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Chiropractic Adjustments

March 31, 2010 Written by JP    [Font too small?]

I have a confession to make. Even after many years of using and working with natural medicine, I still have an underlying fear of chiropractors. Not the men and women who make up the profession. But the actual process of getting an adjustment. I’ve just never gotten used to the cracking and popping sounds brought about by manual adjustments. However my concerns are often at odds with some of the positive evidence that exists about this widely utilized holistic technique. The most recent figures published by the National Center for Complementary and Alternative Medicine estimate that upwards of $4 billion a year is spent on “chiropractic or osteopathic manipulation” in the US alone. It appears that many health conscious consumers do not share my reservations about visiting their friendly, neighborhood chiropractor.

Two recent publications shine a positive light on the efficacy and safety of chiropractic care. The first of the two is presented in the March 2010 edition of the Journal of the Canadian Chiropractic Association. This was a systematic review of chiropractic care in patients with asthma. I chose to focus on this study because, for better or worse, spinal manipulation is primarily associated with providing relief in conditions that involve physical pain or reduced motility. A total of 8 studies were included in this particular evaluation, but none were randomized, double-blind placebo controlled studies – the preferred form of data for scientists. Most researchers believe this variety of test model yields the purest and most reliable evidence. But in this case the researchers from the Canadian Memorial Chiropractic College used the best, peer-reviewed papers they could find. Their conclusion was that chiropractic care typically leads to improvements in subjective measures of asthma severity, such as the number of asthma attacks and a reduced need for medication. Objective changes in asthma symptoms were less apparent but still present. In closing, the authors stated that “Despite a paucity of evidence supporting the successful management of patients with asthma under chiropractic care, and despite the fact that the evidence that does exist is heterogeneous with respect to its quality strength, there is nonetheless some indication that patients experience positive subjective and at times positive objective results while under chiropractic care”. (1,2)

A trial appearing in the February 2010 issue of the Spine Journal assessed the relative merits of spinal manipulation therapy (SMT) vs. light massage in patients with cervicogenic headache (CGH), a condition characterized by chronic pain on one side of the head that is referred from the neck region. 80 patients living with CGH enrolled in a 24 week evaluation. Researchers from Western States Chiropractic College in Portland, Oregon assessed pain scores via a Modified Von Korff Pain and Disability Scale and took note of the number of headaches experienced by the participants. The study volunteers were randomized into 4 treatment groups that received either 8 or 16 chiropractic adjustments or equal quantities of light massage therapy. The respective sessions were provided once or twice per week over an 8 week period. The participants receiving chiropractic care exhibited more significant reductions in pain intensity. Those in the “higher dose” group (16 treatments) found a greater advantage as compared to the lower dose (8 treatments) and massage interventions. On average, the incidence of CGH “was reduced by half” and/or yielded a “50% improvement in pain scale” in the spinal manipulation test subjects. (3)

Common Reasons for Seeking Chiropractic Care
Source: J Can Chiropr Assoc. 2008 August; 52(3): 175–184. (a)

In a recent column, Dr. Andrew Weil addressed the issue of a “kinder, gentler” form of chiropractic care. He suggests seeking out chiropractors that utilize a “reliable and safe” modality known as an Activator (pictured above) instead of conventional “dynamic thrust” adjustments. Dr. Weil describes an Activator in the follower manner: “a low-force, handheld device incorporating a tension spring and plunger that produces a swift pulse of low force at high speed”. In short, there is no pain or twisting involved, and also no cracking and popping sounds. Recent studies have demonstrated positive results using Activators in conditions such as temporomandibular disorder (TMJ) and low back pain. The number of studies involving “mechanical-force, manually assisted chiropractic” devices is somewhat limited due to its relatively recent introduction into the medical care system. However, thus far the evidence that does exists tends to support its efficacy and safety. (4,5,6,7,8)

Many years ago I spent a number of months studying at a holistic clinic in Arizona. The majority of the health professionals on staff were chiropractors. At that time, I felt somewhat uncomfortable with the broad application of this therapeutic modality. It seemed like almost every conceivable condition from anxiety to heartburn to incontinence to vertigo was being addressed via spinal manipulation therapy. The fundamental idea behind this approach was that structural adjustments might not directly cure these conditions but could possibly assist with general healing. You see in chiropractic, misalignments or subluxations of the spine are believed to impair the proper functioning of the nervous system which is alternatively described as the “flow of energy needed to support health”. Reservations aside, I’m thankful that modern science is helping me to expand my own view of what chiropractic is actually capable of accomplishing. (9)

Be well!


