Attention-Deficit Hyperactivity Disorder (ADHD) Outcomes Improve with Chiropractic Care

A report on the scientific literature 


 

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Sangwoo Mah DC, DAAMLP

William J. Owens DC, DAAMLP

 

As a family practitioner of chiropractic, I, the first author, have treated many children who were diagnosed with a spectrum of hyperactivity disorders in the 1980’s. Each of these diagnoses revolved around children being uncontrollably hyperactive and their ages ranged from 3 years through 10 years old. In most of the cases, under chiropractic care, I witnessed that most of these children, according to their parents, demonstrated calmer behavior over a short amount of time with chiropractic care and this scenario became a regular pattern in my office. These clinical observations by a single practitioner is by no means a scientific answer, nor one that should garner conclusions to suggest an entire populous migrate towards this specific potential solution. However, over time, these results have been reported in many chiropractic offices by both parents and chiropractors alike and research is now catching up to these observations in a formal setting.

Attention-deficit hyperactivity disorder, or ADHD, has become a major concern to parents everywhere as of late.  It seems that more and more children are being diagnosed with ADHD as time passes and has the hallmark characteristics of hyperactivity, inattention and impulsivity according to Alcantara and Davis (2010).  They go on to report that parents are concerned regarding the causes of ADHD in children and what kinds of treatment are available should they become diagnosed with ADHD.  Although the definitive cause of ADHD is unknown, genetics and the environment seem to have strong effects.   Medical treatment of ADHD involves use of psychiatric medications and behavior therapy. However, there are growing concerns for long-term use of psychotropic drugs for children.  Again, according to Alcantara, 10 years ago it was estimated that 20% of all white males were taking some type of psychotropic drug for behavioral disorders and based upon the potential for serious side effects, conservative alternative medical approaches were sought.  With regards to the practitioner-based alternative therapies for children, chiropractic has become the most popular and highly utilized for ADHD.

In their literature search, Alcantara and Davis (2010) reported that 4 case studies recounted successful treatment of ADHD. There appears to be, in those cases, a strong connection between the neuro-muscular-structural connections. This suggests to the authors of this article that there is a resultant neuro-chemical imbalance as a result.

Such a case was four children treated with chiropractic adjustment in a single-doctor’s office.  The parents of these children reported a 50% improvement in behavior of their children after 5 months.  These results were collected via questionnaires. 

Another significant case in the same study was a 5-year-old boy with seriously poor neck posture.  This caused him to go for chiropractic treatment, but after 8 weeks, the boy’s behavior improved so significantly that his pediatrician declared he no longer exhibited symptoms of ADHD.  During this time, his neck posture also improved dramatically, suggesting a link between the neck posture and ADHD. 

Perhaps even more significant, a 9-year-old child who suffered for years from multiple chronic conditions including asthma, headaches, Tourette’s syndrome, ADHD, depression, insomnia, and neck pain also improved dramatically with chiropractic care.  The child was taking multiple strong medications.  This child was also found to have significantly stiff joints in the neck.  After six weeks chiropractic care, the child no longer displayed any symptoms and all medications were discontinued except for a half dose of Wellbutrin.  After 5 months, at the conclusion of the treatment, the child remained symptom free.

Muir (2012) reported:

Parents of a 5-year-old boy with diagnosed ADHD brought him for chiropractic care to address his subjective signs (acting out, ability to follow instructions, and poor home and school performance), which also included waking at night due to asthmatic symptoms and low self-esteem. Palpation revealed hypertonicity and trigger points in the paraspinal muscles at the thoracolumbar region with local pain. A preliminary diagnosis included cervical and thoracolumbar facet joint irritation with concurrent muscle hypertonicity.

Intervention and Outcomes: Treatment including spinal manipulative therapy, soft tissue therapy, and stretching was provided. Treatment began on a thrice-weekly basis and declined to twice weekly over the course of approximately 12 weeks. After 1 year of treatment, subjective improvements were noted in episodes of acting out, ability to follow instructions, and general home and school performance (p. 221).

Although much more research is indicated, these examples, along with our personal observations suggest that chiropractic should be considered to be included in comprehensive treatment of ADHD.  Chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration. Whedon et al. (2014) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM (spinal manipulation) induces injury into normal healthy tissues has been identified. (Whedon et al., 2014, p. 5) 

If your child suffers from symptoms of ADHD, consider having a chiropractor evaluate your child. 

