Low back pain. A 2013 Cochrane review found very low to moderate evidence that SMT was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain. The same review found that SMT appears to be no better than other recommended therapies. A 2016 review found moderate evidence indicating that chiropractic care seems to be effective as physical therapy for low back pain. A 2012 overview of systematic reviews found that collectively, SM failed to show it is an effective intervention for pain. A 2011 Cochrane review found strong evidence that suggests there is no clinically meaningful difference between SMT and other treatments for reducing pain and improving function for chronic low back pain. A 2010 Cochrane review found no current evidence to support or refute a clinically significant difference between the effects of combined chiropractic interventions and other interventions for chronic or mixed duration low back pain. A 2010 systematic review found that most studies suggest SMT achieves equivalent or superior improvement in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up. Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain are inconsistent between countries.
One of the most common and well known therapeutic procedures performed by doctors of chiropractic is spinal manipulation (sometimes referred to as a "chiropractic adjustment"). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for an individual. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.
Spinal manipulation is associated with frequent, mild and temporary adverse effects, including new or worsening pain or stiffness in the affected region. They have been estimated to occur in 33% to 61% of patients, and frequently occur within an hour of treatment and disappear within 24 to 48 hours; adverse reactions appear to be more common following manipulation than mobilization. The most frequently stated adverse effects are mild headache, soreness, and briefly elevated pain fatigue. Chiropractic is correlated with a very high incidence of minor adverse effects. Chiropractic are more commonly associated with serious related adverse effects than other professionals following manipulation. Rarely, spinal manipulation, particularly on the upper spine, can also result in complications that can lead to permanent disability or death; these can occur in adults and children. There is a case of a three-month-old dying following manipulation of the neck area. Estimates vary widely for the incidence of these complications, and the actual incidence is unknown, due to high levels of underreporting and to the difficulty of linking manipulation to adverse effects such as stroke, which is a particular concern. Adverse effects are poorly reported in recent studies investigating chiropractic manipulations. A 2016 systematic review concludes that the level of reporting is unsuitable and unacceptable. Reports of serious adverse events have occurred, resulting from spinal manipulation therapy of the lumbopelvic region. Estimates for serious adverse events vary from 5 strokes per 100,000 manipulations to 1.46 serious adverse events per 10 million manipulations and 2.68 deaths per 10 million manipulations, though it was determined that there was inadequate data to be conclusive. Several case reports show temporal associations between interventions and potentially serious complications. The published medical literature contains reports of 26 deaths since 1934 following chiropractic manipulations and many more seem to remain unpublished.
^ Jump up to: a b c d e f g h i Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558. PMID 16000175. The length, breadth, and depth of chiropractic clinical training do not support the claim of broad diagnostic competency required of a PCP. Studies of chiropractic intern clinical experience provides no evidence that chiropractors are trained to a level of a diagnostic generalist for non-musculoskeletal conditions. For chiropractors to describe themselves as PCP diagnosticians is to invite comparisons to other PC diagnosticians, i.e., family practitioners, pediatricians and internists. Such comparisons will not reflect favorably on chiropractic. PCP: primary care providers
There are many possible signs of spinal cord trouble in the neck,8 with or without neck pain, mostly affecting the limbs in surprisingly vague ways that can have other causes: poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); an awkward gait. Sometimes people have both neck pain and more remote symptoms without realizing they are related.
I’ve never really considered going to a chiropractor—I’m healthy, moderately active and I don’t really have much pain on a regular basis. But I work for a health and wellness company that encourages its employees to take an active role in their health, and many of my coworkers swear by their chiropractors. I wasn’t sure what a chiropractor could really do for me, but after a bit of word-of-mouth research, I found out that chiropractic care actually has benefits for your whole body! So I decided to give it a try.