Spinal Manipulation

New Research Project Demonstrates Relief Of Allodynia With Chiropractic Adjusting

By Frank M. Painter|December 18, 2011|Pain Relief, Spinal Manipulation|

New Research Project Demonstrates Relief Of Allodynia With Chiropractic Adjusting

SOURCE: J Manipulative Physiol Ther 2012 (Jan); 35 (1): 18-25

Jaqueline Trierweiler, Débora Negrini Göttert,
Günther Gehlen, PhD

Academic of Chiropractic from the University Feevale,
Laboratory of Comparative Histophysiology, ICS,
University Feevale, Novo Hamburgo, RS, Brazil.
jaquetri@gmail.com

OBJECTIVE: The purpose of this study was to evaluate the mechanical allodynia in animals after immobilization and chiropractic manipulation using the Activator instrument through the Von Frey test in an animal model that had its hind limb immobilized as a form to induce mechanical allodynia.

METHOD: Eighteen adult male Wistar rats were used and divided into 3 groups:

control group (C) (n = 6) that was not immobilized;
immobilized group (I) (n = 6) that had its right hind limb immobilized;
immobilized and adjusted group (IAA) (n = 6) that had its right hind limb immobilized and received chiropractic manipulation after.

The mechanical allodynia was induced through the right hind limb immobilization. At the end of the immobilization period, the first Von Frey test was performed, and after that, 6 chiropractic manipulations on the tibial tubercle were made using the Activator instrument. After the manipulation period, Von Frey test was performed again.

RESULTS: It was observed that after the immobilization period, groups I and IAA had an exacerbation of mechanical allodynia when compared with group C (P < .001) and that after the manipulation, group IAA had a reversion of these values (P < .001), whereas group I kept a low pain threshold when compared with group C (P < .001).

CONCLUSION: This study demonstrates that immobilization during 4 weeks was sufficient to promote mechanical allodynia. Considering the chiropractic manipulation using the Activator instrument, it was observed that group IAA had decreased levels of mechanical allodynia, obtaining similar values to group C.

Discussion

The present study investigated the effects of instrumented assisted spinal manipulation therapy on mechanical allodynia produced by the immobilization of the right hind limb in a small animal model through the Von Frey test. Our group observed that the immobilization of the right hind limb, for a period of 4 weeks, might produce an exacerbation of the local mechanical allodynia and that the manipulation applied to the tibial tubercle, using the Activator instrument, might reduce the severity of local allodynia induced by the immobilization. (more…)

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Acupuncture and Chiropractic Care for Chronic Painin an Integrated Health Plan: A Mixed Methods Study

By Frank M. Painter|December 9, 2011|Acupuncture, Research, Spinal Manipulation|

Acupuncture and Chiropractic Care for Chronic Pain
in an Integrated Health Plan: A Mixed Methods Study

The Chiro.Org Blog

SOURCE: BMC Complement Altern Med. 2011 (Nov 25); 11 (1): 118

DeBar LL, Elder C, Ritenbaugh C, Aickin M, Deyo R, Meenan R, Dickerson J, Webster JA, Jo Yarborough B.

Kaiser Permanente, The Center for Health Research, Portland, Oregon, USA. lynn.debar@kpchr.org

BACKGROUND: Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the “real-world” use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain–despite their high costs, potential adverse effects, and modest efficacy–suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community. (more…)

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Mightier Than the Sword — Using Research to Promote and Defend Chiropractic

By Frank M. Painter|October 13, 2011|Research, Spinal Manipulation|

Mightier Than the Sword — Using Research to Promote and Defend Chiropractic

The Chiro.Org Blog

SOURCE: ACA News

By Daniel Redwood, DC

If the public is to be better educated about the benefits of chiropractic care, doctors of chiropractic must be the ones to do the educating. Research is the strongest tool we have to promote our healing art to those unfamiliar with its value and to defend it from unwarranted attacks. We owe it to our patients, our profession, ourselves and future generations to know the facts so that we can share them far and wide.

This does not mean that every practicing DC needs to become a full-time scholar, familiar with the details and nuances of the approximately 100 randomized clinical trials on spinal manipulation. It does mean that to be effective chiropractic ambassadors, we all need a good grasp of the overall picture, along with working knowledge of a small number of studies, reviews and guidelines that will allow us to most effectively deliver our message. And we need to stay up-to-date as new studies emerge.

