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CF 026: Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues

Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues. 

Today we’re going to talk about chiropractic better than physical therapy and new info and new articles coming out on how chiropractors fit into an integrated care protocol and we’ll explore chiropractic vs. physical therapy according to research. Which should be the first referral in the medical kingdom and why? We hope you’ll help us by liking, sharing, and retweeting our content.  

But first, here’s that bumper music

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

Before we get started, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. On another note, we are accepting speaking engagements so shoot us an email at dr.williams@chiropracticforward.com so we can connect. 

I need to thank Dr. Chris Carr out in Pittsburgh, PA with the Health Nuts Podcast for having me as a guest on Tuesday, May 29th. I had a blast. We talked all about stroke risk, or the lack thereof, and all kinds of good stuff. Make sure you check it out at the link in the show notes

Click here to listen to Health Nuts episode 37 with guest Dr. Jeff Williams

 http://directory.libsyn.com/episode/index/id/6644712/tdest_id/531106

Now, here we go with some vital information that we think can build confidence and improve your practice which will improve your life overall. That’s a tall order but that is the goal. When you know the research, which is what we talk about every week, then you start to speak to colleagues in a more effective way. With stats, research, and confidence. 

You have scooted into Episode #26

But first, my week has been one of renewal I’d say. Don’t we get into a rut sometimes where we go through our lives in a robotic sense? I’m as guilty of it as the next person. As I’ve said here on the podcast before, I’m a big music fan. I used ot be a traveling musician. I wrote and recorded the bumper music you just heard. i am a sculptor. Check out River Horse Art on Facebook. I build live edge furniture if you’d like to see the stuff at Amarillo Furniture and Live Edge Customs on Facebook. I have lots of interests but…..don’t we fall into ruts regardless of how many hobbies or interests we have?

The trick, I think, is outside influence. The right kind of outside influence. Undoubtedly, many of you are non-Christian and I’m not the kind of Christian to tell anyone they’re right or wrong but, if you’ll hang with me just a sec, maybe I can make sense to the non-christians as well. 

On the way to work this morning, I was listening to a podcast by a preacher named Jenetzen Franklin. Now, I usually listen to murder mysteries, music, news, or silence but, every now and then, I just get a calling of sorts to listen to something faith based. Well, that happened this morning. 

This episode was called Don’t Call This Common. Franklin was talking about how we go through our days in a robotic mentality many times. He was saying how, nothing blessed by God can be called common. From our relationships, family and friends, our interactions, our offices, our patients, our work in general. Nothing we do is common. Our days, our jobs, our profession, and our results are extraordinary indeed. What would out patients do without us in their lives? You don’t have to be a Christian to understand how lucky we are to wake up in the morning. How lucky we are to kiss our spouses and out kids. Or how lucky we are to work in a job that makes us happy and allows us to make such a difference in others’ lives. 

It is truly extraordinary. 

Thank you for indulging me there for a minute and allowing me to share my heart with you for a little bit. It’s one of those days of renewed energy and renewed perspective for me. I hope my thoughts spark something similar in you as well. 

Let’s get to some articles and research to get you thinking and speaking in the right direction. 

Last week, we discussed a new paper by Dr. Goertz which had to do with how integrating chiropractors into treatment for Vets suffering from musculoskeltal issues. Mostly low back pain(Goertz C 2018). 

Here’s an article written by Reuters’ writer Lisa Rapaport on the paper(Rapaport L 2018). 

It’s called “Adding chiropractic to back pain care may reduce disability.” I’d like to say from the top that I’m unhappy with the title. What’s this “May reduce” garbage exactly? If Lisa knew about 1/10th of the research, she’d leave out the questioning tone of the title. That’s like saying that heart surgery MAY save lives. You know, some people die during heart surgery so……it doesn’t ALWAYS work does it? Some people don’t have completely outcomes from low back fusion so….low back surgery MAY work. Follow me? 

Dr. Goertz had a couple of interesting quotes included in the article. The first quote is, “Spinal manipulation (often referred to as chiropractic adjustment) may help heal tissues in your body that form as a result of injury, decreasing pain and improving your body’s ability to move correctly.” The other was, “It is also possible that manipulation impacts the way that your body perceives pain through either the brain or the spinal cord and/or decreases pain from muscle strain, inflammation and/or spasm in the muscles next to your spine.”