References:

1. Alcantara J., & Davis J. (2010). The chiropractic care of children with attention-deficit/hyperactivity disorder: A retrospective case series. EXPLORE, 6(3), 173-182.

2. Muir, J. M. (2012). Chiropractic management of a patient with symptoms of attention-deficit/hyperactivity disorder. Journal of Chiropractic Medicine, 11(3), 221-224.

3. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2014). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69. Spine, [Epub ahead of print] 1-33.

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Published in Neck Problems

Patient Outcomes Proves More Effective with Chiropractic Combined with Standard Medical Care Than Standard Medical Care Alone in the Military

 

A report on the scientific literature 


BY: D. Scott Ferguson

DC, William J. Owens DC, DAAMLP

 Mark Studin DC, FASBE(c), DAAMLP, DAAPM

 

Many people suffer from lower back pain at some point in their lives.  Most will seek the advice of a healthcare professional. However, many times this care is fragmented and not based on current evidence and can result in poorer outcomes. When considering outcomes, all doctors must consider creating a diagnosis, prognosis and then conclude a treatment plan. It is that treatment plan, which then determines the outcome after an accurate diagnosis. Many times, low back pain patients seek solely standard medical care and bypass a more effective chiropractic solution. This type of self-referral and physician triage has also been prevalent in the military and asks the question based upon outcome studies, is that in the best interest of both the military and the general public?  

 

In a recent paper by Goertz et al. (2013), the objective was, “To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (chiropractic adjustments) for the treatment of low back pain  among 18 to 35-year-old active-duty military personnel” (p. 627).  The authors stated, “Lifetime prevalence of low back pain has been estimated to be as high as 84%, with a median cost per quality-adjusted life year of $13,015” (p. 627).  The fact that lower back pain is a major source of disability and abuse of pain medication makes providing the best care possible a priority based upon outcome studies.  In this paper, it was reported that, “The majority of systematic reviews find that chiropractic manipulative therapy (adjustments) seems to reduce pain and disability at least moderately for many patients with low back pain” (p. 627).  Therefore, the questions are, “Should chiropractic care be part of your treatment plan and should it be included with standard medical treatment for lower back pain?” 

 

 

In the Goertz et al. (2013) study, the patients were allowed to seek standard medical care in an unrestricted fashion which meant they could go to their medical doctors as they normally would for lower back pain.  “Standard care included any or all of the following: a focused history and physical examination, diagnostic imaging as indicated, education about self-management including maintaining activity levels as tolerated, pharmacological (drug) management with the use of analgesics and anti-inflammatory agents, and physical therapy and modalities such as heat/ice and referral to a pain clinic” (p. 628).  On the chiropractic side, the authors stated “Treatments consisted of HVLA [high velocity low amplitude a.k.a. chiropractic adjustment] manipulation as the primary approach in all cases, with ancillary treatments at the doctor’s discretion, including brief massage, the use of ice or heat in the lumbar area, stretching exercises, McKenzie exercises, advice on activities of daily living, postural/ergonomic advice; and mobilization” (p. 628).  This is important since chiropractors view the spine as an entire system and the approach to patients is different as well as the therapeutic intervention.

 

 

In conclusion, the authors reported, “The results of our pragmatic pilot study indicate a statistically and clinically significant benefit to those receiving chiropractic manipulative therapy (adjustments) in addition to standard medical care” (p. 631).  Finally, they report, “The results of this trial suggest that chiropractic, in conjunction with standard medical care, offers a significant advantage for decreasing pain and improving physical functioning compared with only standard medical care, for active-duty men and women between 18 and 35 years of age with acute low back pain when delivered in a pragmatic treatment setting” (p. 633).

 

This study concurs with a previous study by Liliedahl et al. (2010) who studied 85,402 patients and adds to the growing body of evidence in diverse forums that chiropractic for mechanical back pain is more effective and cost-effective than standard medical care. Evidence such as this helps to dispel the partial truths and overcome the prejudices to help the public make informed choices.

