Chiropractic Research and the effectiveness of Chiropractic treatment
The following article is taken directly from the British Chiropractic Association website at:
http://www.chiropractic-uk.co.uk/For-Health-Care-Professionals-Research-12-mi.aspx
A primary health-care profession with statutory regulation
Numerous Chiropractic research studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective.
Manual Therapies Back and Neck Service, NHS North East Essex – Department of Health Case Study – published 19 July 2011; NHS North East Essex wanted to provide greater choice, easier access and shorter waiting times for patients suffering back and neck pain and at the same time address the unsustainably high demand on local spinal services.
Patients can now choose from 20 different providers of chiropractic, osteopathy and physiotherapy based throughout the Colchester and Tendering area. There are four chiropractic, five osteopathy and 11 physiotherapy providers to choose from and they all meet NHS standards and agreed prices. Patients are given an appointment within two weeks and receive up to four treatments.
During 2009/10, 2,810 patients used these services and 97% of patients were seen within two weeks of referral.
Providers are working to locally agreed common referral and clinical protocols and whilst there is competition, there is
also cooperation between individual providers and disciplines to ensure service integration for patients.Evaluation after the first 12 months of offering patients a choice of any qualified provider has identified improved patient access and choice meaning early treatment and improved outcomes; and reduced primary care consultations, imaging, medication costs and inappropriate referrals to secondary care. Referrals to spinal surgeons have reduced by more than 25%.
To date this service has seen over 7000 patients.
In 2009, this approach to offering chiropractic, osteopathy and physiotherapy services to treat back and neck conditions was awarded the NHS Alliance ‘Acorn Award’ for alternative therapy.
The full case study can be read here
http://healthandcare.dh.gov.uk/back-and-neck-pain-services/
Bronfort; A report into the effectiveness of manual therapy, as practiced by chiropractors, manipulative physiotherapists and osteopaths for various common musculoskeletal disorders such as back pain and other health problems Effectiveness of Manual Therapies: the UK Evidence Report was published in February 2010. This found evidence that spinal
manipulation/mobilisation is an effective treatment for acute, subacture and chronic low back pain; migraine and cerviocogenic headache; cervicogenic dizziness; manipulation/mobilisation is effective for several extremity joint conditions; and thoracic manipulation/mobilisation is effective for acute/subacute neck pain. The conclusions were based on the results of systematic reviews of randomised clinical trials, widely accepted and primarily UK and US evidenced-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories.
NICE Guidelines In May 2009, The National Institute for Health and Clinical Excellence (NICE) published new guidelines to improve the early management of persistent non-specific low back pain. The guidelines recommend what care and advice the NHS should offer to people affected by low back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and one recommendation is to offer a course of manual therapy, including spinal manipulation, spinal mobilisation and massage. This treatment may be provided by a range of health professionals, including chiropractors as spinal manipulation is part of the package of care that chiropractors can offer.
UK Beam Trial; Back pain, exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal Nov 2004; 329; 1377 (doi: 10.1136 /bmj. 38282. 669225.AE)
Medical Research Council; ‘Low Back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment’; Meade et al.
Medical Research Council (Follow-up-study) Trial ‘Randomised comparison of Chiropractic and hospital outpatient management for low back pain; results from extended follow up’; Meade et al.
RCGP – Clinical Guidelines for the Management of Acute Low Back Pain (1996, 1999, 2001)
Clinical Standards Advisory Group; Backpain Report 1994.
Acute Back Pain – Primary Care Project; The Wiltshire and Bath Health Commission.
Carter JT, Birrell LN (Editors) 2000. Occupational health guidelines for the management of low back pain at work – principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work – leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000. Occupational health guidelines for the management of low back pain at work – evidence review. Faculty of Occupational Medicine. London.
Chiropractic Treatment in Workers with Musculoskeletal Complaints; Mark P Blokland DC et al;Journal of the Neuromusculoskeletal System vol 8 No 1, Spring 2000
Musculoskeletal Services Framework – Department of Health July 2006
The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychosocial approach: a) Guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.
Non-rigid stabilisation procedures for the treatment of low back pain – National Institute for Health and Clinical Excellence. June 2006 States that chiropractic intervention can be used in the treatment of acute low back pain.
