medical diagnosis in order to rule out underlying medical conditions that are not suitable for our treatment, and can refer you to the appropriate person for other treatment if needed.

Chiropractors are highly trained in manipulation and therefore know how to use it safely, compared to other therapists who have taken a short course in manipulation. We are always trying to give our patients the best possible care and research has shown that the risk of side effects of chiropractic treatment is very small.

If you want to discuss any of the subjects, please feel free to contact us.

Effectiveness and Cost effectiveness of chiropractic treatment

The following research is mainly about lower back pain.

One of the most ground breaking pieces of research in the UK was the MRC trial in 1991 and its follow-up in 1995, which showed that our treatment was more effective in treating back pain than hospital outpatient management for low back pain and had good long term results especially for people with severe and long-standing back pain. LINK to research.

As a result of the research the guidelines for GPs treatment of back pain (RCGP 1996), that was first produced in 1996 and revised in 2001, included chiropractic treatment as a preferred treatment.

A clinical trial funded by the Medical Research Council in 2004 and published in the British Medical Journal, showed that manipulation was effective and also cost-effective for back pain. LINK to research.

In June 2006 The British Medical Journal published a review of the diagnosis and treatment of low back pain. One of the recommendations given for acute (recent onset) low back pain was that manipulation should be considered as a treatment for pain relief. Manipulation should also be considered for chronic low back pain. LINK to research.

Finally, the National Institute for Health and Clinical Excellence (NICE) have issued in May 2009 guidelines on the management of persistent non-specific low back pain. LINK to Patient Information Leaflet. Chiropractic Manipulation is recommended as one of the possible treatment.

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