Neck Pain (Torticollis), Headaches, Dizziness, Radiating Pain, Nausea, Depression, Confusion, Ringing in the Ears Show Good Outcomes With Chiropractic Care
A report on the scientific literature
By: Marc D. Weiss, D.C., DAAMLP
Mark Studin DC, FASBE(C), DAAPM, DAAMPL
Although neck pain is the number one bodily injury or pain complaint from the general population in the west, many studies verify that chiropractic care for common neck pain has been effective. It has also been generally recognized that chiropractic care has helped a myriad of maladies and we are just starting to see those outcomes or positive results in the scientific literature to verify what both chiropractors and their patients have been reporting for over 100 years. The following study looks at outcomes of chiropractic treatment for neck pain and concurrent complaints throughout the Netherlands.
Rubenstein ET. Al (2007) used 79 chiropractors who each recruited approximately 10 patients. The patients were between the ages of 18-65 and had not received treatment 3 months prior to beginning this study. Participants who were treated for neck pain in this study all had different levels and frequency of visits with the chiropractor. Chiropractic spinal adjustments were the primary form of treatment. Each patient was asked a series of questions to assess their treatment success during each visit as well as during follow up appointments at 3 months and 12 months. Every symptom, including fatigue, headaches, nausea, and depression, significantly decreased from visit to visit, and significantly increased after the visits ceased.
This study covered a large area of patients with varying degrees and specifics of neck pain, as well as chiropractors with varying methods of treatment. Unlike many studies that gather data on effectiveness of treatments, especially pharmaceutical companies, this study showed statistics of both success in curing neck pain as well as adverse effects that arose during and after treatment. Only 5 of 4891 patients in the study group reported worsening of pain at the end of the study, which was 12 months after treatment. Also, only 2 of 4891 patients reported worsening of pain at the 3 month mark, which is when treatment for neck pain stopped.
The most prevalent improvement of neck pain in patients occurred during their first three visits. Additionally, most symptoms other than neck pain also improved during the first 3 months of treatment. Almost 50% of the patients were fully recovered when interviewed at their fourth visit. Almost 75% of the patients were fully recovered when interviewed at the three and twelve month follow up visits.
The following graph was presented by Rubenstein ET. Al (2007)
As you can see from the above graph, by the 2nd visit to a chiropractor, there has been significant improvement that continues to improve by the 4th visit. Although these patients initially sought care for neck pain, this study shows that many complaints respond favorably to chiropractic care and each complaint requires more independent research. The most impressive stastistic was 99.4% of people in the study would visit a chiropractor again at the 2nd visit and 98.7% at the 4th visit. That alone gives more insight than most other variables. If it wasn't successful, those numbers would not be there.
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)
Dizziness in Older Adults and Chiropractic Care
A report on the scientific literature
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
83% of dizziness sufferers showed improvement or eradication under chiropractic care
According to Maarsingh , Dros, Schellevis, van Weert, Bindels, and van der Horst in BMC Family Practice (2010), dizziness in older patients is a very common occurrence as reported by family medical practitioners. They reported that an 8.3% one-year prevalence of dizziness was reported in patients over the age of 65, with females having a higher incidence. It was also reported that the number could be higher as this is a symptom reported by the patient.
According to Web MD in 2009, "Dizzinessis a word that is often used to describe two different feelings. It is important to know exactly what you mean when you say 'I feel dizzy' because it can help you and your doctor narrow down the list of possible problems.
Lightheadedness is a feeling that you are about to faint or 'pass out.' Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness gets worse, it can lead to a feeling of almost fainting or a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded.
Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.
Although dizziness can occur in people of any age, it is more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries" (http://www.webmd.com/brain/tc/dizziness-lightheadedness-and-vertigo-topic-overview).
As reported by Hampton (2005), dizziness has become such a prevalent problem that in spite of rising health care costs, in 2003, Medicare introduced that routine screenings to new beneficiaries for hearing loss, balance disorders and dizziness would be covered. The reason is that the government is looking long-term to save money; something that rarely happens, but in this case is the best solution.
According to Lynn, Schuster, and Kabcenell (2000), Medicare creates "RUG," a classification of patients in nursing facilities grouped by disability and other care needs, for the purpose of determining coverage and rates in the Medicare system. Dizziness is one of the criteria in determining the reimbursement rates for skilled nursing facilities. The costs for a skilled nursing home depending upon the RUG score ranges from $424.97 to $155.66 per day and the variable is the documented impairment of the resident and the amount of care needed to support that population of residents. From a financial perspective, the Federal Governmental and Medicare have a very high stake in ensuring that hearing and dizziness is cared for and corrected at as early an age as possible to save the system significant money.
In 2009, Hawk and Cambron studied the relationship between chiropractic care and dizziness over an 8 week course of manipulative care (chiropractic spinal adjustments). The patients having a "dizziness handicap inventory" baseline score indicating significant dizziness reported an 83% improvement or eradication of the dizziness as a direct result of chiropractic care. Hawk and Cambron reported that this was a pilot study and more research is needed, but their findings could encourage others to find solutions to a growing problem among older adults in American and could positively impact both the lives of Americans and the financial burden of our economy.