Great quotes from a great doctor and a researcher that has been a game-changer for our profession. But, wouldn’t you say there are questions in those quotes as to exactly how Chiropractic works in the first place? What is it about chiropractic or spinal manipulation that actually caused the effectiveness and the reduced pain? Like, what it is exactly? 

Take for example the cardiologist: they are effective because they go in and place a stent or there was blockage in one of the arteries feeding the heart so they either cleared it or bypassed it and now it works better. There’s no doubt as to why they were effective. 

I think until we come up with a unified, provable reason as to why we chiropractors get the results we get, we may always be struggling to explain ourselves in a manner that resonates and makes sense to colleagues in the medical field and to the layperson with back pain out in the general population. 

This needs some work and some resolution in my humble opinion. 

We have mentioned this next paper before so we won’t go through the whole thing again but, when you are discussing chiropractic with medical professionals, it’s clear the MDs prefer to send their musculoskeletal patients to the physical therapist first before taking the next steps toward shots and surgery. That’s progress from immediate medication and shots but, it may not be the most effective referral they can make. What can we do to show that chiropractic better than physical therapy?

Let me first say that I love physical therapy and physical therapists. This is not a competition in my opinion. Yes, we cross over into each others’ territory daily but, that is business and that is life. I think physical therapy most definitely has it’s place. Post-operative rehab is the spotlight in my mind for physical therapy. What would surgical patients do without physical therapy following minor and major surgeries? They are game changers. 

Now, if we talk about pain caused by discs or something originating in the spine, my 20 years has shown me they have little effectiveness in this area. We all know Mckenzie and core building exercises are beneficial. We all know this stuff. You don’t need to be a physical therapist to figure that out. But effectively treating discs…..I have not seen that much at all. For discs, in general, chiropractic better than physical therapy.

In fact, I had a patient that was treating with us. She was a young, healthy, fit, athletic girl having a significant, MRI-confirmed disc issue. We worked and worked with her to the point that she was feeling great. Without consulting yours truly, she got the idea in her head that, if she added physical therapy to the regimen, her results would be twice as good as they already were. 

Well, she went to one appointment with the PT and came back in tears, unable to walk or function, and no matter how much we worked with her from that point, we were never able to get her back to where we had her. She ended up having low back surgery. In her 20’s. Again, in this case, chiropractic better than physical therapy.

Of course that’s not the common experience of patients that go to PTs and I’m not discouraging going to PTs. As I said, we all have our function and certain things we are truly effective in treating. A truly integrated approach is the ideal way to work it. 

But let’s be clear, this podcast is called “Chiropractic Forward.” We aren’t here to advocate for physical therapists. They have plenty of folks doing that. We aren’t here to bash them either by the way. Our function is chiropractic advocacy based on research and evidence. 

In this systematic review and meta-analysis by Ian Coulter, et. al., he concludes by saying, “ There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe(Coulter I 2018).” So…..chiropractic better than physical therapy.

Now, when we argue that patients should be seeing a chiropractor prior to, or in conjunction with, a physical therapist, keep in mind this study from 2017 called, “Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain” by Marc Andre Blanchette et. al. (Blanchett M 2017). 

The study focused on patients in the workers comp system. What practitioner they saw, how long and expensive was treatment, and did they have reoccurrence of the pain?

The authors concluded by saying, “The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest. These differences raise concerns regarding the use of physiotherapists as gatekeepers for the worker’s compensation system.” Bam….chiropractic better than physical therapy.

Chiropractors…..can I get a hell yeah? Maybe an Amen?!?

What about this paper from 2014 called “Cost-effectiveness of manual therapy for the management of musculoskeletal conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials,” by Tsertsvadze(Tsertsvadze A 2014)?

When comparing manual therapy with usual medical care and physical therapy, the authors concluded the paper by saying, “Preliminary evidence from this review shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability.”

