February 2023

• Study Shows Chiropractic Most Effective Care for Lower Back Pain
• Severe Autistic Spectrum Disorder Improved with Chiropractic
• Chiropractic Extremely Safe According to Study
• Resolution of Breastfeeding Difficulties Following Chiropractic Care

A study published on January 03, 2023, in the Journal of Orthopedics and Sports Medicine showed that chiropractic care was more effective in helping people with lower back pain (LBP) than usual medical care or conservative care. According to the authors, the purpose of the study is to "…describe  the  current  evidence  for  the  effectiveness  of chiropractic spinal manipulation in comparison to the conservative intervention on Low Back Pain (LBP)."

The study researchers reviewed scientific literature on chiropractic care related to lower back problems. The researchers used the PubMed database and searched for the terms chiropractic and lower back pain. They reviewed the studies they found for both the results that they described and for the scientific strength of the articles in the various journals.

In much of this paper, the authors interchange the terms "Spinal Manipulative Therapy (SMT), Mobilization, Manipulation, and Spinal Manipulation." Within the chiropractic profession, specific forms of "adjustments" are the more common term used by chiropractors as manipulation can relate to procedures not commonly performed as part of chiropractic care.

The authors do note how widely accepted chiropractic is for lower back issues. "Spinal manipulation or mobilization is recommended as an effective therapy for acute, subacute, and chronic LBP by four guidelines in total which include National Institute for Health and Care Excellence (NICE), The American College of Physicians Pain Society, European guidelines for chronic LBP, and European guidelines for acute BP."

In their results, the authors reported that "There is strong evidence that spinal manipulation or mobilization is a viable therapy choice for people suffering with subacute and chronic LBP. Evidence of moderate quality shows spinal manipulation or mobilization is a viable therapy choice for individuals with acute LBP and older adults with subacute and chronic LBP."

In this study, the authors also pointed out how safe chiropractic is. "When it comes to adopting the principle of ‘do no harm’, chiropractic has a significant advantage. Chiropractic, and especially SMT, is typically safe, according to different research literature. Research suggests that the risk of major harm from SMT is incredibly minimal. Almost all of the side effects associated with SMT are temporary and small. Overall, SMT has a high safety rating, particularly in comparison to alternative therapeutic methods."

In the study discussion and conclusion, the authors report on the effectiveness of chiropractic for lower back pain by stating, "SMT which is delivered by chiropractors, is a regularly utilized treatment that has consistently excellent effects in terms of pain intensity and functionality in a civil population." They continue, "Either chiropractic spinal manipulation alone or integrative care is effective for patients with acute, subacute, and chronic LBP in reducing pain, increasing range of motion, improving disability, enhancing general health and returning to work. Chiropractic care seems to be more effective than conservative intervention for LBP in reducing pain, increasing range of motion in lumbar spine, improving disability status, and enhancing general health."

The Journal of Pediatric, Maternal & Family Health Chiropractic published the results of a case study on February 1, 2023, that documented the improvement under chiropractic care of a child who was suffering with severe Autism Spectrum Disorder (ASD).

This study begins by noting that ASD usually begins before the age of 30 months. The study defines it by saying, "Autism Spectrum Disorder (ASD) is defined by abnormal or impaired development of communication and interaction with others, as well as a marked limitation in interests and activities."

They report that the Center for Disease Control estimated that 2.24% or 1 in 45 U.S. children in 2014 were diagnosed with ASD. They point out that the number has been steadily increasing as in from 2011 to 2013 there were 1.25%, or 1 in 80 children in the U.S. diagnosed with ASD. Additionally, boys are diagnosed with 75% of all cases.

In this case, a three-year-old boy was brought to the chiropractor for help with a variety of issues related to ASD. Six months prior, the boy was diagnosed with Autism Spectrum Disorder by a psychologist. The boy's parents reported that their son did not speak. He was on a liquid diet because he was unable to eat solid food due to his inability to chew or feed himself. The boy did not like being touched, and was experiencing difficulties with both sleeping and constipation.

The boy’s parents also reported that their son had not gained any weight in two years. He was attending a special needs school, but upon arrival each day, he would develop anxiety to the point of vomiting excessively. He was getting speach therapy which did not seem to be helping.

A chiropractic examination was performed which rendered a diagnosis of spinal subluxations. The goal of the chiropractic care was to reduce the subluxations through specific chiropractic adjustments in an attempt to reduce the severity of the symptoms the boy was experiencing from his ASD. The initial recommendation was to have the boy seen three times per week for the first two months.

Following the boy’s first adjustment, his parents reported that their son had slept extremely well and that he had been calm for two days straight for the first time ever. Within the first week of care, the boy started making eye contact with the chiropractor and staff and had learned how to give a "high five."

By the third visit, the boy was becoming comfortable with the chiropractor touching him to give the adjustments. The boy’s parents reported improvements in his constipation, behavior, and sleep habits. They also reported that he had been trying to say his first words.

Over a period of 21 additional visits, it was reported that the boy had learned nine new words and was now starting to repeat words he was hearing. As care continued, the boy showed improvements with his constipation, his sleep, his demeanor, and was becoming social and curious with other children.