European guidelines for the management of acute nonspecific low back pain in primary care. 2005 Recommends the consideration of spinal manipulation for patients failing to return to normal activities.
Chiropractic research post by Peverell Chiropractic Clinic
Related articles
- tags: Chiropractic Research, Chiropractic Research data from the British Chiropractic Association, Plymouth Chiropractor
Neck pain and Chiropractic care.
Neck pain
Pain in the neck can be due to injury, a mechanical or muscular problem, a trapped nerve caused by a bulge in one of the discs between the vertebrae or from arthritis of the neck. It can range from mild discomfort to severe, burning pain.
What causes neck pain?
Many things can trigger neck pain. These include:
- trauma or injury
- worry and stress
- falling asleep in an awkward position
- prolonged use of a computer keyboard.
The underlying problem could be due to stress causing increased muscle spasm, hence reducing spinal flexibility, very 
occassionally a slipped disc, brittle bones (osteoporosis), deformed natural curvature of the spine (scoliosis) and, very rarely, structural damage due to tumours or infection. Finally, road traffic accidents involving whiplash injury may result in acute or chronic neck pain that takes several months to improve.
What does neck pain feel like?
- General pain located in the neck area, as well as stiffness in the neck muscles.
- The pain may radiate down to the shoulder or between the shoulder blades.
- It may also radiate out into the arm, the hand or up into the head, causing a one-sided or double-sided headache.
- The muscles in the neck are tense, sore and feel hard to the touch.
- Acute pain can give rise to abnormal neck posture in which the head is forced to turn to one side. This condition is known as torticollis.
- The pain at the base of the skull may be accompanied by a feeling of weakness in the shoulders and arms,
- There may be a prickly or tingling sensation in the arms and fingers.
Danger signals associated with neck pain
In some cases, neck pain may be a symptom of menegitis. In some cases, neck pain can be a symptom of head injury or disc trouble in the neck.
Your Chiropractor will be able to tell from his or her specialised examination exactly what is causing your neck pain.
What can you do yourself?
Remember that neck pain is rarely caused by a serious illness and will often disappear within a week. However, if you have had pains in the neck for a longer period, it may be advisable to consult a physical therapist such as a chiropractor.
The following symptoms may indicate a more serious underlying problem than simple mechanical neck pain and require that you seek further advice from your GP:
- co-existing illness, such as unexplained weight loss
- actual tenderness or pain in the neck bones (vertebrae)
- the pain simply continues to get steadily worse despite treatment
- if one or both of your arms become affected, eg persistent numbness, weakness or clumsiness.
How does the chiropractor make a diagnosis?
In most cases, a neck problem can be diagnosed by carrying out a thorough examination that may include all or some of the following:
- testing the movement of the neck
- testing for trapped nerves
- examination of the muscles
- examination of the movement of the joints of the spine, neck and hands
How is neck pain treated?
Acute pain at the base of the skull may well disappear without treatment.
For short-term problems, manual treatment (chiropractic) and pain-relieving medicine are recommended.
With longer-term pain (ie three months or more) there’s the following choice of treatment:
- chiropractic treatment ideally with soft tissue therapy and exercise therapy
- intensive muscle training
- physiotherapy, including advice on posture and the use of a supportive pillow
- acupuncture provides relief for significant numbers of people with chronic neck and shoulder pain, although this is not routinely available on the NHS.
What medication is given?
Painkillers taken on a regular basis, eg paracetamol, are often sufficient alone. Medicine used in the treatment of mild muscle pain includes non-steroidal anti-inflammatory drugs (NSAIDs). These are generally effective in those who can tolerate them. But they may cause side-effects in patients with a past medical history of indigestion or asthma and be unsuitable for certain patients with kidney impairment, heart failure and high blood pressure.
Consult your doctor or pharmacist if you think this might apply to you.
Stronger painkillers, such as codeine phosphate, may be used if NSAIDs are not working well or are unsuitable. Sometimes a muscle relaxant (eg diazepam) may be prescribed on a short term basis of up to 1 to 2 weeks depending on progress.
Exercise
People with weak neck muscles are more prone to neck problems, and in such cases an exercise programme to strengthen the neck is a good idea. A good chiropractor will advise on a suitable exercise programme tailored specifically for you.
