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Clinical Studies on Chiropractic Manipulation

Spinal Manipulation and exercise for low back pain in adolescents: a randomized trial.

Evans R1, Haas M, Schulz C, Leininger B,

Hanson Left, Branford G. Spine (Phil Pa 1976).  2001 Ap 1;26(7):788-97; discussion 798-9.

We conducted a multi-center randomized trial comparing 12 weeks of spinal manipulative therapy combined with exercise therapy to exercise alone. Participants were 185 adolescents aged 12 to 18 years with chronic LBP. For adolescents with chronic LBP, spinal manipulation combined with exercise was more effective than exercise alone over a 1-year period, with the largest differences occurring at 6 months. 

Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update.

Hawk C, Schneider MJ, Haas M, Katz P, Dougherty P, Gelberzon B, Killinger LZ, Weeks J.

The project consisted of a systematic literature review and a consensus process. A total of 199 articles were found; after exclusion criteria were applied, 6 articles about effectiveness or efficiency and a 6 on safety were added.

As a result, statements regarding the safety of manipulation were strengthened and additional statements were added recommending that Des advise patients on exercise and that manipulation and mobilization contribute to general positive outcomes beyond pain reduction only. 

Effect of therapeutic exercise versus manual therapy on athletes with chronic low back pain.

Dvorak h1, Kujat C, Brumitt J. J Sport Rehabil. 2011

Nov;20(4):494-504. Epub 2011 Aug 8.

Rehabilitation professionals treat individuals suffering from chronic low back pain (CLBP) using a variety of treatment approaches including manual therapy and the prescription of therapeutic exercises. The use of manual therapy, specifically John mobilization of the lumbar spine, may significantly decrease a patient's pain and contribute to improvement in his or her functioning. Exercise may also improve pain and functioning, with some patients reporting gains up to 1 year after the last treatment.

United Kingdom back pain exercise and manipulation (UK BEAM) randomized trial: effectiveness of physical treatments for back pain in primary care

BMJ 2004; 329 doi: (Published 09 December 2004) Cite this as: BMJ 2004;329:1377

181 general practices and 63 community settings for physical treatments (PT and DC) around 14 around centers across the United Kingdom. Spinal manipulation is a cost effective addition to "best care" for back pain in general practice. Manipulation alone probably gives better value for money than manipulation followed by exercise. 

Case Studies

Cervical Pain Headache

A 34-year-old woman had right-side headaches and neck stiffness after a car accident three months previously. She had never had a pain of this nature and tried muscle relaxants from her MD, but they made her feel odd, and the meds did not reduce the pain significantly. She had a hard time turning right while driving. Her examination revealed some joint fixation in the lower cervical spine and a trigger point in her trapezius, a large muscle in the upper back. She was treated by her Chiropractor and massage therapist for six weeks, and the pain resolved entirely. The movement specialist taught her how to sit in a chair and use her phone without aggravating the neck pain.

Lumbar pain with right lower extremity pain

A 24-year-old male weight lifter came in with severe lower back pain and right leg pain extending behind his knee, describes as sharp. He was leaning away from the leg pain, suggesting a disc herniation that was bulging out to the right side, putting direct pressure on the nerves that ultimately create the sciatica nerve. The Chiropractor determined both the disc was swollen, but the sacroiliac joint below in the pelvis was also grossly restricted. The Cox table designed to minimize herniated discs with unique distraction capabilities was used the first week. Supplements designed to reduced inflammation were helpful to reduced the pain. By the second week we could add gentle manipulation into the sacroiliac joint. By week 3 manipulation he was 75% out of pain and he continued to improve with his daily recommended exercises. He was discharged at the end of  week 4. Hw now understands the value of sitting correctly and lifting correctly to stay out of harms way. 

Hand numbness and carpal tunnel challenge

A 47-year-old woman who worked for a factory had right-hand numbness after falling and catching herself on the ground with her right palm contracting the pavement. She felt pain in her shoulder, and numbness started in her fingers (thumb through the ring finger), particularly at night. Her Chiropractor identified a first rib fixation (where the first rib meets with the thoracic spine hear the base of the neck) and tightness of the scalene muscles (in the front of the neck). Both were creating pressure on the brachial plexus, specifically the median nerve that supples sensation to the first three fingers. After four weeks of spinal manipulation by her Chiropractor and massage to the neck muscles and her hand's palm (where she had the initial trauma), her hand numbness was resolved. The movement specialist taught her how to sleep correctly, so the pillow formation did not stress the lower neck. She was seen by the nutritional coach and realized the excess sugar she was consuming was increasing the Neve inflammation and was given suggestions for supplements to help reduce the pain. 

Rib pain in the mid-back that hurts with inspiration

A 54-year-old man leaned over to pick up his heavier than anticipated grandson from the crib and felt right-sided pressure in his chest area that resulted in mid back pain and tenderness in the chest. The pain was severe in the mid-back, and x-rays taken by his MD were negative for rib fracture. Three weeks passed before a friend recommended our office. Upon exam, tenderness was found where the 5th rib met with the sternum ( chest bone) and the same rib connected to the back. There were exceptional stiffness and tenderness in the articulation (joint). The chiropractor could gently mobilize the joints in the front of the chest and specific manipulation for the rib fixation in the middle back. Within three visits, the pain was gone. Given he was not a very good exerciser, he was sent to our movement person to teach him how to create but straightforward stretch every morning. This stretch came from Dr. Pearson's book, 8 minutes to ageless.

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