CHIROPRACTIC: A SAFE TREATMENT OPTION

Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of back pain, neck pain, joint pain of the arms or legs, headaches, and other neuromusculoskeletal complaints.

(From The American Chiropractic Association, more information available at www.acatoday.org)

Although chiropractic has an excellent safety record, no health treatment is completely free of potential adverse effects. The risks associated with chiropractic, however, are very small. Many patients feel immediate relief following chiropractic treatment, but some may sometimes experience mild soreness or aching, just as they do after some forms of exercise. Current literature shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours.1

In addition to being a safe form of treatment, spinal manipulation is incredibly effective, getting patients back on their feet faster than traditional medical care. A March 2004 study in the Journal of Manipulative and Physiological Therapeutics found that chiropractic care is more effective than medical care at treating chronic low-back pain in those patients who have been experiencing the symptoms for one year or less. In addition, a study published in the July 15, 2003, edition of the journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications.

NECK ADJUSTMENTS

Neck pain and some types of headaches are sometimes treated through neck adjustment. Neck adjustment, often called cervical manipulation, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension. Neck adjustment is a precise procedure that is generally applied by hand to the joints of the neck. Patients typically notice a reduction in pain, soreness, stiffness, and an improved ability to move the neck.

Neck manipulation is a remarkably safe procedure. Although some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. While we don't know the actual incidence of stroke associated with high-velocity upper neck manipulation, the occurrence appears to be rare, approximately 1 in 5.85 million manipulations, based on the clinical reports and scientific studies to date.

To put this risk into perspective, if you drive more than a mile to get to your chiropractic appointment, you are at greater risk of serious injury from a car accident than from your chiropractic visit.

It has also been suggested that sudden, severe upper-neck pain and/or headache, which may indicate a pre-stroke condition, could cause someone to visit a doctor of chiropractic. In addition, some common activities, such as stargazing, rapidly turning the head while driving, and having a shampoo in a hair salon may cause an aneurysm (a widening of an artery resulting from the weakening of the artery wall)of the neck arteries, resulting in stroke. Such events remain very difficult to predict.

It is important for patients to understand the risks associated with some of the most common treatments for neck and back pain (prescription non-steroidal anti-inflammatory drugs (NSAIDS) as these options may carry risks significantly greater than those of manipulation. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.

Furthermore, surgery for conditions for which manipulation may also be used carries risks many times greater than those of chiropractic treatment. Even prolonged bed rest carries some risks, including muscle atrophy, cardiopulmonary deconditioning, bone mineral loss and thromoembolism.

If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider. If the issue of stroke concerns you, do not hesitate to discuss it with your doctor of chiropractic. Depending on your clinical condition, he or she can forego manipulation, and instead can recommend joint mobilization, therapeutic exercise, soft-tissue techniques, or other therapies.

RESEARCH ONGOING

The ACA believes that patients have the right to know about the health risks associated with any type of treatment, including chiropractic. Today, chiropractic researchers are involved in studying the benefits and risks of spinal adjustment in the treatment of neck and back pain through clinical trials, literature reviews and publishing papers reviewing the risks and complications of neck adjustment.

All available evidence demonstrates that chiropractic treatment holds an extremely small risk. The chiropractic profession takes this issue very seriously and engages in training and postgraduate education courses to recognize the risk factors in patients, and to continue rendering treatment in the most effective and responsible manner.

REFERENCES

Senstad O, et al. Frequency and characteristics of side effects of spinal manipulative therapy. Spine 1997 Feb 15;435-440.
Haldeman S, et al. Arterial dissection following cervical manipulation: a chiropractic experience. Can Med Assoc J 2001;165(7):905-06.
Lanas A, et al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal anti-inflammatory drug use. Am J Gastroenterol 2005;100:1685–1693.
Lauretti W. The Comparative Safety of Chiropractic. In Daniel Redwood, ed., Contemporary Chiropractic. New York: Churchill Livingstone, 1997, p. 230-8.

CHIROPRACTIC: MYTHS

As successful as chiropractic has become, there are a lot of myths circulating among the general public. Times have definitely changed for the better, but the fact is that many people still do not understand what chiropractors do. Let's talk about a few of the more common myths about chiropractic.

MYTH #1: SPINAL ADJUSTMENTS HURT

Quite the contrary. Many patients feel instant relief immediately after their treatments. In fact, most look forward to their chiropractic treatments. In patients suffering from severe bouts of back or neck pain, some discomfort may be experienced for obvious reasons, however, for most patients this is not the case.

MYTH #2 - CHIROPRACTORS ARE NOT REAL DOCTORS.

