Patients & Friends,
A study of neck pain by chiropractic scientists at Macquarie University in Sydney, Australia, supports the idea that the “dose” of chiropractic affects the treatment outcome.
Young adult volunteers mainly aged 20-30 received either regular chiropractic, light chiropractic (i.e., Activator instrument), or stretching (control procedure) for their neck pain that had been going on for more than a month.
Subjects who received a single regular chiropractic adjustment were able to turn their neck better in three directions, and had the most improvement in pain even 7-days later, than subjects who received light instrument technique. No serious events were reported in any group, however, more subjects had temporary discomfort after stretching (4) than after regular chiropractic (1) or instrument chiropractic (1).
The findings, by Lindsay M. Gorrell, MChiro, MRes, PhD, Kenneth Beath, and Roger M. Engel, DO, DC, PhD, are reported in the current issue of the Journal of Manipulative and Physiological Therapeutics.
The work is the latest to lend support to the idea that patients with chronic and more severe pain will benefit from a greater “dose” of chiropractic (a greater number of treatments and/or regular chiropractic treatment that results in an audible release, or “popping,” as opposed to slower or lighter instrument treatment).
An exception to this idea was that hand grip-strength improved more after a single instrument adjustment as opposed to a single regular adjustment in this trial of 65 subjects who finished the trial (of 73 initially treated). Also, a role for instrument adjustments for treatment of complicated cases, or for cases where lighter technique is clinically indicated, has yet to be explored. More research is needed to confirm, reject or extend these findings.
In the meantime it just makes sense that when you hurt worse or longer, you probably need to be even more serious about going to your chiropractor until the pain is completely resolved, and do your home therapy and ice and exercise/stretches exactly as instructed, for best results.
Robert A. Leach, DC, MS, FICC(h), CHES
A study is being planned to test the dose-response of spinal manipulation for neck tension headache: http://www.ncbi.nlm.nih.gov/pubmed/27280016
Reporting in BMC Complementary and Alternative Medicine Journal, scientists found that generally increasing the speed of the chiropractic thrust affects muscle responses as measured by electromyography: http://www.ncbi.nlm.nih.gov/pubmed/27249939
Study has begun to determine whether chiropractic clinicians can improve their ability to apply an optimal dose of traction in patients with neck pain: http://www.ncbi.nlm.nih.gov/pubmed/25452013
One of the first studies to support dose response of chiropractic for patients with chronic low back pain was reported in Spine Journal by chiropractic scientist Mitch Haas and co-workers in 2014. Patients who had at least 12 visits during the first month of care had the best results a year later, compared with control subjects who had placebo care: http://www.ncbi.nlm.nih.gov/pubmed/24139233
It is possible that increasing the dose of instrumented technique such as use of PulStar multiple impulse therapy as opposed to single Activator thrusts may yield faster or longer lasting clinical results, but this remains to be tested in rigorous clinical research: http://www.ncbi.nlm.nih.gov/pubmed/11896378