New research: increased chiropractor visit frequency renders better patient outcomes
As written by Mark Studin DC September 2, 2022
It has been well-established that chiropractic renders positive outcomes for mechanical spine pain. DeVochet, et al. (2005), reported that 87% of chiropractic patients reported improvement. Leeman, et al. (2014), reported that 95% of chronic pain patients reported improvement. Shokri, et al. (2018), reported that 95% of sacroiliac joints, a primary pain generator in low-back pain, improved with manipulation (chiropractic spinal adjustments or CSA). But new in 2022, Yang, et al., verified through functional MRI (fMRI) that immediate changes in the brain involving pain and emotional and cognitive changes were achieved using CSA, reporting further diminishing chronic low-back pain in all patients, and supporting chiropractor visit frequency and improved results for patients.
The above outcomes are all related to pain and do not consider the biomechanical changes in the spine that are necessary to “normalize” the pain generators.
These pain generators make up the mechanoreceptors and nociceptors. They are comprised of Pacinian corpuscles, Ruffini corpuscles, Golgi ligament organs, and the nociceptors found in the joint capsule and on the facets. The fMRI changes reported by Yang, et al. (2022), are a direct result of a CSA causing afferent innervation, as reported by Coronado, et al. (2012), from the mechanoreceptors and nociceptors into the lateral horn. According to Montero, et al. (2021), these evoke central sensitization with both primary and secondary hypoalgesia.
The pain mechanisms are a result of biomechanical failures and neurological compromise as described herein, which are a result of joint capsule (ligamentous) subfailures.
Holsgrove, et al. (2016), reported, “Any disruption to the various hard and soft tissue structures of the facet joint has the capacity to elicit pain. The facet capsule and synovial folds are innervated by nociceptive and mechanoreceptive afferents. Pain can result from direct damage of nociceptors but can also be produced indirectly through damage to the mechanoreceptors, which alters feedback and increases neck instability, leading to pain in muscles and/or from muscular contractions” (pg. 1).
Chronic pain indicates a persistent biomechanical failure and a constant firing of the nociceptors and mechanoreceptors to the central nervous system. Chronic neck and low-back pain as reported by Herman, et al. (2021), “usually cannot be cured, but it can be managed” (pg. E62).
Medicine for too long has tried to apply a pharmacological solution to a mechanical problem, with poor outcomes. Cifuentes, et al. (2011), reported that medical management of mechanical spine pain had a 250% increase in disability duration vs. chiropractic care. Herman, et al. (2021), reported that if patients didn’t receive chiropractic care, their pain would have been double.
It was reported by Herman, et al., that 30-60% of patients in the United States with chronic low-back pain have seen a chiropractor, creating an easy “pool” of people to study. These results of studying 2,024 patients indicate that increased chiropractor visit frequency (greater than once weekly) over a three-month period rendered better outcomes. The study also found that adding complementary therapy (i.e., massage, etc.) rendered better functional improvement. It was also found that the more significant the pain initially, the more frequent chiropractic care per week rendered better outcomes.
According to Shokri, et al. (2018), “compared to common treatments for lumbar disc herniation, chiropractic care is 37,000 to 148,000 times safer than non-steroidal anti-inflammatory drugs and 55,000 to 444,000 times safer than surgery.”
Whedon, Mackenzie, Phillips and Lurie (2015) reported on the safety in general of chiropractic patients and based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study, with the total patient number accounting for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon, et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.
Chiropractic is safe, creates a mechanical solution for biomechanical pathology, and renders better outcomes when used as clinically indicated.
Should the medical community and insurers read the evidence in the literature, chiropractic isn’t the best “first choice” for mechanical spine pain, it should be the only first choice. There are tools in the industry (i.e., X-ray digitization) that render demonstrative guidance to DCs on where and when to adjust, and when MMI has been attained. These demonstrative tools also give evidence of the biomechanical changes made with a CSA. It is tools like this and others that will help “bridge the knowledge gap” to bring chiropractic to the forefront as a Primary Spine Care Provider.