And lastly for this topic, there’s this paper from 2003 from Korthals-de Bos, et. al. called “Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial. Randomized controlled trial” that was published in the British Medical Journal(Korthals-de Bos IB 2003). Shazzam…..chiropractic better than physical therapy.

The authors wanted to evaluate, contrast, and compare effectiveness of manual therapy to physiotherapy/physical therapy and to care by a general medical practitioner in regards to neck pain specifically.

They concluded the paper by saying, “Manual therapy (spinal mobilisation) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner.”

So, as you can see, there are several, research-backed arguments to be made to medical colleagues when you are asking them for their referrals rather than physical therapy being their knee-jerk reaction and first choice.

Go forth with confidence and assertiveness knowing that your profession is validated in a thousand different ways. 

Key Takeaways

Chiropractic kicks butt any way you want to look at it when you’re looking at it through a research-based lens and it’s great to see it continually excel and surpass usual medical care and physical therapy in terms of effectiveness, cost-effectiveness, and risk vs. reward. 

As I mention at the end of every episode, I want you to know with absolute certainty that when Chiropractic is at its best, you cannot beat the risk vs reward ratio. Plain and simple. Spinal pain is a mechanical pain and responds better to mechanical treatment rather than chemical treatment such as pain killers, muscle relaxants, and anti-inflammatories.

When you look at the body of literature, it is clear: research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, compared to the traditional medical model, patients get good to excellent results with Chiropractic. It’s safe, more cost-effective, decreases chances of surgery, and reduces chances of becoming disabled. We do this conservatively and non-surgically with minimal time requirements and hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward, we can likely keep it that way while raising the general, overall level of health! And patients have the right to the best treatment that does the least harm. THAT’S Chiropractic folks.

Please feel free to send us an email at dr dot williams at chiropracticforward.com and let us know what you think or what suggestions you may have for us for future episodes. Feedback and constructive criticism is a blessing and we want to hear from you on a range of topics so bring it on folks!

If you love what you hear, be sure to check out www.chiropracticforward.com. We want to ask you to share us with you network and help us build this podcast into the #1 Chiropractic evidence-based podcast in the world. 

We cannot wait to connect again with you next week. From Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Social Media Links

iTunes

Bibliography

Blanchett M (2017). “Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain.” J Occup Rehabil 27(382).

Coulter I (2018). “Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis.” Spine 0(0).

Goertz C (2018). “Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain A Comparative Effectiveness Clinical Trial.” JAMA 1(1): E180105.

Korthals-de Bos IB (2003). “Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial.” British Medical Journal 326(7395): 911.

Rapaport L (2018). “Adding chiropractic to back pain care may reduce disability.” Reuters 0(0).

Tsertsvadze A, e. a. (2014). “Cost-effectiveness of manual therapy for the management of musculoskeletal conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials.” J Manipulative Physiol Ther 37(6): 343-362.

CF 008: With Dr. Craig Benton – Brand New Information Based on Results Chiropractic Proven Effective For Low Back Pain

CF 016: Review of The Lancet Article on Low Back Pain (Pt. 1)

CF 015: DEBUNKED: The Odd Myth That Chiropractors Cause Strokes (Part 3 of 3)

CF 007: Awesome Alternatives To High Blood Pressure Treatment

CF 012: Proven Means To Treat Neck Pain

Proven Means To Treat Neck Pain

In today’s podcast, we are going to talk about research on how to treat neck pain but hopefully in a fun way. We like to have fun on the Chiropractic Forward podcast. Let’s face it, research can be a bit boring so why not try to have some fun with it?

Before we get started, I want to draw your attention to the reviews over at iTunes. If you would be kind enough to leave us a great review, that tells iTunes that people are finding value in what we are sharing and it will help us grow this podcast. We sure would appreciate you!

Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast where we talk about issues related to health, chiropractic, evidence, and research and how those things all fit into a comprehensive approach for treating different conditions. Thank you for taking time out of your day to give us a listen. I know your time is valuable and I will always try hard to fill our time with valuable content.

In the words of Chris Berman, you have back back back backed into Episode #12 and this week we’re going to have more fun than having your teenage son spank you in video games that you’ve always beat him at. Yes, this recently happened to yours truly. Not only that but he did it with a pistol and I’m asham   ed. Call of Duty was my safe space y’all…..

