Chiropractic Care Improves Senses and Reduces Risks of Falling in the Elderly Population

A report on the scientific literature



William J. Owens DC, DAAMLP


As our population ages, our most senior are being told that their heart diseases or cancers won’t be as likely to cause death as sequella from a fall. Therefore, doctors are urging that sect of population to rely more and more on canes, walkers and other devices to help offer greater support when balance issues become even slightly problematic. According to Holt et. Al (2016) “Falls account for more than 80% of injury related hospital admissions in people older than 65 years and they are the leading cause of injury related death in older adults. Approximately 30%-40% of community-dwelling older adults suffer from at least 1 fall per year.” (pg. 267)


Holt et. al. listed the following risks associated with falls

  1. Lower limb weakness
  2. Recent History of Falling
  3. Gait Deficits
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging


The National Institute of Health (NIH) expanded the list of risk factors in older adults to include:

  1. Muscle weakness
  2. Balance and gait
  3. Blood pressure drops
  4. Postural hypotension
  5. Reflexes slower
  6. Foot problems
  7. Sensory problems
  8. Vision issues
  9. Confusion
  10. Medications



Comparatively speaking, both the Holt et. Al. and the NIH are in agreement that falling can be a multifactorial issue with often no single cause or solution. However, if an older person, who has one or more of the above risk factors can minimize those risks, the likelihood of falling can be decreased and potentially extend their life. Holt et. al. continued “There is however, a growing body of basic science evidence that suggests that chiropractic care may influence sensory and motor systems that potentially have an impact on some of the neuromuscular risk factors associated with falling.” (pg. 268) In short, the evidence has suggested that chiropractic can reduce the risk of falling in older adults.


Holt et. al. found that the mechanisms where chiropractic may influence sensorimotor functions are:

  1. Neuroplastic processes in the central nervous system through altered afferent input.
  2. Pain and altered cognition as a result with respect to attention focus and physical function
  3. Muscle strength and muscle activity patters
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

Looking at those neuroplastic processes or effects of chiropractic on the central nervous system, Gay et al. (2014) reported, “…pain-free volunteers processed thermal stimuli applied to the hand before and after thoracic spinal manipulation (a form of MT).  What they found was that after thoracic manipulation, several brain regions demonstrated a reduction in peak BOLD [blood-oxygen-level–dependent] activity. Those regions included the cingulate, insular, motor, amygdala and somatosensory cortices, and the PAG [periaqueductal gray regions]” (p. 615). In other words, thoracic adjustments produced direct and measureable effects on the central nervous system across multiple regions, which in the case of the responsible for the processing of emotion (cingulate cortex, aka limbic cortex) are regarding the insular cortex which also responsible for regulating emotion as well has homeostasis. The motor cortex is involved in the planning and execution of voluntary movements, the amygdala’s primary function is memory and decision making (also part of the limbic system), the somatosensory cortex is involved in processing the sense of touch (remember the homunculus) and, finally, the periaqueductal gray is responsible for descending pain modulation (the brain regulating the processing of painful stimuli).


This is a major step in showing the global effects of the chiropractic adjustment, particularly those that have been observed clinically, but not reproduced in large studies.  “The purpose of this study was to investigate the changes in FC [functional changes] between brain regions that process and modulate the pain experience after MT [manual therapy]. The primary outcome was to measure the immediate change in FC across brain regions involved in processing and modulating the pain experience and identify if there were reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity” (Gay et al., 2014, p. 615). 


Coronado et al. (2012) reported that, “Reductions in pain sensitivity, or hypoalgesia, following SMT [spinal manipulative therapy or the chiropractic adjustment] may be indicative of a mechanism related to the modulation of afferent input or central nervous system processing of pain” (p. 752). “The authors theorized the observed effect related to modulation of pain primarily at the level of the spinal cord since (1) these changes were seen within lumbar innervated areas and not cervical innervated areas and (2) the findings were specific to a measure of pain sensitivity (temporal summation of pain), and no other measures of pain sensitivity, suggesting an effect related to attenuation of dorsal horn excitability and not a generalized change in pain sensitivity” (Coronado et al., 2012, p. 752).These findings indicate that a chiropractic spinal adjustment affects the dorsal horns at the root levels which are located in the central nervous system.  This is the beginning of the “big picture” since once we identify the mechanism by which we can positively influence the central nervous system, we can then study that process and its effects in much more depth.    