 

References:

1. Goertz, C. M., Long, C. R., Hondras, M. A., Petri, R., Delgado, R., Lawrence, D. J.,…Meeker, W. C. (2013). Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results of a pragmatic randomized comparative effectiveness study. Spine, 38(8), 627-634.

2. Liliedahl, R. L., Finch, M. D., Axene, D. V., & Goertz C. M. (2010). Cost of care for common back pain conditions initiated with chiropractic doctor vs. medical doctor/doctor of osteopathy as first physician: Experience of one Tennessee-based general health insurer. Journal of Manipulative and Physiological Therapeutics, 33(9), 640-643.

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Published in Low Back Problems

Harvard Report Points to Chiropractic Care for Pain Relief

& The Safety of the Chiropractic Adjustment

By

Noah Herbert, D.C., CCSP®

William J. Owens DC, DAAMLP

Mark Studin DC, FASBE(C), DAAMLP, DAAPM

A recent article released by Harvard Health Publications at Harvard Medical School points to chiropractic care as a form of pain relief. There are currently many Americans that seek out chiropractors, but many people don’t realize the wide variety of treatments that a chiropractor can provide for pain relief. The article states “while the mainstay of chiropractic is spinal manipulation, chiropractic care now includes a wide variety of other treatments, including manual or manipulative therapies, postural and exercise education, ergonomic training (how to walk, sit, and stand to limit back strain), nutritional consultation, and even ultrasound and laser therapies. In addition, chiropractors today often work in conjunction with primary care doctors, pain experts, and surgeons to treat patients with pain.”

While this is nothing new for the chiropractic community, it may serve to further educate the public as to the many tools a chiropractor possesses to help patients. While the majority of research on chiropractic has focused on spinal manipulation, or adjustment of the spine, for pain relief, there have been studies done on the effectiveness of chiropractic for treating musculoskeletal pain, headaches, asthma, carpal tunnel syndrome and fibromyalgia (Harvard Health Publications). The author goes on to state “a recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain and whiplash.” It should be pointed out there have been reports of serious complications, including stroke, but this has been shown to be extremely rare and some studies suggest this may not be directly caused by the treatment provided by the chiropractor (Harvard Health Publications).

Spinal manipulation, or adjustment of the spine, is a term used to describe providing a high velocity, low amplitude thrust to the vertebra. Chiropractors use this technique to correct the body’s spinal alignment to relieve pain and improve function and to allow the body to heal itself. Treatment usually takes between 10 to 20 minutes and most patients are scheduled 2-3 times per week initially. Patients generally see improvement of their symptoms in the first two to three weeks (Harvard Health Publications).

Harvard Medical School is now saying what chiropractors have been saying for over 100 years and although their article was based on pain, it does add more evidence to the false rhetoric of chiropractic patients having a greater risk of stroke. In the future, reports from Harvard and other medical academic institutions will embrace the growing body of scientific evidence of the varied maladies that respond to chiropractic care.

 

References:

  1. Harvard Health Publications. (2015). Chiropractic Care for Pain Relief. Retrieved from http://www.health.harvard.edu/pain/chiropractic-care-for-pain-relief

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Published in Low Back Problems

Back Pain:

Chiropractic vs. Medical Doctors

Who Get Better Results and Who is More Cost Effective?

 

Chiropractic Proves 300% more effective

Chiropractic Proves 50% More Cost Effective

A report on the scientific literature 


 

BY: Donald Capoferri DC, DAAMLP

William J. Owens DC, DAAMLP

Mark Studin DC, FASBE(C), DAAMLP, DAAPM

 

In 2010 a study of back pain patients insured by Blue Cross Blue Shield of Tennessee revealed patients receive nearly 3x better results at almost half the cost when consulting a chiropractor instead of a traditional medical doctor.

 

Statistics show that back pain, and more specifically lower back pain will affect 70-80% of all Americans.  Back pain is one of the top 10 most costly conditions treated in the United States.  Costs directly associated with examination and treatment are in excess $50 billion dollars per year.  Indirect cost of back pain include lost work day, reduced employee productivity and disability are $47 billion dollars.  That makes the total economic impact of lower back pain in excess of $97 billion dollars per year.

