Chiropractic Risks and Research

When you think of healthcare research, pharmaceutical and nutrition studies are probably what come to mind. It seems that the media reports on these every day. However, when it comes to research into the risks and benefits of non-drug interventions, chiropractic stands out.

In fact, more research for chiropractic treatment of specific conditions has been completed than for almost any other type of healthcare. Only approximately 15% of all medical interventions, including surgery, are supported by scientific evidence, according to David Edy, M.D., Ph.D., of Duke University. On a recent episode of the ABC network news show "20/20," Dr. Paul Shekelle, of the RAND Corporation, noted "There are considerably more randomized controlled trials which show benefit of this (chiropractic) than there are for many, many other things which physicians and neurosurgeons do all the time."

There are many resources, online and off, to explore studies of chiropractic treatment. Some of these are outlined below. Overall, despite some controversies, these studies show that chiropractic is a safe and effective form of healthcare.

The Risks of Chiropractic Adjustments: Myth and Reality

You may be aware of media claims that chiropractic is dangerous, especially with regard to neck adjustments and stroke. While these claims cannot be dismissed out of hand, they require closer examination, one that will unravel myth from reality. Though there have been a few cases of stroke or brain injury following chiropractic adjustments, they all occurred in patients who already had significant risk factors for these illnesses. Further investigation of these cases has failed to find a significant causal connection between chiropractic adjustment and the illnesses of these unfortunate patients.

How is it that these cases have made it to the press as evidence of the dangers of chiropractic? In many cases, the problem is poor reporting by the press. Physicians associated with these cases have written letters to medical journals branding chiropractic as a dangerous practice, letters that are published in what amounts to the opinion section of the journal. The press reads these letters, mistakes them for supported medical fact, and reports these opinions to the public.

In fact, there has been considerable research into the risks and benefits of chiropractic treatment. In the case of cervical (neck) adjustments, large studies in both the U.S. and Canada have found no evidence that chiropractic treatment increases the risk for stroke or spinal cord injury. One such study, covering a decade of stroke patient history in several large hospitals, concluded: "The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care." (Spine. 2008 Feb 15;33(4 Suppl):S176-83.)

Chiropractic is a safe practice when performed by trained professionals. Doctors of chiropractic have extensive training in evaluating each patient to determine if chiropractic care is appropriate for you. If you have questions about the risks or benefits of a particular technique, ask your chiropractor before starting treatment.

Chiropractic Benefits and Research

Studies on the risks of chiropractic are only a small percentage of all research in the field, though they seem to be the ones that make the news. A large and growing body of research has examined the benefits and cost effectiveness of chiropractic treatment in depth. Below are a few of the areas that have been frequently featured in research studies:

Chiropractic Care and Neck Pain

This is one of the most frequently studied areas of chiropractic treatment. An interesting 2007 study from the Netherlands examined the risks and benefits of chiropractic treatment for cervical pain. Over 500 patients were selected from several medical centers, with a primary complaint of neck pain. They were tracked for 12 months for both adverse effects and benefits. Some adverse effects were noted, such as dizziness or tiredness following chiropractic treatment, but over two thirds of the cohort reported their neck pain to be resolved during the study. The authors concluded, "Adverse events may be common, but are rarely severe in intensity. Most of the patients report recovery, particularly in the long term. Therefore, the benefits of chiropractic care for neck pain seem to outweigh the potential risks." (J Manipulative Physiol Ther. 2007 Jul-Aug;30(6):408-18)

Chiropractic Treatment and Arthritis

Studies have examined chiropractic treatment for arthritis by itself and compared with physical therapy, pharmaceutical therapy and applied heat and cold. Dozens of these studies have been completed in the past decade, and chiropractic has been revealed to be an effective, cost-effective choice for arthritis of the low back, knees, ankles, elbows, and hands. In several studies, it was found that combining therapies, such as moist heat packs and chiropractic adjustments for example, gave the best result. In general, research has confirmed that chiropractic is a reasonable choice for arthritis sufferers, with risks much lower than those associated with over-the-counter NSAIDs, such as aspirin and ibuprofen.

Chiropractic and Chronic Low Back Pain

This is the classic complaint that brings many people to chiropractic for the first time. A number of studies have challenged the effectiveness of chiropractic for low back pain, but in the end even these critical studies concluded that chiropractic is effective for mechanical low back pain. Currently, several new projects to extend our knowledge of chiropractic adjustment and low back pain are being overseen by the National Institutes of Health (NIH). Especially when compared to surgery, chiropractic consistently emerges as the conservative choice.

Chiropractic Treatment for Chronic Headaches

All three types of headaches, tension, cervicogenic and migraine, can be effectively treated with chiropractic in many individuals. The NIH and other medical institutions, are currently studying chiropractic treatment of headache to determine which patients will benefit the most. The usual treatment for headache, NSAIDs, presents significant risks for many people, especially over long use. Research has indicated that a holistic and natural alternative, like chiropractic, is a reasonable and often effective therapy to try, and carries with it far fewer potential side effects.

Taken together, the body of existing research strongly suggests that chiropractic is an effective, safe therapy for a wide range of health problems. If you are interested in reading more on this subject, and doing a bit of your own research, visit the NIH's National Center for Complementary and Alternative Medicine.

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