In the study conclusion, the authors wrote, "The chiropractic care of a 3-year-old patient diagnosed with Autism Spectrum Disorder is presented. Significant improvement in sleeping, behavior, sensitivity to touch, eye contact, hypertonicity of musculature, retained primitive reflexes, vocabulary expansion, and parroting was achieved. It is feasible that chiropractic care can influence Autism Spectrum Disorder…"

A retrospective analysis study published on January 23, 2023, by Scientific Reports showed that chiropractic care is extremely safe with very few adverse events. The study was conducted from January 1, 2017, through August 31, 2022, and involved 30 chiropractic clinics in Hong Kong. Scientific Reports is an open access peer reviewed journal that publishes original research on subjects related to natural sciences, psychology, medicine and engineering.

The study begins by defining what an adverse event is by saying, "An adverse event (AE) is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of medical treatment or procedure that may or may not be considered related to the medical treatment or procedure."

This study graded all adverse events into one of five categories based on severity of the event, (1-mild, 2-moderate, 3-severe, 4-life-threatening, 5-death). During the study period, there were 960,140 patient visits involving a chiropractic adjustment that the study referred to as Spinal Manipulative Treatment (SMT) given to a total of 54,846 unique patients.

Information related to any adverse events in patients was obtained by reports from the clinical professional staff (38%), followed by a phone call (28%), the front desk staff at the clinic (10%), text patient survey (8%), other support staff (5%), internet (5%), and emails (5%).

The authors reported that in this entire study, with all these patients, there were no adverse events that were rated either in category 4-life threatening, or in category 5-death. There were only two cases that were listed as category 3-severe. Both of those cases involved women who were over 60 years of age and suffered with osteoporosis. Osteoporosis is when the bones lose calcium and become more brittle. In these two cases, the women involved suffered rib fractures. The study also noted that there were no cases of stroke, transient ischemic attack, vertebral or carotid artery dissection, cauda equina syndrome, or spinal fracture.

From the 960,140 total chiropractic visits, only 37 adverse events were listed that fit into either category one or category two, that were potentially associated with chiropractic care. Of these, 28 were listed as a temporary increase in the patient’s original symptoms. The remaining 9 were associated with symptoms such as jaw pain, chest pain, headaches, or some kind of new radiating pain. Each of these cases either had a prior history of these conditions or were receiving other types of professional care that could also have been responsible for the adverse events.

The study authors noted in their conclusions that adverse events associated with chiropractic are exceedingly rare. They reported, "This current study, which retrospectively studied a large dataset from integrated chiropractic clinics in Hong Kong, found that severe AEs potentially occurring in relation to SMT were rare, yielding an incidence of 0.21 per 100,000 SMT sessions. No AEs were identified that were life-threatening or resulted in death."

The title above comes from a January 16, 2023, review study published in the Journal of Pediatric, Maternal & Family Health Chiropractic. This paper looked at numerous previous studies on chiropractic care for mothers and infants with breastfeeding problems.

The author begins by noting that "Breastfeeding is the process of feeding a mother’s breast milk to her infant, either directly from the breast or by expressing the milk from the breast and bottle-feeding it to the infant. Breastfeeding provides essential nutrition."

According to the Centers for Disease Control and Prevention's, Division of Nutrition, Physical Activity, and Obesity, "Breastfeeding has health benefits for both babies and mothers. Breast milk provides a baby with ideal nutrition and supports growth and development. Breastfeeding can also help protect baby and mom against certain illnesses and diseases."

The author of this review study searched a number of scientific publications and databases for studies relating to chiropractic and breastfeeding issues. In his search, the author found 26 case reports, 12 articles, and 3 literature reviews that were related to this subject.

In the 26 cases reports, the common factor was that there was some sort of birth trauma followed by sub-optimal breastfeeding. In several of the case studies reviewed, the author found that the inability to properly breastfeed would lead to a lack of weight gain and a failure to thrive situation.

In these case studies, the infants ranged in age from just a few days to just over 3 months of age. All had trouble breastfeeding and all had the situation either improve or completely resolve with chiropractic care. In the case studies, the chiropractic care rendered was focused on correction of vertebral subluxations. Subluxations happen when vertebrae in the spine are not properly positioned causing some form of nerve system interference.

The author of this review did note, however, that although there were published case studies that showed breastfeeding improvement with chiropractic, there was a lack of strong clinical trials on this subject.

One of the other papers included in this review stated that there was a lack of clinical data and addressed the issue when the author of that paper stated, "There is a lack of high-level evidence available on the effects of chiropractic intervention, a situation partly due to the ethical issue of assigning infants with suboptimal breastfeeding into a high level randomized controlled trial where some children would be allocated to a non-treatment group." In other words, the problem with having clinical trials is that some babies would receive care that could help them, while others would be left to suffer for the purpose of a study.

In the review study conclusion, the author summed up the findings by saying, "Breastfeeding is beneficial for an infant’s health as well as for the mother in the long and short-term. Chiropractic care has the potential to help assist in improving suboptimal breastfeeding."