 

The study was conducted on 85,402 patients, all insured with Blue Cross Blue Shield of Tennessee.  This insurer was chosen because it provided equal access to both traditional medical and chiropractic care. The population of patients were diagnosed with the following conditions: Spinal disc disorders, Lower back pain, muscle spasms, joint mobility restrictions, Sacroiliac joint sprain/strain and lumbar spine sprain/strain.  The results of the study revealed those patients who initiated care with a chiropractor had a 61% “very satisfied response” when surveyed.  Those patient who initiated care with a medical doctor had a 27% “very satisfied response.” The patients who initiated care with a chiropractor incurred 40% less cost than those choosing traditional medical care.

 

There is a growing body of evidence indicating that chiropractic care is more effective and less costly than medical care for back pain.  In contrast to this and many other studies indicating the efficacy of chiropractic care for back pain, only 7% of U.S. back pain sufferers consult a chiropractor.  Using the data from this study insurers nationally would realize billions of dollar of savings if the population of back pain patients initiated care with a chiropractor first. 

 

Insurance companies that restrict access to chiropractic care at this juncture with statistical evidence, are paying more for care and delaying necessary, effective care for no apparent reason other than politics or prejudice. If all restrictions for chiropractic access were removed carriers would save money and offer a significant public health benefit. The statistics speak for themselves.

 

Reference:

Liliedahl R., Finch M., Axene D., Geertz C., (2010) Cost of Care for Common Back Pain Conditions Initiated with Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician:  Experience of One Tennessee-Based General Health Insure, Journal of Manipulative and Physiological Therapeutics 33 (9) pgs. 640-643

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Published in Low Back Problems

An online post on January 30, 2015 from the group Circle of Docs titled “Chiropractic in the Super Bowl” describes how not only are chiropractors part of the health care staff of the two Super Bowl contenders but that all 32 NFL teams offer players and personnel chiropractic services as part of the team to manage and prevent injuries. According to the Foundation for Chiropractic Progress, “this distinction is a benchmark for the profession and documents the important role that chiropractic care plays in optimizing athletic performance.”

The article states that Dr. Ramogida of the Seattle Seahawks was originally supposed to stay with the team for a couple of years but the players asked that he stay with them because they liked getting adjusted on game days, that was over 12 years ago.

Dr. Miller, who has been with the New England Patriots for over 25 years is present during mini-camps, training camp, preseason games, regular-season games (both home and away), and postseason games.

In fact the NFL has just released a statement advocating for all NFL teams as now employing a Chiropractor as part of their medical staff.

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Chiropractic Protects an Aging Population

From Loss of Function

 

*Chiropractic Decreased Medicare Costs by 23%

*Primary Care, Physical Therapy, Physical Medicine, Orthopedics, and Neurology

Increased Medicare Costs Ranging From 18% - 32% 

 

A report on the scientific literature 


 

By: Robert Reiss DC

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

 

It was reported by Weigel, Hockenberry, and Wolinsky (2014) that 4.1% to 5.4% of Americans ages 70 and older utilize chiropractic care.  6%-7% of Americans between ages 62 and 70 utilize chiropractic care, which is close to the national average.  They go on to say that the activities of daily living (ADL's) facing an aging population are associated with every day mobility tasks such as walking, stooping, lifting, bending, reaching, carrying and all other forms of movement, as well as tasks associated with living independently, including cognitive functioning.  Any spine-related problems that limit a person’s ability to perform basic activities of daily living can decrease independence.  With normal aging and accumulation of chronic diseases, including musculoskeletal spine-related pain, the risks for functional decline and loss of independence increase. 

 

They also share that Medicare covers many treatment options for spine-related injuries like chiropractic adjustments and physical therapy which are non-invasive, as well as more invasive treatments like prescription narcotics, steroid injections and surgery.  While the increase in more invasive and technologically intensive treatments has substantially grown over the past 15 to 20 years, the levels of improvement in outcomes and disability have not improved to the same degree.

 

An article by Foster, Phillips, Hamel, and Eisenberg (2000) concluded, “Thirty percent of Americans aged 65 and older reported using alternative medicine (amounting to 10 million Americans based on extrapolations to census data) and 19% visited an alternative medicine provider (making 63 million visits based on extrapolations to census data) within the past year. The two modalities used most commonly were chiropractic and herbs…” (p. 1560).