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with dizziness. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
1. Maarsingh, O. R., Dros, J., Schellevis, F. G., van Weert, H. C., Bindels, P. J., & van der Horst, H. E. (2010). Dizziness reported by elderly patients in family practice: Prevalence, incidence, and clinical characteristics. BMC Family Practice, 11(2), Retrieved from http://www.biomedcentral.com/1471-2296/11/2
2. WebMD (2009). Dizziness: Lightheadedness and vertigo-topic overview. Retrieved from http://www.webmd.com/brain/tc/dizziness-lightheadedness-and-vertigo-topic-overview
3. Hampton, D. (2005). New medicare benefit includes screening for hearing loss and dizziness. Hearing Review, Retrieved from http://www.hearingreview.com/issues/articles/2005-03_07.asp
4. Lynn, J., Schuster, J. L., & Kabcenell, A. (2000). 9.1.2 Skilled nursing facilities. In Improving care for the end of life: A sourcebook for healthcare managers and clinicians. Retrieved from http://www.mywhatever.com/cifwriter/content/66/4332.html
5. Hawk, C., & Cambron, J. (2009). Chiropractic care for older adults: Effects on balance, dizziness, and chronic pain. Journal of Manipulative and Physiological Therapeutics, 32 (6), 431-437.
Effectiveness of Chiropractic Care
1. Low Back Pain: Chronic, severe, moderate & non-specific
2. Neck Pain: Severe and moderate
3. Migraine Headaches
4. Headaches: Cervicogenic
5. Dizziness: Cervicogenic
6. Hip Pain: From Arthritis
A report on the scientific literature
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
In order to understand the vast importance of this study, it is critical to understand the context of the work. These conclusions were based on randomized clinical trials and evidenced based results. The studies which the conclusions were based upon come from the input of hundreds of sources.
Randomized Clinical Trials
According to the National Cancer Institute (2004), "Randomization is a process that assigns research participants by chance, rather than by choice, to either the investigational group or the control group of all phase III (and some phase II) clinical trials...Each study participant has a fair and equal chance of receiving either the new intervention being studied (by being placed in the investigational group), or of receiving the existing or 'control' intervention (by being placed in the control group)" (http://www.cancer.gov/clinicaltrials/learning/what-is-randomization).
"The goal of randomization is to produce comparable groups in terms of general participant characteristics, such as age or gender, and other key factors that affect the probable course the disease would take. In this way, the two groups are as similar as possible at the start of the study. At the end of the study, if one group has a better outcome than the other, the investigators will be able to conclude with some confidence that one intervention is better than the other. A randomized, controlled trial is considered the most reliable and impartial method of determining what medical interventions work the best" (National Cancer Institute, 2004, http://www.cancer.gov/clinicaltrials/learning/what-is-randomization).
Evidenced Based Healthcare/Practice
According to Schardt and Mayer (2010), "[Evidenced based practice] is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology" (http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm).
"The evidence, by itself, does not make a decision for you, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature" (Schardt & Mayer, 2010, http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm).
In a 2010 study by Bronfort, Haas, Evans, Leininger and Triano, the researchers both randomized clinical trials and studied evidenced based practice results utilizing guidelines found in scientific literature. In each case, they compared the results of manipulation (chiropractic spinal adjustments or extremity adjusting) to "sham" treatment and concluded that manipulation was effective for:
1. Low back pain, soreness or tension
2. Neck pain
3. Hip pain from arthritis
5. Headache localized in the neck or back of the head
6. Dizziness emanating from the neck
The following entities were included in the above study to help conclude the results of this research: The American College of Physicians/American Pain Society, The Journal of the AMA, the World Health Organization, Journal of Manipulative Physiological Therapeutics, New Zealand Journal of Medicine and many others. Some clarified what was not yet conclusive while others certified chiropractic as a viable choice for care. The arguments as to whether chiropractic works or not has been long silenced. The only question that now arises is when will the more scientific literature be published?
Asthma is one area is that is lacking in research. As the author of this article and a chiropractic practitioner for 30 years, there has not been one asthma patient that didn’t respond to chiropractic care ranging from the acute to the chronic patient where most discarded their drugs and inhalers (as a result of the advice of their medical practitioners) because they didn’t need them anymore. During most of my career, there was no literature, it just worked. Today, we do not have to go simply on faith as there is much literature in the scientific community confirming the benefits of chiropractic.
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for many problems and returning to a normal life. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
1. National Cancer Institute. (2004, August 3).What is randomization? Retrieved from http://www.cancer.gov/clinicaltrials/learning/what-is-randomization
2. Schardt, C., & Mayer , J. (2010, July). What is evidence-based practice. Retrieved from http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm
3. Bronfort, G., Haas M., Evans R., Leininger, B., &Triano, J. (2010). Effectiveness of manual therapies: The UK evidence report. Chiropractic and Osteopathy, 18(3). Retrieved from http://www.chiroandosteo.com/content/18/1/3