Future prospects
This depends on the underlying cause of the pain. The prognosis is generally good, provided you remain active and obtain the correct treatment without delay.
Related articles
- Study comparing spinal manipulation, advice with exercises and medication for neck pain. (peverellchiropracticclinic.co.uk)
CORE STRENGTH EXERCISES POSTURE AND HEALTH
CORE STRENGTH EXERCISES POSTURE AND HEALTH. A lot of people think that the spine is an inflexible rod but it is actually quite flexible. Its structure is strong and reflects the dynamic movement of the human body. It protects both the sensitive and delicate spinal cord and spinal nerves as well as supporting the body and all its organs. Every activity, even breathing, demands movement of the spine, ribs and attachments. The spine gives the human structure both strength and agility.
Human beings are classified as ‘biped’ meaning stands erect on two legs. This position gives man leverage, mobility and agility but at the same time can cause certain structural stresses.
The most obvious benefit of good posture is efficiency and comfort. But because of the interrelationship of the structural (bone) and functional (organ) systems of the body, posture can determine health. Poor posture comprises the movements of the rib cage and doesn’t allow the lungs to function at maximum efficiency in order to bring much needed oxygen to the tissues and remove carbon dioxide wastes. When body posture is not good other organs of the body can also be restricted. This causes structural stress.
A chiropractor specializes in body mechanics. He is concerned with structural, muscular and neurological aspects of the human body. With treatment he aims to maintain sound structure of the body by correcting spinal and postural problems. Remember core strength exercises posture and health are all inter-related.
The Importance of Posture to Physical Development
If you have good posture you’ll stand straighter and look better but advantages to correct posture go further than your appearance.
In 1930, the White House Conference on Child Health recognized the importance of spinal integrity in the physical development of the child. Doctors have, since then, stressed how important it is to health, agreeing with chiropractors emphasis of the importance of good body mechanics AND STRENGTHING THE MUSCLES SUPPORTING THE SPINE WITH CORE EXERCISES.
The human body is subject to rhythm, balance, timing and coordinated action of all its components. Having the right posture enables the body to work more efficiently, allowing proper development.
Can Posture Affect Mental Attitude?
Your image is affected by your posture, as other people see you as you see yourself. It reflects your personality, your confidence, your attitude, your ability and your health.
There is an interrelationship between how you stand, sit and walk and how you feel. Other people can also tell whether you’re a positive or negative person, a strong or weak person, a healthy or ill person.
Check your Posture
There are a lot of tests for evaluating your posture, many needing precise instruments and expert evaluation. However, you may wish to give yourself a preliminary self-test.
Test 1
Stand with your back to the wall. Place head, shoulder blades, calves and heels against the wall. Place your hands at your
sides. Flatten the hollow of your back by pressing the buttocks back against the wall. If the space at your back of your waist is greater than the thickness of your hand, your posture is not correct.
Test 2
Face a wall with your toes touching the wall. If your posture is correct, your chest will just touch the wall. If your head touches, your posture is fair. If your abdomen touches, your posture is poor.
Test 3
Face a full-length mirror and view your shoulders and hips. These areas should be level. If one shoulder is higher or one hip is lower, there is an imbalance in your posture which should be checked professionally.
If a postural problem is indicated as a result of the self-test, it would be wise to discuss it with your chiropractor. He will be able to determine if there is a health or developmental problem and recommend proper procedures. As a preliminary to treatment, the chiropractor will examine your spine and related tissues. You can depend upon his specialized knowledge to diagnose the problem, and offer corrective treatment and sound advice.
What Causes Poor Posture?
There are many reasons for poor posture, the most serious of which is a birth defect. Normally it’s a combination of several reasons that causes a person to have poor posture. Among the causes are the following:
1 Visual problems.
2 Emotional problems.
3 Excessive weight.
4 Foot problems or improper shoes.
5 Weak Muscles, muscle imbalance.
6 Improper nutrition.
7 Laziness.
8 Poor sleep support ( mattress )
9 Injury to muscles, ligaments, tendons or bones.
10 Negative mental and physical attitudes.
11 Occupational stress and position.
Many Postural Faults Can Be Helped
If you have poor posture it can be serious in terms of health, comfort and efficiency, causing fatigue. Most of the problems caused can be helped. If you have what seems to be a postural problem then you should seek advice from a chiropractor. Unless there is an anatomical ( structural deformity ) or pathological ( disease-caused ) disturbance, the chances for correction are excellent.
