The world of chiropractic is constantly evolving with new and fascinating research taking place all the time. We always like to know about new developments in the medical world so that we can provide you with the best possible care. So that you can also be in the know, we’ve posted the research papers we find most interesting here.
Research: Chiropractic effective for low back pain
This study measured the effects of a chiropractic adjustment on the low back (facet) joints. It proved that there was an effective gapping and stretching of these joints which was shown to help improve mobility and reduce the adhesions that are common place in the low back.
MRI scans were used to show how the gapping was most effective in the group using chiropractic techniques which also was the group which had the greatest reduction in pain.
Cramer GD, et al. Magnetic resonance imaging zygaphosphyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. Journal of Manipulative and Physiological Therapeutics 2013; pii: S0161-4754(13)00055-9. doi: 10.1016/j.jmpt.2013.04.003
Injections a waste of time for sciatica
Epidural corticosteroid injections are unlikely to provide any meaningful long-term pain relief for patients with sciatica, a review has found.Despite the approach becoming increasingly popular worldwide, the review of 23 “high quality” randomised trials found it gave only modest, short-term pain relief compared to placebo.
Writing in the Annals of Internal Medicine (online), the authors cautioned against using the injections, especially for acute sciatica.
“The small size of the treatment effect challenges the clinical utility of this procedure,” wrote the authors, who included Professor Chris Maher, director of musculoskeletal research at the George Institute, Sydney.
Patients in the trials ranked their referred leg pain and disability on scales from 0 (no pain or disability) to 100 (worst possible pain or disability).Three months after corticosteroid injections, leg pain was reduced by six points on average and disability by three points.
Beyond 12 months, pain reduction was even smaller and not statistically significant.
“Until the current evidence changes, we would recommend patients with acute sciatica receive a course of conservative care before any invasive approach is considered.”
Injections were given using either a caudal, interlaminar or transforaminal approach, with no clear difference in pain reduction between the three.
The corticosteroids used were either methylprednisolone, prednisone/prednisolone, triamcinolone or betamethasone.
Chiropractic safety update
Here’s a little article showing that a neck adjustment at the chiropractor is no more traumatic than simply turning your head left or right! Read on…
The primary objective of this study was to quantify the strains applied to the internal carotid artery (ICA) during neck spinal manipulative treatments and range of motion (ROM)/diagnostic testing of the head and neck.
Strains of the ICA (n = 12) were measured in 6 fresh, unembalmed cadaveric specimens using sonomicrometry. Peak and average strains of the ICA obtained during cervical spinal manipulations given by experienced doctors of chiropractic were compared with the corresponding strains obtained during ROM and diagnostic testing of the head and neck.
Peak and average strains of the ICA for cervical spinal manipulative treatments were significantly smaller (P < .001) than the corresponding strains obtained for the ROM and diagnostic testing. All strains during ROM and treatment testing were dramatically smaller than the initial failure strains of the ICA.
This study showed that maximal ICA strains imparted by cervical spinal manipulative treatments were well within the normal ROM. Chiropractic manipulation of the neck did not cause strains to the ICA in excess of those experienced during normal everyday movements. Therefore, cervical spinal manipulative therapy as performed by the trained clinicians in this study, did not appear to place undue strain on the ICA and thus does not seem to be a factor in ICA injuries.
More details of the research paper on the PubMed website.