For much of our history, prior to the dawn of the modern era of chiropractic research in the 1970s and 1980s, DCs had no choice but to rely completely on powerful, true stories about the patients we had helped in our offices. These individual stories still matter and can legitimately be shared with others as part of our outreach.But in this evidence-based era, we must use these anecdotes as the spice only, rather than the main course. Otherwise, we risk losing many opportunities to strengthen our case through strategic use of the increasingly broad and deep body of evidence researchers have made available to us. We best honor their work by sharing it widely, forcefully and accurately.

1. Low-Back Pain

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Is Pediatric Chiropractic Care Safe?

By Frank M. Painter|October 5, 2011|Iatrogenic Injury, Pediatrics, Spinal Manipulation|

Is Pediatric Chiropractic Care Safe?

The Chiro.Org Blog

SOURCE: Clinical Chiropractic 2011 (Sep); 14 (3): 97–105

Matthew F. Doyle

This new “best evidence” literature review explored reported adverse events and the overall safety of chiropractic pediatric care, as well as other forms of care for the same complaints routinely treated in a chiropractic office.

The results were quite interesting:

The chiropractic literature reports incidence between 0.53% and 1% for mild adverse events (AE) associated with chiropractic pediatric manipulative therapy (PMT). Put in terms of individual patients, this means that somewhere between one in 100-200 patients presenting for chiropractic care may experience a mild adverse event; in terms of total patient visits, this means that one mild AE may occur every 1310 to 1812 visits.This incidence rate compares favorably with: (more…)

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Manual Therapy With and Without Vestibular Rehabilitation for Cervicogenic Dizziness: A Systematic Review

By Frank M. Painter|October 2, 2011|Cervicogenic, Dizziness, Spinal Manipulation|

Manual Therapy With and Without Vestibular Rehabilitation for Cervicogenic Dizziness: A Systematic Review

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2011 (Sep 18)

Reidar P Lystad, Gregory Bell, Martin Bonnevie-Svendsen
and Catherine V Carter

Department of Chiropractic,
Macquarie University,
Sydney, Australia.
reidar.lystad@mq.edu.au

BACKGROUND: Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness.

METHODS: A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria.

RESULTS: A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity.

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The Biological Rationale For Possible Benefits of Spinal Manipulation

By Frank M. Painter|September 7, 2011|Spinal Manipulation|

The Biological Rationale For Possible Benefits of Spinal Manipulation

The Chiro.Org Blog

SOURCE: Chapter X; AHCPR Publication No. 98-N002: December 1997

By Howard T. Vernon, DC

Manipulation is a form of treatment that dates to antiquity and has been practiced in some form in most cultures since that time (Lomax, 1997; Anderson, 1992). One of the first theories related to manipulation might be the statement attributed to Hippocrates: “Look to the spine as the cause of disease.” The theories of the early pioneers of chiropractic were firmly grounded in notions that had been widely held in the 1800s, particularly the idea of “spinal irritability” and its correlation with disease (Lomax, 1997; Terrett, 1987). Theories on the nature of the primary spinal disorder amenable to manipulation and on the mechanisms of action of spinal manipulation abound within chiropractic, osteopathy, physiotherapy, and manual medicine. The original chiropractic theory suggested that misaligned spinal vertebrae interfered with nerve function, ultimately resulting in altered physiology that could contribute to pain and disease. In recent decades, chiropractic theories about how mechanical spinal joint dysfunction might influence neurophysiology have undergone significant modification and reflect more contemporary views of physiology (Gatterman, 1995).

Spinal manipulative procedures produce a short-lasting (100-300 milliseconds), high velocity impulse into the body (Herzog, 1996; Triano, 1992). Herzog (1996, p.271) has summarized the work done on manipulative forces in his laboratory (Conway, 1993; Gal, 1995; Kawchuk, 1992; Kawchuk, 1993; Herzog, 1991; Herzog, 1993a; Herzog, 1993b; Herzog, 1995; Hessel, 1990; Suter, 1994) as follows:

“The peak and preload forces achieved in CSMT (chiropractic spinal manipulative therapy) were lowest for (manipulations) in the cervical spine” while being similar in the thoracic and lumbo-pelvic regions.
“The peak forces achieved using a (mechanical assistive adjusting device) were considerably smaller than any of the peak forces resulting from CSMT.”

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Subluxation and Neurology Page

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