 

This study showed that those utilizing chiropractic experienced less functional decline in ADLs, such as lifting, stooping and walking several blocks and were less likely to rate their health as worsening compared with those who only received medical services. It also provided evidence that while overall Medicare spending on spine conditions has grown due to the more costly services and volume growth, spending on chiropractic was flat and declined as a percentage of total spending among those choosing chiropractic. Not only does chiropractic cost the system less and prevent the loss of function, but chiropractic users rate their satisfaction levels higher in regards to the explanation of their problems, as demonstrated by the examination findings and discussion of their ongoing progress. 

 

References:

1. Weigel, P., Hockenberry, J., & Wolinsky, F., (2014). Chiropractic Use in the Medicare Population: Prevalence, patterns and associations with 1-Year Changes in health and satisfaction with care. Journal of Manipulative and Physiological Therapeutics, 37(8), 542-551.

2. Foster, D.F., Phillips, R.S., Hamel, M.B., & Eisenberg, D.M. (2000).  Alternative medicine use in older Americans. Europe PubMed Central, Retrieved from http://europepmc.org/abstract/MED/11129743

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Published in Research

Disc Herniations and Low Back Pain Post Chiropractic Care

88% of patients reported continued improvement at 1 year post-care

A report on the scientific literature 


By Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Robert Reiss DC

According to Hoy et. al. (2014), "Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, LBP [low back pain] ranked highest in terms of disability (YLDs), and sixth in terms of overall burden (DALYs)...LBP causes more global disability than any other condition" (p. 968). Low back pain is one of the most common maladies among the general population and the incidence of occurrence was reported by Ghaffari, Alipour, Farshad, Yensen, and Vingard (2006) to be between 15% and 45% yearly. Hoiriis et al. (2004) reported it to be between 75% and 85% over an adult lifetime in the United States. Chou (2010) wrote that, "Back pain is the fifth most common reason for office visits in the US, and the second most common symptomatic reason..." (p. 388).

There are many treatment options available that fall into one of two categories, surgical or conservative care.  Spinal manipulation/adjustments are one of the most widely used conservative treatment options with doctors of chiropractic performing the majority of them.  There have been various studies comparing the effectiveness of spinal manipulative therapy (SMT) on low back pain (LBP) patients with disc herniations to other therapies, all of which have been inconclusive. 

But now, a 2013 study by Leemann, Peterson, Schmid, Anklin, and Humphreys concluded that, “a large percentage of acute and importantly chronic lumbar disc herniation patients treated with high-velocity, low-amplitude side posture SMT reported clinically relevant “improvement” with no serious adverse events” (p. 162). The study’s purpose was to evaluate patients with low back pain and leg pain that was the result of a herniated lumbar disc which had been confirmed by magnetic resonance imaging.  The patients were treated with high-velocity, low-amplitude spinal manipulations by chiropractors.  The patients’ outcomes of self-reported global impression of change and pain levels were collected at various time points up to 1 year.

The results showed significant improvement for all outcomes at all of the time points.  “Patients responding ‘better’ or ‘much better’ were categorized as ‘improved,’ and all other patients as ‘not improved.’ ‘Improved’ was the primary outcome measure. ‘Slightly improved’ was not considered clinically relevant improvement” (Leemann et al., 2013, p. 158).  At 1 year, 88.0% were much better or better. According to the authors, “The results in this current study are encouraging when considering that it is chronic LBP patients who are a large economic burden with greater use of prescription medications and increased use of other health care resources” (Leemann et al., 2013, p. 161).

To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiropracticDirectory.com and search your state.

References:

1. Hoy, D., March L., Brooks, P., Blyth, F., Woolf, A., Bain, C.,…Buchbinder, R. (2014). Extended Report, The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, 73, 968–974.

2. Ghaffari, M., Alipour, A., Farshad, A. A., Yensen, I., & Vingard, E. (2006). Incidence and recurrence of disabling low back pain and neck-shoulder pain. Spine, 31(21), 2500-2506.

3. Hoiriis, K. T., Pfleger, B., McDuffie, F. C., Cotsonis, G., Elsangak, O., Hinson, R., & Verzosa, G. T. (2004). A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. .Journal of Manipulative and Physiological Therapeutics, 27(6), 388-398.