So, I’ll just bury myself into my work, stuff it deep down inside to explode at a later date.

Now, If you have spent any significant amount of time with our videos, podcasts, or blogs, you are probably aware that there is an excess of research regarding chiropractic’s effectiveness in patients suffering from low back pain.

Although there are some excellent research papers having to do with chiropractic and neck pain, I would argue that it demands more attention. Without question. The first reason being that neck pain is as important or more so than low back pain. In the paper we will be discussing this week, they cite research suggesting that neck pain is responsible for up to 25% of the patients seen in outpatient orthopedic practices and 50% of the general population will have neck pain at some point in their lives.

The second reason I believe neck pain demands more attention from our industry is that we have been unfairly labeled as the profession out there in the world causing strokes every day. There needs to be a clear, factual representation of the risk vs. reward ratio and, if there is a small body of evidence, our case doesn’t stand up quite as strongly.

To be more clear, there is an abundance of evidence that Chiropractic is not linked to strokes any more than going to the primary practitioner. However, there is scant evidence of Chiropractic’s effectiveness to treat neck pain WHEM COMPRAED to the research available to treat low back pain.

This does not mean there isn’t great research in our favor on hwo to treat neck pain. That is not what I’m saying at all. It just means we have not documented it through research in the amounts that we have for the low back pain and I would like to see more. If I were a researcher myself, it is the condition I would be targeting without question.

Now, with that being said, this week’s paper is titled “The Immediate Effects of Upper Thoracic Translatoric Spinal Manipulation on Cervical Pain and Range of Motion: A Randomized Clinical Trial” published in the Journal of Manual Manipulative Therapeutics in 2008 that shows the effectiveness of spinal manipulative therapy. Here’s the catch, it was performed by physical therapists, not chiropractors. It was done by John Krauss, PT, PhD, OCS, FAAOMPT, et. al. Look at all of those letters.

At this point, I would like to diverge from the original path for a few moments. If chiropractors are unaware, along with research validating the chiropractic adjustment to treat neck pain, low back pain, and other maladies comes more competition for the service.

Physical therapists were restricted to muscles and exercise essentially. Now, they are adjusting. This is going to become a turf war between chiropractors doing what we have always done and physical therapists adopting our treatments as their own.

Of course, physical therapists can’t call what they do “chiropractic adjustments” so they have changed the term to “translatoric spinal manipulation.”

It’s irritating to the chiropractic profession but it is a fact the profession will be facing more and more in the years to come so be prepared for it.

It is particularly irritating when you consider that physical therapists have been part of the medical machine that have torn down the chiropractic profession for generations prior to adopting its techniques as their own.

Now, back to the research paper.

Why They Did It

The authors of the paper wanted to determine the effectiveness of thoracic (upper back) adjustments to treat neck pain and neck range of motion.

How They Did It

  • The active range of motion of the neck in each subject was measured before and after the manipulation. The term “active range of motion” means the patient turned their neck as far as possible in rotation both ways without the assistance of the researcher.
  • The range of motion was measured with a cervical inclinometer.
  • The patient’s neck pain was measured prior to and after treatment with the Faces Pain Scale. A quick trip to Wikipedia tells us that the Wong-Baker Faces Pain Rating Scale is a pain scale that was developed by Donna Wong and Connie Baker. The scale shows a series of faces ranging from a happy face at 0 which represents “no hurt” to a crying face at 10 which represents “hurts worst.”
  • The study included 32 patients having pain in the cervical region and limited range of motion.
  • 22 of these were randomly split into an experimental group while the other ten were randomly placed into a control group.
  • The evaluator measuring the pre- and post-manipulation outcomes was a blinded evaluator to reduce risk of bias.
  • The experimental (treatment) group received the manipulation treatment to the areas of the upper back region that had been determined to be hypomobile. In simpler terms, they delivered the adjustment to the areas of the upper back that were stiff or not moving like they should.
  • The control group had no treatment.
  • Paired t-tests were used to determine the changes within the group for cervical rotation and pain. A paired t-test is used to compare two population means where you have two samples in which observations in one sample can be paired with observations in the other sample.
  • A 2-way repeated-measure ANOVA was used to analyze between-group differences in cervical rotation and pain. A two-way repeated measures ANOVA is often used in studies where you have measured a dependent variable over two or more time points, or when subjects have undergone two or more conditions. The primary purpose of a two-way repeated measures ANOVA is to understand if there is an interaction between these two factors on the dependent variable.