A chiropractic college grants a D.C. or Doctorate of Chiropractic degree. Chiropractors are licensed as health care providers in every U.S. state and dozens of countries around the world. While the competition for acceptance in chiropractic school is not as fierce as medical school, the chiropractic and medical school curricula are extremely rigorous and virtually identical. In fact, chiropractors have more hours of classroom education than their medical counterparts. As part of their education, chiropractic students also complete a residency working with real patients in a clinical setting, supervised by licensed doctors of chiropractic. Once chiropractic students graduate, they have to pass four sets of national board exams as well as state board exams in the states where they want to practice.

Just like medical doctors, chiropractors are professionals that are subject to the same type of testing procedures, licensing and monitoring by state and national peer-reviewed boards. Federal and state programs, such as Medicare, Medicaid, and Workers' Compensations programs cover chiropractic care, and all federal agencies accept sick-leave certificates signed by doctors of chiropractic. Chiropractors are also commissioned as officers in the military.

The biggest difference between chiropractors and medical doctors lies not in their level of education, but in their preferred method of caring for people. Medical doctors are trained in the use of medicines (chemicals that affect your internal biochemistry) and surgery. Consequently, if you have a chemical problem, such as diabetes, hypothyroidism, or an infection, medical doctors can be very helpful. However, if your problem is that your spine is misaligned or you have soft tissue damage causing pain, there is no chemical in existence that can fix it. You need a physical solution to correct a physical problem. That is where chiropractic really shines.

Chiropractors provide physical solutions -- adjustments, exercises, stretches, muscle therapy -- to help the body heal from conditions that are physical in origin, such as back pain, muscle spasms, headaches, and poor posture. Another distinction is the fact that it is completely appropriate to receive chiropractic care even if you do not have symptoms. Unlike standard medical doctors, whom you visit when you have a symptom to be treated, chiropractors offer adjustments to improve spinal alignment and overall well-being before symptoms develop.

Medical Doctors

Sees the disease
Studies the disease
Relies on drugs
Treats Symptoms

Chiropractors

Sees the person with the disease
Seeks the cause of the problem
Relies on the body's innate ability to heal itself facilitated by the adjustment
Aims to treat the root of the problem by improving nervous system integrity, reducing causes of nerve interference and promoting proper bodily function

Clearly, these are two very different philosophies. Yet, each has its place. If you have broken bones or you’re bleeding by the side of the road, you want the heroic lifesaving measures of emergency medical treatment. But if you have chronic aches and pains or an interest in wellness, you may want the health restoration possible that is the focus of chiropractic care.

MYTH #3 - MEDICAL DOCTORS DON'T LIKE CHIROPRACTORS.

The American Medical Association's opposition to chiropractic was at its strongest in the 1940s under the leadership of Morris Fishbein. Fishbein called chiropractors "rabid dogs" and referred to them as "playful and cute, but killers" He tried to portray chiropractors as members of an unscientific cult who cared about nothing but taking their patients' money. Up to the late 1970s and early 1980s, the medical establishment purposely conspired to try to destroy the profession of chiropractic. In fact, a landmark lawsuit in the Supreme Court of Illinois in the 1980s found that the American Medical Association was guilty of conspiracy and was ordered to pay restitution to the chiropractic profession.

In the 20 years since, the opinion of most medical doctors has changed: several major studies have shown the superiority of chiropractic in helping people with a host of conditions, and medical doctors developed a better understanding as to what chiropractors actually do. Many people have returned to their medical doctors and told them about the great results they experienced at their chiropractors office. Hospitals across the country now have chiropractors on staff, and many chiropractic offices have medical doctors on staff. Chiropractors and medical doctors are now much more comfortable working together in cases where medical care is necessary as an adjunct to chiropractic care.

MYTH #4 - ONCE YOU START GOING TO A CHIROPRACTOR, YOU HAVE TO KEEP GOING FOR THE REST OF YOUR LIFE.

This statement comes up frequently when the topic of chiropractic is discussed. It is only partially true. You only have to continue going to the chiropractor as long as you wish to maintain the health of your neuromusculoskeletal system. Going to a chiropractor is much like going to the dentist, exercising at a gym, or eating a healthy diet: As long as you keep it up, you continue to enjoy the benefits.

Many years ago, dentists convinced everyone that the best time to go to the dentist is before your teeth hurt, that routine dental care will help your teeth remain healthy for a long time. The same is true of chiropractic care for your spine. It is important to remember that, just like your teeth, your spine experiences normal wear and tear as you walk, drive, sit, lift, sleep, and bend. Like your dentist and like many of the medical experts are now recognizing, prevention is the key to reducing recurrences of existing health conditions and minimizing new injuries in the future.

Routine chiropractic care minimizes spinal and nerve stresses, reduces recurrences of old injuries, prevents new injuries from developing, minimizes degenerative processes, which in turn enhances overall health and wellness. Although you can enjoy the benefits of chiropractic care even if you receive care for a short time, the real benefits come into play when you make chiropractic care a part of your wellness lifestyle.