One of the main questions asked by Corando et al. (2012) “…was whether SMT (chiropractic adjustments) elicits a general response on pain sensitivity or whether the response is specific to the area where SMT is applied. For example, changes in pain sensitivity over the cervical facets following a cervical spine SMT would indicate a local and specific effect while changes in pain sensitivity in the lumbar facets following a cervical spine SMT would suggest a general effect. We observed a favorable change for increased PPT [pressure pain threshold] when measured at remote anatomical sites and a similar, but non-significant change at local anatomical sites. These findings lend support to a possible general effect of SMT beyond the effect expected at the local region of SMT application (p. 762).


The above mechanisms take the effects of chiropractic care out of the realm of theory and validates the processes through which chiropractic works based upon the scientific evidence (literature).



Holt et. Al found that outcomes measured for both sensorimotor and quality of life increased with chiropractic care. The primary outcomes of improvement choice stepping reaction time (CSRT)and sound-induced flash illusion. The CSRT involves feet placement in a timed scenario and sound-induced flash illusion involves multisensory processing to ascertain reaction to perceived illusions. Both have been significantly related to older populations and falling. Although the results of this study has its limitations, as many studies do. Holt concluded” The results of this trial indicated that aspects of sensorimotor integration and multisensory integration associated with fall risk improved in a group of community-dwelling older adults receiving chiropractic care. The chiropractic group also displayed small, statistically significant improvements in health-related quality of life related to physical health when compared with a “usual care” control. These results support previous research which suggests that chiropractic care may alter somatosensory processing and sensorimotor integration.” (pg. 277)  


As with many of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number 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., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.



  1. Holt K., Haavik H., Lee A., Murphy B., Elley C., (2016) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial, Journal of Manipulative and Physiological Therapeutics, 39(4) 267-278
  2. Falls and Older Adults, Causes and Risk Factors (n.d.) National Institute of Health, retrieved from:
  3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.Journal of Manipulative and Physiological Therapeutics, 37(9), 614-627.
  4. Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis, Journal of Electromyography Kinesiology, 22(5), 752-767.
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

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Published in Neck Problems

Balance and Movement and The Effect

of Chiropractic Care


Utilization with the Elderly, Cerebral Palsy, the Athlete

and the General Population


Chiropractic care reverses maladaptations in sensorimotor integration
and improves motor control

A report on the scientific literature 



William J. Owens DC, DAAMLP


Sensorimotor is defined as our ability to feel and move. With infants, Piaget, the renowned researcher, categorized the first 2 years of an infant’s life as the sensorimotor stage. "During this period, infants are busy discovering relationships between their bodies and the environment. Researchers have discovered that infants have relatively well developed sensory abilities. The child relies on seeing, touching, sucking, feeling, and using their senses to learn things about themselves and the environment. Piaget calls this the sensorimotor stage because the early manifestations of intelligence appear from sensory perceptions and motor activities" (Anderson, n.d.,

As we develop and our nervous systems have acquainted us to our surroundings, we need the neurological "hookups" to remain intact to function optimally and pain free. In addition, our sensory and motor systems need to work in tandem in order for us to function normally.

To further break it down, our sensory system is part of the nervous system that consists of receptors that receive stimuli from both our internal and external environments. These receptors, such as the ones located in our fingertips, sense external stimuli, such as hot or cold, or what we feel. An internal receptor may be found in the tendons (connect your muscles to your bones) and lets you know what your joints are doing, such as are my fingers sensing if they are relaxed or in a fist. The sensory system is also controlled by the brain that processes what we feel.