What They Found

  • Significant changes were found for neck rotation within the group as well as between the groups.
  • The translatoric spinal manipulative group showed more range of motion in right rotation as well as in left rotation.
  • The levels of pain the subjects experienced after the manipulation were significantly reduced.

Wrap It Up

The authors of the paper concluded by saying, “This study supports the hypothesis that spinal manipulation applied to the upper thoracic spine (T1-T4 motion segments) significantly increases cervical rotation ROM and may reduce cervical pain at end range rotation for patients experiencing pain during bilateral cervical rotation.”

Did you know that research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, compared to the traditional medical model, patients get good to excellent results with Chiropractic. It’s safe, more cost-effective, decreases chances of surgery, and reduces chances of becoming disabled. We do this conservatively and non-surgically with minimal time requirements and hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward, we can likely keep it that way while raising the general, overall level of health! What better way to treat neck pain?

Please feel free to send us an email at dr dot williams at chiropracticforward.com and let us know what you think or what suggestions you may have for us for future episodes. If you love what you hear, be sure to check out www.chiropracticforward.com.

As this podcast builds, so will the website as we add more content, educational products, and a little further down the road, webinars, seminars, and speaking dates as they get added.

We cannot wait to connect again with you next week. From Creek Stone here in Amarillo, TX, home of the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Source Material

Krauss J, et. al., “The Immediate Effects of Upper Thoracic Translatoric Spinal Manipulation on Cervical Pain and Range of Motion: A Randomized Clinical Trial.” J Man Manip Ther. 2008; 16(2): 93–99.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565124/

 

CF 010: Surprise Unique Information Shows Chiropractic May Work On The Brain Too

Surprise Unique Information Shows Chiropractic May Work On The Brain Too

Welcome to the Chiropractic Forward podcast. I am your host Dr. Jeff Williams and we’re exctied to have you along for the ride. In today’s show, we’re going to talk about how chiropractic may work in the brain itself rather than how it affects just the musculoskeletal system.  We include some intriguing stuff from New Zealand that will make you think, hmmmm, that’s interesting, and we’ll have a little fun along the way

Bring on the bumper music

Again, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast This is where we talk about issues related to health, chiropractic, evidence, and research and how those things all fit into a comprehensive approach for treating different conditions. Thank you for taking time out of your day to give us a listen. I know your time is valuable and I will always try hard to fill our time with valuable content.

You have bobbed and weaved your way into episode #9 of the Chiropractic Forward podcast.

Before we get started, I want to draw your attention to the reviews over at iTunes. If you would be kind enough to leave us a great review, that tells iTunes that people are finding value in what we are sharing and it will help us grow this podcast. We sure would appreciate you!

For anyone that has paid any amount of attention to chiropractic, it’s clear that chiropractic treats muscles, bones, and the biomechanics overall. But what some people don’t commonly consider is the fact that chiropractic is effective when treating the nerves that make it all work together.

For instance, what do you think about when you think of chiropractic? More than likely, you think about back pain, neck pain, athletes, and headaches and migraines. It is unlikely that phrases like “cortical drive” or “movement related cortical potential” comes to mind.

According to the author of the paper we’re going to be talking about today, “Scientists use to believe spinal manipulation was a biomechanical treatment option for spinal pain conditions. However, the growing basic science evidence suggests there may be more of a neurophysiological effect following spinal manipulation than previously realized.”

When we begin to talk about the brain, physiology, neurology, and neurological processes, you can get into some highly complicated terms and ideas. I’m going to do everything I can to put it into terms that anyone and everyone can easily process without having a year of neurology classes.

