Chiropractic Care for Wellness: What Research Says

By:  Brian Morrison, DC

Researchers asked Americans:  “Do you visit a chiropractor or osteopathic physician for “hands on” therapy? Are you looking for treatment of a specific health problem or are you interested in disease prevention/general health and wellness enhancement?”  

Results were published in the National Health Statistics Report, Number 85, titled, “Wellness-related Use of Common Complementary Health Approaches Among Adults: United States, 2012” on November 4th, 2015, based on a National Health Interview Survey with the National Center for Complementary and Integrative Health (NCCIH).

Data was collected from 34,525 adults aged 18 and over was collected and analyzed and national estimates of selected wellness-related reasons for consumer’s selection of natural product supplements, yoga, and spinal manipulation (chiropractic or osteopathic spinal manipulation) among U.S. adults in 2012 were reported.  They asked those who used the selected complementary health approaches if they did so to treat a specific health condition or for any of five wellness-related reasons as well as whether these adults perceived that this use led to any of nine health-related outcomes. They also examined self-reported perceived health outcomes.

Over 50% reported using spinal manipulative therapy (SMT) for wellness while over 65% reported using spinal manipulation for treating a specific health condition. 

The most common responses from those using SMT for general wellness or disease prevention was:

• improved overall health, and 
• spinal manipulation “made them feel better.”​

What is Spinal Manipulation?

Spinal manipulation is a form of manual therapy. The term manual therapy is nonspecific and refers to techniques that use the hands to diagnose and treat disorders of the musculoskeletal system. It is often used to treat a variety of painful musculoskeletal conditions, and several studies have demonstrated its effectiveness. Many studies show a significant effect on pain and improvement in outcome measures, although in some cases the effect size is small. 

Considering treatment for specific health problems, many people who seek chiropractic care have low-back pain. People also commonly seek chiropractic care for other kinds of musculoskeletal pain (e.g., neck, shoulder), headaches, and extremity (e.g., hand or foot) problems. Among those who had used chiropractic for back pain, 66 percent perceived “great benefit” from their treatments. How does spinal manipulative therapy (SMT) relieve pain?  In a peer-reviewed article, Bialosky and his team suggest three mechanisms by which SMT relieves pain:

1. SMT reduces  inflammatory response at an injury site. Several studies demonstrate reduction of inflammatory cytokines, increased  β-endorphin serotonin, and endogenous cannabinoid levels..
2. Spinal manipulation may counteract feelings of pain.  SMT may exert an effect on the spinal cord and data suggests that it acts as a counter irritant to modulate pain and is speculated to overwhelm the central nervous system with sensory input from the muscle proprioceptors, negating or decreasing the influence of nociceptive input.
3. SMT changes how your nervous system processes pain.  SMT has been shown to decrease activation of structures in the brain that are instrumental to pain processing and modulate associated autonomic and opioid responses. Additionally, neurophysiological effects related to increased descending inhibition have been demonstrated due to variables such as placebo, expectation, and psychosocial factors. 

Spinal Manipulation for Wellness/Disease Prevention

In regard to general wellness/prevention effects of SMT, a 4-year study of several thousand people demonstrated that those who received chiropractic care experienced:

• decreased hospital admissions by 43%.
• decreased admission stays by 58.4%.
• decreased outpatient surgeries and procedures by 43.2%.
• decreased  pharmaceutical costs by 51.8%.
• substantially improved clinical outcomes.

Generally, patient satisfaction with chiropractic care is high, while cost for care is less than that of any other discipline or service when chiropractors are the first provider seen.  Additionally, there is typically less utilization of imaging and specialist referrals than with usual medical care.  

In addition to addressing specific health concerns like musculoskeltal pain and dysfunction, studies show that spinal manipulation could be helpful for your overall health and wellness!

References

• “Wellness-related Use of Common Complementary Health Approaches Among Adults: United States, 2012” on November 4th, 2015_. 
• Chiramonte D, Adamo C, Morrison B: “Integrative Approaches to Pain” in Practical Management of Pain, 5th Edition.  Honorio Benzon, MD ed.  Elsevier, 2014. Ch 49, pp 658-668.
• Chiropractic: An Introduction. Department of Health and Human Services, National Institutes of Health, NCCIH Pub No.: D403 Date Created: November 2007Last Updated: February 2012. 
• Bialoskly J, Bishop M, Price D, Robinson M, George S. The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model Man Ther. 2009 Oct; 14(5): 531–538.  10.1016/j.math.2008.09.001
• Kosloff, T. Conservative Spine Care: The State of the Marketplace and Opportunities for Improvement. Optum. 2012
• Sarnat SL, Winterstein J: Clinical and Cost Outcomes of an Integrative Medicine IPA. JMPT 57 (5) 336-347, 2004

Author Bio

Brian Morrison, DC

Dr. Brian Morrison, clinical instructor at the University of Maryland School of Medicine in the Department of Family & Community Medicine, is a licensed chiropractor with over 27 years of experience in private practice. Dr. Morrison realized early in his career that manipulation and manual therapy were healing arts spanning many disciplines. In addition to chiropractic, he studied the manipulative techniques of osteopathy, orthopedic manual therapy, and various methods of rehabilitation. His practice offers a variety of techniques that feature state of the art manual therapy combined with corrective rehabilitation. He believes providing both pain education and correction of biomechanical dysfunctions can reduce or eliminate pain and restore comfortable, healthy, efficient movement.  He recently co-authored a chapter on Integrative Management of Pain in Practical Management of Pain, 5th Ed. H. Benzon Ed. In 2005, the Maryland Chiropractic Association honored him as “Chiropractor of the Year” for his role in creating collegial relationships between the chiropractic and medical communities in Maryland. Dr. Brian Morrison earned his B.S. in biology at the State University of New York at Binghamton. He attended Logan College of Chiropractic in Chesterfield, MO where he graduated magna cum laude, valedictorian from. He went on to complete a residency in Chiropractic Family Practice at Lindell Hospital in affiliation with Barnes and Jewish Hospitals in St. Louis, MO. Dr. Morrison is a featured presenter for the University of Maryland Center for Integrative Health and Healing’s Annual Wellness Conference, Maryland Chiropractic Association, Maryland Massage Therapy Association, DC Dental Society and the Howard County Dental Hygiene Association. He is a member of the Columbia Association Medical Advisory Board.

Dr. Morrison and his colleague, Dr. Reza Eftekhar, see patients at the Center for Integrative Health & Healing, the clinical practice of the University of Maryland School of Medicine Center for Integrative Medicine. Call 410-448-6361 or email CIMClinicInfo@som.umaryland.edu for an appointment.  Most health insurances are accepted.  Reach them directly at info@morrisonchiropractic.com.

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