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8 Comments & Updates to “Chiropractic Adjustments”

  1. Liz Says:

    I am one of those people that are also very skeptical about chiropractors. I have been doing a lot of research about asthma and allergies and I found this website called BioVeda Technologies. It has some great articles and information about asthma, allergies, and chiropractic care. You should check it out!

  2. JP Says:

    Thank you, Liz.

    I’ll check it out.

    Be well!


  3. Jason Piken Says:

    I have blogged a small bit in the past and I am about to begin 1-2 time a week entries. I stumbled upon your blog to see what info is out there already. I am a Chiropractor/Nutritionist in New York City. I have been in practice for 14 years and I tend to love seeing patients that are “scared” of what I do. Typically after the first adjustment they realize how gentle an approach to health care chiropractic can be.

    Chiropractic is the largest licensed drug free health profession in the World. Chiropractic is also the safest treatment option for many conditions. One of the facts I like to educate my patients about is the cost of my malpractice insurance. I pay a bit over $3200/year. If the insurance industry, who knows risk better than anyone, says that I am extremely low risk then I tend to believe it. Go out and ask your allopathic doctors how much they pay each year. I bet its a lot more.

    One more comment…the best summary I can give about how chiropractic works is that it is the most efficient way of removing the effects of stress from the body. The less stress you carry around the better your overall health!

  4. JP Says:

    Thank you for adding your perspective, Jason. Much appreciated! 🙂

    Be well!


  5. Stacey Burke Perth Says:

    Thanks for the interesting post. I also am a chiropractor an have been practicing since 1996. as chiropractic has over 200 techniques its always a bit frustrating to see everything always lumped under one generic umbrella. we have utilised multiple thrust low force instrument adjusting for a number of years now along with traditional techniques. I have had patients in their 90’s that have benefited immensely from this type of adjusting. I echo your concerns regarding certain types of manipulations and would point out that there are good and bad in every profession. Although the good that is done rarely makes the headlines in our profession, it would seem that people always will seek out any of the bad and magnify that in the press to the nth degree. thanks JP for sheading some positive light. If our profession could generate the funding necessary to carry out double blind studies etc, I am sure that we would see many other positives as well. Then again, if we were to scrutinize all the so called research as has recently come to light, we may find there has been quite a bit of conflicting interests and payments made to the so called researchers anyways. Great blog JP please keep the posts coming and thanks for hearing my piece!

  6. JP Says:

    Thank you for your sharing your thoughts with us, Stacey. It’s always helpful to get an insider’s point of view. Much appreciated!

    Be well!


  7. Anonymous Says:

    How frequently should Chiropractic Adjustments be done?
    My Chiropractor wants to see me 3 times a week, every week for a year for a chiropractic treatment. I have canceled appointments because of soreness and inflammation, and I feel that the adjustments are excessive. I’ve dealt with chiropractors all my life and I have never heard of adjustments being done so frequently for so long. Does anybody have any info on the safety of frequent adjustments? Should I be getting that many adjustments? Links to professional articles and info on the matter would be greatly appreciated. Thanks.

  8. Jason Piken DC, CNS Says:


    I have never evaluated you so I cannot make a clinical descision about how many visits you may or may not need. That being stated, I personally cannot understand how after a couple of visits a determination can be made about the length and frequency of your care. What you should understand is that there are many ways to practice chiropractic and they all have their merits. If one doctors recommendations make you feel uneasy then get a second opinion.
    As far as your question regarding safety, as far as I know there aren’t any articles that demonstrate any clear negative effects of getting adjsted frequently. Chiropractic adjustments have continually been shown to be the safest option in healthcare.
    In my opinion frequency of visits should be determined by the amount of degenerative changes a body has, the quality of their lifestyle(wether they exercise and eat well), and most importantly their current and accumulated exposure to stress.
    Simply put the chiropractic visit should reduce your stress so the more you have to deal with the more visits you may need.
    I hope that helps a bit.

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