And let’s be crystal clear, I’m not a neurologist or a chiropractic neurology diplomate either with tons of extra education on the brain and nervous system specifically. Many of these terms go above MOST of our heads and MOST of the heads in the medical field as well. That is just a matter of fact. But that doesn’t mean we can’t read, comprehend, and relay the overall pertinent information, which is what we are doing here.

Basically, “What’s the big idea?” That’s what I’m trying to bring to you here without making your eyes glaze over and making you fall into a deep state of hibernation.

Now, with all of that being said, there is some potentially fascinating research coming out of New Zealand we’re going to be talking about here having to do with the dact that chiropractic may work on the brain itself. We are going to talk about two papers that have been done by roughly the same group at the Centre for Chiropractic Research at the New Zealand College of Chiropractic in Auckland New Zealand. Just the name “Auckland” makes me want to go visit. I hear New Zealand is fantastic and the Lord Of The Rings was filmed there so you know it’s stunning. If an epic is filmed in your country, then you know it must be truly epic.

Here is a bit of a disclaimer to start off with. I have seen some dispute from other evidence-based chiropractors online of a different study from Dr. Haavick so I want you to understand that this sort of research cannot be accepted as the gospel. Not just yet anyway. I’d say it’s promising to an extent but there needs to be A LOT more exploration here before we hold it up as the gospel truth. Today’s podcast is more of a, “Hey, look what they’re studying, look what their findings are, and look what the potential for this sort of study could be.” rather than drawing any firm conclusions at this time.

The first study is titled, “Impact of Spinal Manipulation on Cortical Drive to Upper and lower Limb Muscles,” and was published in the journal ‘Brain Sciences’ in December of 2016(1).

Why They Did It

The researcher wanted to find out whether chiropractic care changes motor control. Motor control is basically the messages your brain sends your body in order make it move. Bending your arm, writing on a piece of paper, kicking your leg, or walking are examples of motor control. They assessed whether chiropractic care affected motor control for the arms as well as the legs and tried to find out if the changes may partly happen in the cortical part of the brain, which   is the part that issues motor commands. Although the researchers couldn’t completely rule out the idea that chiropractic adjustments can help motor function at the actual spinal level manipulated, the theory was that some of the changes must happen in the brain itself.  Basically, do chiropractors change how the brain controls muscles(2)? 

How They Did It

  • They conducted two experiments to test their theory. One for the arm and one for the leg.
  • In the first, transcranial magnetic stimulation input-output curves for an upper limb muscle known as the abductor pollicis brevis were recorded.
  • They also recorded F-waves before and after spinal manipulation or the control intervention for the control group on the same subjects on two different days.
  • The researchers did the same in a separate experiment for the lower limb using the tibialis anterior muscle.

What They Found

Before getting into what they found, let’s define the term motor evoked potential.”  According to Medscape, the definition is, “Single- or repetitive-pulse stimulation of the brain causes the spinal cord and peripheral muscles to produce neuroelectrical signals known as motor evoked potentia ls. Clinical uses of motor evoked potential include as a tool for the diagnosis and evaluation of multiple sclerosis and as a prognostic indicator for stroke motor recovery(3).”

With that knowledge the following was noted:

  • Spinal manipulation caused an increase in maximum motor evoked potential in both muscles tested.

Wrap It Up

In a quote from the research abstract, the authors conclude, “Spinal manipulation may therefore be indicated for the patients who have lost tonus of their muscle and or are recovering from muscle degrading dysfunctions such as stroke or orthopaedic operations. These results may also be of interest to sports performers. We suggest these findings should be followed up in the relevant populations.”

In another quote from the lead author, she said, “This research has big implications,says an enthusiastic Heidi Haavik. “It is possible that patients who have lost muscle tonus and/or are recovering from muscle degrading dysfunctions such as stroke or orthopaedic operations could also benefit from chiropractic care. These findings are also very relevant to sports performers (although this too must also be followed up with more research), because it indicates that chiropractic care may help their brains to more efficiently produce greater outputs. So all in all a very exciting study!”