Pain is part of the sensory nervous system and to the surprise of many, pain is an important component to protecting yourself. Without pain, you could get seriously hurt, such as by keeping your finger on a hot stove too long or touching a sharp object too heavily and cutting your hand. Internally, pain is a warning sign that an organ or system is "sick" and alerts you to seek medical care.

All pain receptors are free nerve endings, meaning they only bring information to your brain and function as the "pain receptors." There are three types of pain receptors; mechanical, thermal and chemical. They are found in skin and on internal surfaces such as the coverings of the bone and joint surfaces. "Deep internal surfaces are only weakly supplied with pain receptors and will propagate sensations of chronic, aching pain if tissue damage in these areas is experienced. Pain receptors do not adapt to stimulus. In some conditions, excitation of pain fibres becomes greater as the pain stimulus continues, leading to a condition called hyperalgesia [commonly known as, "WOW, that hurts a lot!"]" (Global Oneness, n.d.,

Your motor system is what allows you to move, maintain your posture and control your muscles. The motor system is controlled through nerves similar to the sensory system and like the sensory system, has a controlling element in the brain.

Functional tasks are defined as those things we do in our lives. Answering a telephone, putting a key in a door lock or picking up a fork to eat are all examples of functions. These functions, just like Piaget described in infants, are how we have a relationship with our body and the environment and require an integrated motor and sensory nervous system. Every functional task that we do involves both the motor and sensory components of our nervous system and while performing these tasks, we are protected by our ability to perceive pain.

Due to the development and integrategration of the world around us necessary to complete every task in our lives, as we get older, postural disturbances can arise and negatively affect how we integrate the sensorimotor information we are receiving both internally and externally and lead to significant balance disorders. Lord and Ward (1994) reported that, "All of the sensory, motor and balance system measures showed significant age-associated differences" ( This means that as one gets older, his/her sensorimotor system often fails to integrate the internal and external environment as it once could.

A research study by Taylor and Murphy (2008) concluded that chiropractic care reverses maladaptations in sensorimotor integration and improving motor control. The study suggests that spinal dysfunction may lead to muscle specific alterations of the brain’s ability to process motor control. The "real-life" implications of this finding affect every facet of our lives and every person. Whether it be an older person who is starting to exhibit balance disorders, or a cerebral palsy victim who struggles on a daily basis with the simple tasks of life or a world class athlete looking to increase his/her fine motor skills just 1/10 of 1%, the results of chiropractic care can be dramatic.

From the clinical observation of Dr. Mark Studin, a co-author of this article and a practicing chiropractor for 30 years, "This now gives scientific evidence and validation to what patients have been sharing after receiving chiropractic care. The most common comment from patients post care is, 'I perceive my surroundings more acutely and feel straighter.'" Dr. Studin continues, "Although I have heard this from every age group, my first patient was a cerebral palsy patient who stated that without getting adjusted he could barely function. With care, he walked to and from the office, a distance of 3 miles."

These studies, along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to increase integration between the motor and sensory systems of your body. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at and search your state.


1.  Anderson, M. (n.d.). Sensorimotor stage. Jean Piaget's Theory of Development. Retrieved from
Global Oneness. (n.d.). Pain - Physiology. Retrieved from
3.  Lord, S. R. & Ward, J. A. (1994). Age-associated differences in sensori-motor function and balance in community dwelling women. Age and Ageing. Retrieved from abstract/23/6/452
4.  Taylor, H. H. & Murphy, B. (2008). Altered sensorimotor integration with cervical spine manipulation. Journal of Manipulative and Physiological Therapeutics, 31(2), 115-126.