4. Chou, R. (2010). Pharmacological management of low back pain. Drugs, 70(4), 387-402.

5. Leemann, S., Peterson, C. K., Schmid, C.,  Anklin, B., & Humphreys, B. K. (2013).  Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniations receiving high-velocity, low-amplitude, spinal manipulative therapy: A prospective observational cohort study with one-year follow-up. Journal of Manipulative and Physiological Therapeutics, 37(3), 155-163.

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Published in Research

Chiropractic: Safer Pregnancy and Birthing

A recent article in the Jamaica Observer in the May 25 issue titled “Safer pregnancy, birthing through chiropractic care,” highlighted a increase in the number of pregnant women who are looking for a safer, more natural and easier birthing process.  The article goes on to describe what happens to the woman’s body structurally and hormonally throughout the pregnancy.

These changes include increases in weight, which shift her center of gravity outward and forward.  When this is added to the laxity of ligaments, due to the release of relaxin and elastin, needed for the birthing process it tends to destabilize posture and realign the carriage of weight and forces throughout the joints of the body.  This can lead to misalignment in the spine and pelvis or subluxations causing low back pain. 

The author goes on to explain how a condition called intrauterine constraint can be effected by spinal and pelvic misalignment.  The mother’s pelvic anatomy and the relationship between its biomechanics and the baby's positioning can be affected adversely.  If the pelvis is supported symmetrically it allows the baby optimal room for movement and the opportunity to develop free of constraint. 

On the other hand if the pelvis is out of alignment it can create an uneven pulling effect on the uterine ligaments limiting the space available for the baby to develop.  This can lead to development problems in the baby's musculoskeletal system.  Fetal positioning is important for delivery without outside intervention.  The optimal positioning is rear-facing, head down.  When the baby presents breech or posterior, it often is the result of an imbalance in the mother's pelvis. 

If the mother's biomechanics are not working properly then obstetric interventions are more likely to be recommended and implemented.  The problem is that each and every intervention has significant side effects for both mother and baby.  Fortunately, today more and more parents are becoming aware of the detrimental effects of these interventions and are choosing safer alternatives including chiropractic to address both the needs of the mother and the newborn.

For more news articles or chiropractic research please click on the research link on the Uschirodirectory.com website.

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Frozen Shoulder Syndrome Improves With Chiropractic Care



98% of patients studied with Frozen Shoulder Syndrome (Adhesive Capsulitis) responded positively

 

A report on the scientific literature 


By Mark Studin, DC, FASBE(C), DAAPM, DAAMLP
 Michael Schonfeld, DC, DABCO



Frozen shoulder syndrome (FSS)  is a common condition presenting to a variety of health care practitioners including chiropractors, osteopaths, medical doctors, and physical therapists. Also referred to as adhesive capsulitis, FSS remains one of the most poorly understood shoulder conditions, with its cause most of the time, unknown. Recently, a consensus definition of FSS was reached by the American Shoulder and Elbow Surgeons to be a condition characterized by functional restriction of both active (while moving) and passive (while still) shoulder motion for which  x-rays of the shoulder are usually negative. It occurs usually between 40 and 60 years of age, is 3 to 7 times more prevalent in women than men and it is characterized by sudden onset, night pain along with a painful restriction of numerous motions of the shoulder. Common  traditional medical treatments include nonsteroidal anti-inflammatory drugs, steroid injection, and shoulder surgery. 

The purpose of this study was to describe the treatment and outcomes of a series of patients presenting with frozen shoulder syndrome who received a chiropractic approach (OTZ Tension Adjustment) which was mostly neck and midback adjustments.

The files of 50 consecutive patients who presented to a private chiropractic practice with frozen shoulder syndrome were reviewed. Two primary outcomes were extracted from the files for initial examination and at final evaluation: (1) the 11-point numeric pain rating scale and (2) the percentage change in shoulder abduction (ability to raise their arm from their side as far as they could go). Each patient received a series of chiropractic manipulative procedures that focused on the cervical (neck) and thoracic (mid back) spine.
 
Of the case files reviewed, 20 were male and 30 were female; and all were between the ages of 40 and 70 years. The average number of days under care was 28 days (range, 11 to 51 days). The median change in Numeric Pain Rating Scale score was −7 (range, 0 to −10). Of the 50 cases, 16 resolved completely (100% improvement), 25 showed 75% to 90% improvement, 8 showed 50% to 75% improvement, and 1 showed 0% to 50% improvement.