Dynamic Chiropractic – February 1, 2018, Vol. 36, Issue 02
What Patients Love About Chiropractic
BY EDITORIAL STAFF
Findings from the 2012 National Health Interview Survey, "the most recent source providing data on the use of complementary health care approaches by adults in the United States," reveals why patients utilize chiropractic and what they value most.
The survey provides data on lifetime (54.6 million; 24%) and 12-month (19.1 million; 8.4%) utilization of chiropractic and various sociodemographic characteristics. But the most intriguing data illuminates the primary reasons for visiting a DC and the perceived health and wellness benefits received by chiropractic users:
Reasons for Visiting a DC
For general wellness / disease prevention: 43.6%
To improve energy: 16.3%
To improve athletic or sports performance: 15.4%
To improve immune function: 11.4%
To improve memory or concentration: 5.3%
Benefits of Chiropractic
Improves overall health or makes feel better: 66.9%
Helps to sleep better: 41.9%
Helps to reduce stress level or to relax: 40.2%
Makes it easier to cope with health problems: 38.5%
Gives a sense of control over own health: 32.5%
Helps to feel better emotionally: 27.4%
Improves attendance at job or school: 17.0%
Improves relationships with others: 13.3%
Chiropractic also motivated patients to "exercise more regularly" (21.6%) and "eat healthier" (10.7%), emphasizing the DC's value as a source of information / guidance in these areas.
Overall Value in Maintaining Health and Well-Being
Very important: 47.9%
Somewhat important: 29.6%
Slightly important: 13.9%
Not at all important: 8.7%
Effectiveness in Helping Specific Health Problem
Helped a great deal: 64.5%
Helped some: 25.8%
Helped only a little: 6.1%
Didn't help at all: 3.5%
Why Not Just See an MD?
Chiropractic combined with medical treatment would help: 64.8%
Chiropractic treats the cause and not just the symptoms: 61.9%
It is natural: 37.5%
Medical treatments do not work for specific health problem: 33.8%
Chiropractic focuses on the whole person: 24.9%
Medications cause side effects: 18.1%
Complete survey findings appear in Spine, Dec. 1, 2017 issue (Adams J., et al.).
Chiropractic and Exercise Are Better than Drugs Says New Study
Chronic pain impacts an estimates 76.5 million americans, one-third who describe their pain as severe or disabling (American Pain Foundation, Pain Facts and Stats).
Among them, many suffer from neck pain, which is the third most common type of pain according to the American Pain Foundation.
It is estimated that 70% of people will experience neck pain in their lives but research into effective treatments is surprisingly limited (Annals of Internal Medicine, January 3, 2012).
If you visit a physician for pain there is a good chance you will leave with a perscribition for pain medication. HOWEVER, there are better options than drugs for neck pain, not only in terms of pain relief, but also in helping to treat the underlying cause of the pain so that healing can truly occur.
New Study Shows Exercises and Chiropractice Care Beat Drugs for Neck Pain.
According to a new study published in the Annals of Internal Medicine and funded by the National Institutes of Health, medication is not the best option for treating neck pain.
After following 272 neck-pain patients for 12 weeks, those who used a chiropractor or exercise were more than twice as likely to be pain free compared to those who took medication.
"For participants with acute and subacute neck pain, SMT (spinal manipulation therapy) was more effective than medication in both the short term and long term. However, a few instructional sessions of HEA (home exercise with advice) resulted in similar outcomes at most time points."
Want a demonstration of the 5 specific exercises to target chronic neck pain? Contact Dr. Kelley today!
Click HERE to see what Harvard Medical School has to say about the benefits of Chiropractic.
Printed in the New York Times is an article that exonerates the Chiropractic industry and sets a tone for the science moving forward. Take a look and see for yourself the implications of the science and the standard of the Chiropractic community. The article is titles "For Bad Backs, It May Be Time to Rethink Biases About Chiropractors" Click HERE for the article.