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Published in Balance

Increased Balance, Movement
& Kinematics as a Result of
 Chiropractic Care

A research conclusion that affects rehabilitation patients, athletes, balance disorders and increased production in the workplace

A report on the scientific literature 


William J. Owens DC, DAAMLP

"Much chiropractic research has been devoted to determining the effects of chiropractic care on various symptoms and disorders such as low back pain, neck pain, and headaches. In addition, some basic science research demonstrates that these disorders (particularly low back pain) are related to perceptual and behavioral changes in individuals ranging from reduced proprioception to changes in muscle recruitment patterns to altered kinematics" (Smith, Dainoff, & Smith, 2006, p. 257).
"Proprioception (pronounced /ˌproʊpri.ɵˈsɛpʃən/PRO-pree-o-SEP-shən), from Latin proprius, meaning "one's own" and perception, is the sense of the relative position of neighbouring parts of the body" (Wikipedia, 2010,
"Proprioception doesn't come from any specific organ, but from the nervous system as a whole. Its input comes from sensory receptors distinct from tactile receptors — nerves from inside the body rather than on the surface. Proprioceptive ability can be trained, as can any motor activity" (
Anissimov, 2010,
"Without proprioception, drivers would be unable to keep their eyes on the road while driving, as they would need to pay attention to the position of their arms and legs while working the pedals and steering wheel. And I would not be able to type this article without staring at the keys. If you happen to be snacking while reading this article, you would be unable to put food into your mouth without taking breaks to judge the position and orientation of your hands"
(Anissimov, 2010,
"Kinematics is the study of motion and the forces required to produce it. This includes the different forces at work during the movement of a single part of the body, and more complex movements such as running and climbin
g" (NASA, 1999,
"Chiropractic research has looked mainly at movement control from neurophysiological and biomechanical perspectives. This research has shown that chiropractic affects several factors that influence movement control. For example, reductions in resting muscular tone (quantified by surface electromyography in prone posture) have been documented following adjustments, as have improvements in muscular strength
. In addition, reaction times to a complex mental rotation task have decreasedwith adjustments. A recent review of the neurophysiological effects of spinal manipulation identifies experimental evidence that spinal manipulation influences proprioceptive primary afferent neurons from paraspinal tissues. Spinal manipulation also affects how pain signals are processed, possibly by altering the central facilitated state of the spinal cord. In summary, the available biomechanical and neurophysiological data indicate that spinal manipulations can affect the motor control system" (Smith, Dainoff, & Smith, 2006, pp. 257-258).
"Kinematic changes following chiropractic have also been noted…findings by Smith also indicate that coordination and balance changes result from chiropractic adjustments. A recent study using magnetic resonance imaging has shown that spinal adjusting produces movement at the zygapophyseal joints of the spine, thus revealing biomechanical effects of chiropractic
" (Smith, Dainoff, & Smith, 2006, p. 258).

In designing a model for studying human movement time (MT), we look at accepted scientific principles and laws for standardization of evaluation. "There is at least one immutable rule for interface design and movement that we know about, and it's called Fitts's Law. It can be applied to software interfaces as well as Web site design because it involves the way people interact with mouse or other pointing devices. Most GUI platforms have built-in common controls designed with Fitts's Law in mind. Many Web designers, however, have yet to recognize the powerful little facts that make this concept so useful" (Microsoft Corporation, 2010,

"The basic idea in Fitts's Law is that any time a person uses a mouse to move the mouse pointer; certain characteristics of objects on the screen make them easy or hard to click on. The farther the person has to move the mouse to get to an object, the more effort it will take to get to. The smaller the object is, the harder it will be to click on...It means that the easiest objects to locate and target are the ones closest to the mouse's current position and that have large target spaces. Fitts wrote several papers describing these findings, with significant mathematical rigor, expressing in formulas how you can measure the impact of different velocities, distances, and target sizes on a user's ability to click on objects" (Microsoft Corporation, 2010,

Results of Chiropractic and Movement Time

"All participants in the experimental group had significantly improved movement times following spinal adjustments compared with only 1 participant in the the control group. The average improvement in movement time for the experimental group was 183 ms, a 9.2% improvement, whereas the average improvement in movement time for the control group was 29 ms, a 1.7% improvement
" (Smith, Dainoff, & Smith, 2006, p. 257).

