When people think of chiropractic, they immediately think of low back pain and are often surprised to find out that chiropractic can benefit many conditions such as carpal tunnel syndrome, tennis elbow, rotator cuff tears, as well as hip, knee, and ankle conditions. There is also research support for manipulation (a key component of chiropractic) and its role in managing “somatovisceral” related conditions such as pneumonia, dizziness, stage 1 hypertension, PMS, asthma, colic, and bed wetting.
Research clearly shows that chiropractic manipulation out performs other forms of treatment for acute, subacute and chronic low back pain. But, the question remains, can “maintenance chiropractic” PREVENT problems down the road? Ironically, two medical doctors in August of 2011 published an article in a leading medical journal (SPINE) entitled, “Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?” The study’s objective was to determine if treating chronic low back pain patients (pain >6 months) after a course of 12 treatments in the first month would do better, the same or worse if treatments were continued at 2-week intervals for an additional 9 months.
They compared 3 groups of patients: 1.) 12 treatments of “sham” (placebo) manipulation over a 1-month period. 2.) 12 treatment of “real” spinal manipulative therapy (SMT) for 1 month but no treatments for the subsequent 9 months. 3.) The same as #2 but with treatments every 2 weeks over the next 9 months. To determine the differences between these 3 groups, the authors measured pain and disability scores (using questionnaires), generic health status (questionnaire), and back-specific patient satisfaction (questionnaire) at 1, 4, 7 and 10-month intervals.
The results showed that groups 2 (SMT for 1 month only) and 3 (SMT for 1 month + every 2 weeks for 9 months) had significantly lower pain and disability scores than the 1st group (sham/placebo group) at the end of the 1st month or, 12 visits. However, only group 3 (treatments were continued for 9 months at 2 week intervals) showed more improvement in pain and disability scores at 10 months. Equally important, the scores for the non-maintained group 2 patients returned to near their pre-treatment levels by month 10!
The authors concluded that not only is spinal manipulative therapy effective for chronic low back pain, but more importantly, REGULAR ADJUSTMENTS EVERY 2 WEEKS after the initial course of concentrated care (3x/week for 4 weeks) was needed, “…to obtain long-term benefit,” suggesting that, “…maintenance SM after the initial intensive manipulative therapy,” is appropriate care to obtain long-term results.
This study FINALLY supports the recommendations made by chiropractors for many years –regular adjustments are beneficial to obtain a higher quality of life, less pain and less disability!
We realize you have a choice in who you choose to provide your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
Given the close anatomical proximity between the neck and shoulder, it’s no wonder the two are intimately related. In our hectic lifestyles of driving, hunching over computers, talking on the phone, not to mention stress arising from multiple sources, the muscles in the neck, upper back and shoulders seem to tighten up and hurt at the same time. The question is, between the neck and the shoulder, which one is the “chicken” and which is the “egg?”
The neck gives rise to the nerves that innervate the head (C1-3 nerve roots), the shoulders (C4-5), and the arms (C5-T2). Hence, there are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), and 6 sets in the lumbar or low back region and 5 sets in the sacrum, all of which travel to a specific destination allowing us to move our muscles and to feel hot, cold, sharp, dull, vibration and position sense. When these nerves get pinched or irritated, they lose their function and the ability to feel, making it challenging to button a shirt, thread a needle, or pick up small objects. It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, the nerves arising from the neck, when pinched, can have a dramatic effect on our ability to carry out our desired activities in which the shoulder, arm and hand use is required.
On the other hand, when the shoulder is injured (such as a rotator cuff tear), this can also result in neck problems. There are several ways pain from the neck affects the shoulder and vice versa. When the shoulder is injured, pain “information” is relayed to the brain starting at the nerve endings located in the area of the shoulder injury, transmitting impulses between the shoulder and the neck, and finally from the neck to the sensory cortex of the brain. That information is processed and communication to the motor cortex prompts nerve signals to be sent back to the shoulder through the neck and to the injured area (in this case, the shoulder). A reflex muscle spasm often occurs as a result, serving as kind of an “internal cast” as the muscle spasm tries to protect the injured shoulder. This can become a “vicious cycle” or never-ending “loop” until the reflex is interrupted (perhaps by a chiropractic adjustment).
Another means by which both areas become injured has to do with modifications in function. We tend to change the way we go about our daily chores when an injury occurs to the shoulder, such as putting on a coat differently by leaning over to the opposite side. These functional changes can also give rise to neck pain. Because of this reflex cycle, as well as the close anatomic relationship between the neck and shoulder, not to mention the “domino effect” of soft-tissue injuries which seem to change the function at the next joint level, it’s not surprising that both the neck AND the shoulder require simultaneous treatment for optimal treatment benefit. However, the good news is, regardless which one is the “chicken or the egg,” chiropractic treatments of shoulder injuries will almost always include the neck and vice versa.
We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