Conclusion: 98% of patients treated with frozen shoulder syndrome were reported to have improved with chiropractic care.

Reference:

Murphy F., Hal, M., D'Amico L., Jensen A., (2012) Chiropractic management of frozen should syndrome using a novel technique: a retrospective case series of 50 patients, Journal of Chiropractic Medicine 11, 267-272




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Chiropractic Care Reduces the Odds
of Low Back Surgery

42.7 Percent of Workers Who Consulted a Surgeon First - Had Surgery
vs.
1.5% Who Consulted a Chiropractor First - Had Surgery

A report on the scientific literature 


By Mark Studin, DC, FASBE(C), DAAPM, DAAMLP
 Michael Schonfeld, DC, DABCO


Back injuries are the most prevalent occupational injury in the United States. Few prospective studies have examined early predictors of spine surgery after work-related back injury. It was reported by Keeney et. al. in May 2013 that the chances of the patient undergoing lumbar spinal surgery vary dramatically changes depending upon what specialist they saw first.

Trauma, aging, improper body mechanics, and normal wear and tear can all injure your spine. Damage to any part of your back or pressure on the nerves in your spine can cause back pain and other symptoms. If you have ongoing back pain, maybe you've wondered — could back surgery help?

The rate of spinal fusion surgery has risen six fold in the United States over the past 20 years, according to federal figures, and the expensive procedure has become even more common than hip replacement. The rate of spinal fusions in the United States is about 150 per 100,000 people, according to federal data. In Australia, it is about one-third of that; in Sweden, it is about 40 per 100,000; and in Britain it is lower still.

Even by American health-care standards, the rise of spinal fusions has been remarkable. According to federal figures, the number of spinal fusions in the United States rose from 56,000 in 1994 to 465,000 in 2011.

Using Disability Risk studies by Keeney et. al., they examined the early predictors of lumbar spine surgery within 3 years among Washington State workers, with new workers compensation and temporary total disability claims for back injuries. In the sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. They concluded that there was a very strong association between surgery and first provider seen.

If back surgery is something you must seriously consider, consider this:

Back surgery is needed in only a small percentage of cases. Most back problems can be taken care of with nonsurgical treatments.

It was reported by McMorland, Suter, Casha, du Plessis, and Hurlbert in 2010 that over 250,000 patients a year undergo elective lumbar discectomy (spinal surgery) for the treatment of low back disc issues in the United States. The researchers did a comparative randomized clinical study comparing spinal microdiscectomy (surgery) performed by neurosurgeons to non-operative manipulative treatments (chiropractic adjustments) performed by chiropractors. They compared quality of life and disabilities of the patients in the study.

The study was limited to patients with distinct one-sided lumbar disc herniations as diagnosed via MRI and had associated radicular (nerve root) symptoms. Based upon the authors’ review of available MRI studies, the patients participating in the study were all initially considered surgical candidates. Both the surgical and chiropractic groups reported no new neurological problems and had only minor post-treatment soreness. 60% of the patients who underwent chiropractic care reported a successful outcome while 40% required surgery and of those 40%, all reported successful outcomes. This study concluded that 60% of the potential surgical candidates had positive outcomes utilizing chiropractic as the alternative to surgery.

Choosing a conservative approach for your back injury requires choosing a conservative practitioner of healthcare that has been certified to equate to successful outcomes without surgery. Chiropractors are trained in a drugless/non-surgical approach to treating you and your back. 

The bottom line is this: see a chiropractor first and the research supports that decision.

42.7 Percent of Workers Consulted a Surgeon First - Had Surgery
vs.
1.5% Who Consulted a Chiropractor First - Had Surgery



References:

     1.      Mayo Clinic staff. Retrieved from http://www.mayoclinic.com/health/back-surgery/HQ00305

     2.      Whorksy, P. and Keating, D. of the Associated Press. Retrieved from
               http://union-bulletin.com/news/2013/oct/28/spinal-surgery-raises-questions-excess/


     3.      McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or microdiscectomy for               sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics, 33(8),               576-584.





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Published in Low Back Problems