Implications of Increased MT Time Based on Chiropractic Care

MT is one of the most important variables influencing the way we control our movements. It can affect athletes, Parkinson’s patients, and balance disorder patients. It can increase productivity at work and influence every other facet of our lives that increased movement can help. What business wouldn’t want a 9.2% increase in work productivity where movement of your body is required for production? What balance disorder patient wouldn’t want a 9.2% increase in balance? What sprinter wouldn’t want 9.2% of their time taken off without the use of performance enhancing drugs?

While many see chiropractic as an effective modality to relieve back or neck pain, this study along with many others, see chiropractic as the solution to many interrelated issues in health, work, sports, rehabilitation and the workplace. This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to increasing your body’s ability to function better. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.


1.  Smith, D. L., Dainoff, M. J., & Smith, J. P. (2006). The effect of chiropractic adjustments on movement time: A pilot study using Fitts Law. Journal of Manipulative and Physiological Therapeutics,  29(4), 257-266.
2.  Wikipedia, The Free Encyclopedia. (2010, July). Proprioception. Retrieved from
3.  Anissimov, M. (2010, May). What is proprioception? wiseGEEK. Retrieved from
4.  NASA. (1999, July). Science glossary (G-M).  References, Glossaries. Retrieved from
5.  Studin, M., Owens, W. J., & Bonk, A. (2010, August). Increased sports performance and chiropractic. US Chiropractic Directory. Retrieved from
6.  Microsoft Corporation. (2010). Fitt's UI law applied to the Web. msdn. Retrieved from

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Published in Balance

Balance, Chronic Pain and Chiropractic

A report on the scientific literature 

The results showed decreased pain and increased balance; helping to avoid falls


William J. Owens DC, DAAMLP


When we age, it seems that there are more and more challenges to our health and well being.  Falling and chronic pain are most likely fighting to be #1 on that list.  Whether there was a prior injury, decades of hard labor, years of inactivity or just simple daily wear and tear, chronic pain is difficult to manage.  Our societal tendencies are to medicate to “make the pain go away,” but the TRUTH is, it is still there, we just feel it less.  What happens to our bodies when year after year, we continue to work through it?  Well, the problem gets worse and we take more pills! 

In a recent study from the University of California’s Geriatric Primary Care lecture, the presenter stated, “Ambulatory elderly fill between 9-13 prescriptions a year...”
(Johnston, 2001, slide 3 ).She goes on to state, “Surveys indicate that elders take average of 2-4 nonprescription drugs daily” (Johnston, 2001, slide 5).  Adding additional “pills” to the mix for pain is often not a very good idea.  Although necessary medications are clearly indicated and needed, what are the options for those medications that are optional and potentially dangerous when taken over a long period of time? 

In a recent study published in a chiropractic research journal, the authors stated, “The purpose of this study was to collect preliminary information on the effect of a limited and extended course of chiropractic care on balance, chronic pain, and associated dizziness in a sample of older adults with impaired balance" (Hawk, Cambron, & Pfefer, 2009, p.438). The results showed decreased pain and increased balance (helping to avoid falls).

The authors finally reported, "Another interesting finding in this study that warrants further investigation is that it appeared that for the group on the extended care schedule, pain and disability decreased and remained at a lower level than for the limited care schedule, for the year we followed patients.  This provides preliminary support for chiropractic maintenance care for older adults with chronic pain”
(Hawk, Cambron, & Pfefer, 2009, p.445).

This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with balance disorders and chronic pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.


1. Johnston, C. B. (2001, May). Drugs and the Elderly: Practical Considerations. PowerPoint presentation presented at the UCSF Division of Geriatrics Primary Care Lecture Series.
2.  Hawk, C., Cambron, J. A., & Pfefer, M. T. (2009). Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain and dizziness in older adults. Journal of Manipulative and Physiological Therapeutics, 32(6), 438-477

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Published in Balance

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