Out Core exercise program produces excellent results, after a few months of doing the correct core exercises your posture changes……you stand straighter and taller because your muscles are supporting your spine and organs the way they were intended.
If poor posture is not corrected, it can affect the health and well-being of the individual. Poor posture contributes to shallow breathing: a cramped chest cavity, faulty digestion, poor elimination, and poor venous return, each of which affects not only the functions of individual organs, but also the system. Tiredness and reduced coordination are just two of many symptoms of a body that is not functioning efficiently.
What Are The Benefits Of Correct Posture?
1. Improves your health.
2. Improves your appearance.
3. Improves your coordination.
4. Increases your strength.
5. Gives you more stamina.
6. Makes your clothes fit better.
7. Gives you better body balance and makes you more agile.
8. Reduces the possibility of injury.
9. Gives you confidence.
10. Helps in physical and mental development.
tags: core strength exercises posture and health, core strength exercises,
Acute Back Pain – What to do at home
low back pain is commonly due to a sprain injury to the joints at the base of the spine. It’s very important to rest the injury and ice it to reduce the inflammation and promote healing during the acute stage of back pain.
Lie on the floor with your legs on a chair so they are bent at approx 90 degrees at the hips and the knees. Put a pillow or cushion behind your head.
Lying in this position flattens the curve at the base of your spine and takes the pressure off the damaged area.
Use an ice pack (make sure its flexible when you take it out of the fridge) if it’s not leave it for a few minutes – you don’t want to be resting on a BLOCK of ice.
Wrap the ice pack in a tea towel and place it under your spine when lying with your leg raised, leave it there for half an hour and repeat 4X – 5X per day.
Try and have a few short 5 minute walks every hour to help to loosen your spine. Anti inflammatory medication for eg Ibuprofen maybe taken to help reduce the inflammation if you are not allergic to it.
Visit your chiropractor when your are able to stand and walk…remember early correct treatment drastically speeds up your back injuries recovery reducing your back pain quickly to more tolerable levels.
Study comparing spinal manipulation, advice with exercises and medication for neck pain.
Study performed by Bronfort et al
- It’s hard to concentrate at work with neck pain
Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain.
Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.
At our clinic we use a multifactorial approach to treatment which encompasses spinal manipulation and advice and exercises. Our neck exercises can be downloaded here
Back pain? Low back pain exercises
There are 2 main two main types of exercises you can do to help to relieve your Lower back pain and Sciatica.
(1) Core exercises to strengthen your core muscles.
(2) Mobility exercises to loosen up your spine by mobilising your joints and stretching and relaxing your muscles.
We are focusing on the mobility exercises we give to our patients in this article:
In conjunction with rest and regular weight bearing exercise (short walks) a specific lower back pain mobility exercise routine performed regularly will greatly enhance your recovery from lower back injury, reducing your lower back pain
and helping to prevent future problems by keeping your spine more supple and flexible.
Also doing these exercises every morning before you get out of bed will generally help to keep your spine mobile and loose. REMEMBER these exercises are tried and tested, we have given them to thousands of patients over the last twenty years, many of these patients religously do these exercises every morning because they have noticed a difference: they have less morning back pain and stiffness.
Primary Chiropractic treatment, ie spinal manipulative therapy is highly effective (hence Chiropractic’s popularity) however we can enhance our patient’s recovery by also providing advice, soft tissue therapy, mobility exercises and core exercises. A lot of chiropractors do use other modalities/treatments as an adjunct to their spinal manipulative therapy. At Peverell Chiropractic Clinic we have found that using a multi-factorial approach to treatment particularly with more serious and more chronic back pain cases does produce slightly better results.
These simple exercises have been designed to gently mobilize the spine aiding it’s return to normal function without
putting undue stress on the joints and tissues.
If you have lower back pain and/or sciatica perform the exercises at least 4X per day (or as directed). Always do them before you get out of bed to mobilise your spine and loosen it up before you actually put any stress on it when standing
up and weight bearing, then do them every few hours through theday. After the first 2-3 days as the acute back pain diminishes spend more time on your feet, taking regular 5 – 10 minute walks, this will aid in returning your spinal joints and muscles back to normal function.
