Contemporary Chiropractic Research Is Not Simply for Pain…

Len Siskin, DC Promote Chiropractic, Co-Chair ICA Best Practices

As most of us realize, chiropractic is a special and unique profession where the information we have about what we do has evolved over the years. Ironically, when taking a critical look at the practical application of chiropractic adjustments performed in most chiropractic offices, the foundation of making an adjustment to the spine largely stays the same. Even in the clinics where they choose to employ modalities of a more medical flavor like decompression, cold laser, or where the chiropractor might integrate rehabilitation or a physical therapist, the general chiropractic part of the treatment largely remains… chiropractic. When asked, most Chiropractors hold a value for correcting the chiropractic subluxation as well rather than embracing a pain management model despite what they choose to tell their patients.

Because the chiropractic part of chiropractic practice seems similar to the way it has been practiced for many years by many Chiropractors, it is interesting to see that chiropractic research is also still not dedicated solely to pain relief of low back and neck. In fact, the most recent meeting of volunteers to read and rate research for the ICA Best Practices Guidelines document held in November, 2009 in NJ, found that the following conditions in chiropractic research papers were shown to receive help from chiropractic intervention (in alphabetical order):

Acetabular Labrum Injury, Adhesive Capsulitis, Bronchopulmonary Dysplasia, Bulbar Palsy, Cerebral Palsy, Costochondritis, Dysmenorrhea, Foraminal Stenosis, Knee Arthritis, Lateral Epicondylalgia, Low Back Pain, Neck Pain, Paroxysmal Supraventricular Tachycardia, Subluxation, Tibialis Posterior Strain, and Viral Torticollis.

All of these named health conditions were in chiropractic research papers from 2007-2009 and do not represent all published chiropractic papers as we have not exhausted our data update through 2009 yet. This will be done in the first half of 2010.

The highest treatment amount in this set of papers was 76 treatment visits with the average number of treatment visits being TWENTY! Overall, only 4% of the studies we reviewed failed to show positive treatment outcomes. It was interesting that of papers failing to show effectiveness of treatment; all but one was performed by a non-Chiropractor (Generally an MD or PT). In the one rated paper failing to show a positive treatment outcome by a Chiropractor, the measurement being considered was for normal mouth opening. As is typical for chiropractic research, 76% of papers were observational studies such as case studies (Level III and IV evidence), and the remaining studies were clinical control trials (Level I and II evidence). Opinion papers (Level V Evidence) were not included nor were academic papers or research papers not working with human subjects.

On a whim I typed, “Research in Chiropractic”, into a Google search. The outcome of this is actually pretty impressive. As a chiropractor in clinical practice, I am all too familiar with common misperceptions held by the general public about our profession. Just the other day a newspaper reporter, who called me to ask for an interview, asked if chiropractic was a two year degree or if I had to go to formal school for my license. The same woman was further in shock when a patient of mine told her I adjust my three year old son.

Searching Google resulted in a more cosmopolitan representation of our profession. In determination to find something bad or negative about chiropractic in this list to complain about, I was delighted to find it took until hit number 126 to see anything that tightened my stomach as a Chiropractor. In fact, hit 126 was banter between the president of the ACA and the President and CEO of the Public Broadcasting Service from June 2002 on a broadcast of, “Scientific American Frontiers”. The two people involved were arguing the possibility of performing scientific research in chiropractic. As far as bad PR for our profession goes, I thought this was not so terrible. I have found some of the best public relations material in our profession is in our published research. The information thankfully speaks positively about chiropractic pretty much any way you look at it.

Along these lines, the ICA Best Practices Guidelines Database currently holds over 1400 original research studies of which only 17 chiropractic papers (about 1%) failed to show positive improvement in patients and none indicated significant, long-term risk or damage from chiropractic treatment. The ones not showing improvement simply did not show improvement. On the other hand, 99% of the papers published show chiropractic has helped a growing list of about 304 named health disorders/conditions using chiropractic treatment.

Critics might believe: “Aren’t those chiropractic papers published only in trade journals?” However, the research papers reviewed at the November 2009 meeting were from indexed publications; let’s look… BMC Musculoskeletal Disorders, Chiropractic and Osteopathy, Chiropractic Journal Of Australia, Clinical Chiropractic, Complementary Therapies in Medicine, Dynamic Chiropractic, European Spine Journal, Journal Canadian Chiropractic Association, Journal of Alternative And Complimentary Medicine, Journal of Chiropractic Education, Journal Of Chiropractic Medicine, Journal Of Clinical Chiropractic Pediatrics, Journal Of Manipulative And Physiologic Therapeutics, Journal Of Manual And Manipulative Therapy, Journal of Orthopedic and Sports Physical Therapy, Journal of The American Chiropractic Association, Journal of Vertebral Subluxation Research, Physical Therapy, & Spine.
http://www.icabestpractices.org/

Chiropractic BioPhysics, ICA Best Practices Chiropractic Guidelines