Guess what? They took their own advice in their conclusion and followed up this paper with another similar paper focused more specifically on athletic performance. Here’s the last paper we will discuss called, “The Effects of a Single Session of Spinal Manipulation on Strength and Cortical Drive in Athletes” published in the European Journal of Applied Physiology in January of 2018. Brand new information(5).

Why The Did It

Of course, they did it because they suggested the need for the paper in the conclusion of the previous study but more specifically, they did it because they wanted to test if a single chiropractic adjustment could change things in the muscles of the lower leg for an elite Taekwondo athlete.

How They Did It

  • The muscle measured was the soleus muscle, which lies just under what is commonly known as the calf muscle or the gastrocnemius.
  • Soleus evoked V-waves, H-reflex and maximum voluntary contraction of the plantar flexors were recorded from 11 elite Taekwondo athletes
  • A randomized controlled crossover design was utilized.
  • Treatments used consisted of either spinal manipulation in the treatment group or passive movement control in the control group.
  • Outcome measurements were noted prior to treatment, immediately after treatment, 30 minutes after treatment, and an hour after treatment.

What They Found

  • Spinal manipulation was responsible for increasing each factor measured when compared to the control group.
  • The differences were considered significant through each time interval.

Wrap It Up

The authors are quoted in the conclusion of the paper as saying, “A single session of spinal manipulation increased muscle strength and corticospinal excitability to ankle plantar flexor muscles in elite Taekwondo athletes. The increased maximum voluntary contraction force lasted for 30 minutes and the corticospinal excitability increase persisted for at least 60 minutes.“

As I said in the beginning, I feel that this sort of research is really just beginning and consider it in its infancy but I also think that the results are enough to demand more exploration into this area of how chiropractic can affect neurology.

There is actually a court case in Texas this very minute. The appeals argument starts on February 28th down in Austin. The Texas Medical Association is attacking Texas Chiropractors’ rights to treat the “neuromusculoskeletal” system. They argue that chiropractors do not (and cannot) treat anything further than the “musculoskeletal”system. Certainly, NOT the “neuromusculoskeletal” system.

Regardless of the opinions held by those in the leadership of the Texas Medical Association and their legal team, both of these papers (and many other by the way), in my opinion, render their arguments ignorant, nit-picky, archaic, and obsolete. It’s not a question of what research is out there. It’s a question of if they can understand it or will let their pride go. My guess is, “No.” They have to prevent Chiropractic from moving into their territory at any and all costs. It is NOT about patient safety. It never has been and it never will be. It’s purely based on power and the threat of losing it.

What’s your opinion. We would love to hear it.

Research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, compared to the traditional medical model, patients get good or excellent results with Chiropractic. It’s safe, more cost-effective, decreases chances of surgery, and reduces chances of becoming disabled. We do this conservatively and non-surgically and do it with minimal time requirements and hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward, we can likely keep it that way while raising the general, overall level of health! And, of course now, we see that chiropractic may work on the brain too!

Please feel free to send us an email at dr dot williams at chiropracticforward.com and let us know what you think or what suggestions you may have for us for future episodes. If you love what you hear, be sure to check out www.chiropracticforward.com. As this podcast builds, so will the website as we add more content, educational products, and a little further down the road, webinars, seminars, and speaking dates as they get added.

We cannot wait to connect again with you next week. From Creek Stone here in Amarillo, TX, home of the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Sources:

  1. Haavik H, Niazi IK, Jochumsen M, Sherwin D, Flavel S, Türker KS. Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Brain Sci. 2016 Dec 23;7(1).https://chiropracticscience.com/increase-cortical-drive-following-spinal-manipulation/

2) https://spinalresearch.com.au/new-study-reveals-impact-spinal-manipulation-cortical-drive-limb-muscles/

3) https://emedicine.medscape.com/article/1139085-overview

4) https://www.researchgate.net/publication/322199907_The_Effects_of_a_Single_Session_of_Spinal_Manipulation_on_Strength_and_Cortical_Drive_in_Athletes

5) Christiansen L, et. al. (2018). The Effects of a Single Session of Spinal Manipulation on Strength and Cortical Drive in Athletes. European Journal of Applied Physiology. . 10.1007/s00421-018-3799-x/fulltext.html.