Perform the exercises in numerical order. Only do the exercises to about 70% of full motion so as not to overstretch the damaged tissues but to gradually restore normal function by: relaxing tight muscles, stretching and strengthening weak muscles, relieving joint inflammation and swelling, increasing bloodflow to aid healing, and reducing joint stiffness. Peverell Chiropractic Clinic 2012.
Do the exercises rhythmically and if any exercise causes discomfort DO NOT CONTINUE WITH IT until your injury has recovered more fully.
Click Here To Go to Downloads Area to download full size A4 version
Does anyone have Joint pain in the winter?
Any arthritis sufferers out there? if there are then you will probably be used to having more pain in your joints over the winter months, and not just because of playing on your grandsons Wii or overdoing it on the dance floor after too many Xmas drinks!
Cold weather increases joint pain and those arthritis sufferers travelling to warmer climates in the winter spend relatively pain free fortnight’s in the sun ….only to have the debilitating pain return less 12 hours of landing in the UK, it’s pretty chilly in europe too at the moment - David Cameron found that out this week ……………but that’s another story.
Damp weather/rain also increases joint pain why does this occur? ” it soaks through to your bones” as my grandmother used to say……. as the skin is waterproof and we don’t dissolve like snow men in the rain I discounted this theory at a very early age.
It’s all to do with pressure changes the suspect most often singled out by arthritis sufferers and researchers is a drop in barometric pressure, this occurs in cold and wet weather and is a reduction in the pressure exerted by the air around us. A drop in barometric pressure often precedes a storm, and the theory goes that a decrease in the air pressure can cause the tissues around the joints to swell, causing arthritic pain. Proponents of the idea use a balloon in a barometric chamber as a simulator. If the pressure outside drops, the air in the balloon expands. If the same happened in the area around an arthritic joint, the expansion or swelling could cause pressure/irritate the nerves, causing pain.
Heat influences blood flow and viscosity of fluids and body tissues, in the same way that cooking oil becomes more viscous in the cold our tissues and the fluid in our peripheral areas (central core areas are not affected as the bodies core temperature stays stable) becomes more viscous in the cold, the elasticity of muscles decreases because of greater viscosity, this tightness and increased viscosity of tissues may also increase pain.
Peverell Chiropractic Clinic – Liskeard branch now open in the popular Well Being Centre
Peverell Chiropractic Clinic is pleased to announce the opening of it’s new Liskeard branch located in the popular Well Being Centre in Liskeard. Chiropractor Kevin Kelly said “he was very impressed with the Well Being Centre”. He added “You can always tell a noteworthy business by the length of time the staff and employess have been working there.
In the Well Being Centre many of the staff and practitioners there have been working there for a considerable amount of time which only happens in Health Centres providing an excellent service to the local population.
Established in 1989 by business consultant Geoff Teasdale BSc. and his surgical chiropodist wife Teresa Teasdale MSSCh MBChA, the Well Being Centre is situated in the heart of Liskeard adjacent to Liskeard’s Co-operative in the 250 space Westbourne Car Park and just yards away from several disabled parking bays and with wheelchair access right to the door.
The centre has four treatment rooms and fully embraces the DDA (Disability Discrimination Act) with ground floor wheelchair access, a disabled WC and disabled access to all treatment rooms via a stair lift to the upper floor treatment. rooms.
Chiropractor Kevin Kelly said “He was enjoying to working in the Well Being Centre in Liskeard” He added a considerable number of of his patients travel all the way from Liskeard and other areas of Cornwall to visit his Clinic in Plymouth.
The treatment rationale Mr Kelly uses has been developed over the last 20 years. His treatment is designed to relieve pain, relax tense tissues and muscles and restore normal function and motion in your joints. Various mobilising and manipulative (Chiropractic adjustive) techniques are used to return the range of motion of your stiff joints back to normal. Advice on exercise, care at home and future prevention is also given with treatment.
Eating to reduce stress
The less stress we have ….the healthier we are. There’s evidence that too much pressure doesn’t just put you in a bad mood it can also affect our well-being. People who are under constant stress are more vulnerable to diseases ranging from coughs and colds to high blood pressure.
One solution is to eat stress-fighting foods. CLICK HERE to see a slideshow explaining a little about healthy foods.
