Neck Pain? Bone Out of Place, or Inflammation?
Dear Patients & Friends:
The past several months we have been discussing the role of inflammation in cardiovascular disease, diabetes and carcinogenesis, and how antioxidants, a good diet and exercise help prevent these diseases. Here’s where the story gets interesting. An early chiropractic theory was that a bone out of place could pinch a nerve and cause your body to hurt or not work right. Instead, it turns out that even the pain in your neck may have more to do with inflammation than about the position of a bone on an x-ray. That said, although chiropractic theory was wrong, growing research evidence suggests chiropractic and lifestyle changes help. How do we know?
Examination can rule out the so-called “red flags” for serious disease, such as night time pain, worsening numbness, tingling or weakness, or unexplained bleeding, fever, cough or weight loss. A good chiropractor or physician is trained to know when a problem may be serious. In these cases or trauma cases x-rays may be indicated. However, for most common back and neck problems x-rays or other imaging may only be necessary if you do not get well after a few weeks of treatment. Studies show patients generally get well after chiropractic, whether or not problems show up on x-rays or other imaging like MRI.
Recent research by chiropractic scientists demonstrated that inflammatory chemicals are associated with neck pain. Prior research revealed similar inflammation around joint lesions in animals, but the new research shows this happens in humans as well.
Growing evidence suggests that chiropractic care, along with use of ice, exercise, and medical co-management when indicated, is effective for such diverse applications as treating chronic neck pain in veterans, and improving grip strength in elite judo players. So while chiropractic theory was wrong, research suggests the treatment may be right!
Rob Leach, DC, MS, CHES, FICC(H)
Current guidelines suggest x-rays are not needed unless there are red flags for serious disease or trauma, and that most chiropractic schools adhere to most of the guideline statements: http://www.ncbi.nlm.nih.gov/pubmed/18722195
State of the art chiropractic research suggests chemokines may be involved in regulation of local inflammatory response in patients with neck pain: http://www.ncbi.nlm.nih.gov/pubmed?term=chiropractic%20chemokines
In a small randomized trial neck adjustments in elite judo players caused immediate and significant improvement in grip strength compared with sham treatment: http://www.ncbi.nlm.nih.gov/pubmed/22079053
Research of veterans receiving chiropractic care at VA centers indicates up to 43% improvement in neck pain after chiropractic: http://www.ncbi.nlm.nih.gov/pubmed/22068371