Spinal Manipulation

Spinal Manipulation evidence


The first day of the WFC’s 2011 Congress saw the legendary chiropractor and neurologist, Scott Haldeman, speak of the physiological mechanisms and effects of spinal manipulation. Dr Haldeman, a professor of neurology at the University of California and head of the Bone and Joint Decade 2000-2010, first qualified as a chiropractor in 1964 and has led the field in researching chiropractic and its effects since this time.

He said that there is now a large body of clinical research which demonstrates spinal manipulation to be effective in the management of back and neck pain and headaches.During his lecture, Dr Haldeman ran through a range of effects for which evidence now exists:

1. Relaxation of muscles and relief of muscular pain.

There have been a number of different research approaches to this question, but it’s been demonstrated that cortical evoked potentials are abnormal on the side of spinal pain when compared to the normal side and it’s been noted that these return to normal folowing spinal manipulation.

2. Changes in Pain Sensitivity

At least one study has shown that skin pain sensitivity to electrica

l stimulation was diminished after spinal manipulation. A more recent RCT showed a change in thermal pain sensitivity.

3. Impact on Dorsal Horn neurons in the spinal cord.

Mechanical movement of the spine has been shown to stimulate Group I and Group II neurons and that the responses in these neurons can be sensitised by maintained changes in muscle length. Group III and IV Neurons can also be stimulated by vertebral movement. This has been hypothesized as a possible mechanism that may impact on the pain-spasm-pain cycle in paraspinal muscles.

4. Impact on Tissue Inflammatory Responses

Recent studies have raised the possibility that spinal manipualtion may have an impact on the inflammatory response of certain tissues.

5. Impact on Somato-Autonomic Responses

Research has repeatedly demonstrated that stimulation of somatic structures including peripheral somatic nerves, skin and muscles and can result in responses in autonomic nerves and can result in measureable changes in the function of a number of internal organs. It’s unknown whether or not these responses have any clinical significance.

Reference:

WFC 11th Biennial Conference Proceedings pp46-49

Dr Patrick Ryder (MChiro)