Chiropractic Research

"Pain is inevitable, misery is optional."

Pape Chiropractic & Wellness Center, LLC

Call Us:  +1.860.739.3600

Pape Chiropractic & Wellness Center, LLC
Tel. 860-739-3600
Fax 860-739-3400
Email: drpapechiro@att.net
305 Flanders Road, Suite 6
East Lyme, CT 06333

Cost Benefit

2/08 Return on investment on wellness programs: Employers can save $1.65 in healthcare expenses for every $1 spent on a comprehensive employee-wellness/ chiropractic program, according to a study published in the Journal of Occupations and Environmental Medicine (JOEM). Pittsburgh-based health insurer Highmark Inc. conducted a study of its own corporate wellness program, which saved $1.3 million during a 4 year period.

5/07 Chiropractors who serve as primary care providers (PCPs) save patients money and have high patient satisfaction: A study in the 5/07 issue of the Journal of Manipulative and Physiological Therapeutics tracked data from a unique Independent Physicians Association (IPA) where chiropractors serve as first-contact, primary care physicians. The report analyzes data from 2003-2005 and found that patients visiting chiropractors had 60% fewer hospitalizations, 62% fewer surgeries and used 85% fewer pharmaceuticals than HMO patients who received traditional medical care. In addition, patients reported on the quality of care they received through the use of annual patient satisfaction surveys. During the 3 years of data, patients demonstrated a high degree of satisfaction with their care (96%, 94% and 91%, respectively).

2005 Back Pain less costly with 'alternative' care: 'Alternative' providers, predominantly chiropractors, report significantly less average cost per patient than when patients consult a 'conventional' provider, predominantly medical doctors ($342 vs. $506). These figures excluded patients requiring surgical or other hospital care. The study involved over 600,000 adults. Published in the research journal Spine.

9/04 Chiropractic is more cost effective than Medical care for Workers Compensation cases: The study was a retrospective review of 96,627 closed injury claims in North Carolina between 1975 and 1994. The results showed that the average cost of treatment, hospitalization, and compensation payments were higher for patients treated by Medical Doctors than for patients treated by Doctors of Chiropractic. The results further showed that the average number of lost workdays was less for patients treated by Chiropractors than MDs. The results were published in the 9/04 issue of the Journal of Manipulative and Physiological Therapeutics.

3/03 Chiropractic inclusion in Managed care plans saves money: A 4 year study conducted by researchers from the company American Specialty Health Plans, Inc. reviewed the health care utilization of 1.7 million people enrolled in a California managed-care plan. Approximately 1 million of the people had chiropractic coverage while the other 700,000 did not. The results showed that the total health care costs for people in the plans with chiropractic coverage were 12% lower than those without chiropractic coverage. The cost of treating people with low back pain was 28% lower in the group with chiropractic coverage. Chiropractic care reduced hospitalizations among back pain patients by 41% and reduced back surgeries by 32%. Chiropractic care reduced the cost of medical imaging by 37%. These results were reported in papers presented at the Research Agenda Conference held in March 2003 and were published in the October 2004 issue of the American Medical Association's Archives of Internal Medicine.

Back/Neck Pain & Headaches

Chronic back pain is associated with brain shrinkage and atrophy. This study was published in the Journal of Neuroscience 2004. Using MRI brain scan data and automated analysis techniques, the authors compared brain morphology of 26 chronic back pain patients to matched control subjects. They found that the patients with chronic back pain had 5-11% less neocortical gray matter volume than control subjects. This brain shrinkage is equivalent to 10-20 years of normal aging! The longer a person has chronic back pain, the more their brain shrinks.

10/05 Chiropractic is effective for chronic back pain: A group of chronic low back pain patients who underwent chiropractic treatment showed higher pain relief and satisfaction with the care and lower disability scores than a group that underwent medical care. Journal of Manipulative and Physiological Therapeutics http://www.jmptonline.org/article/S0161-4754(05)00227-7/abstract.

Chiropractic care shown to be more effective than acupuncture and anti-inflammatory drugs for chronic neck and back pain. A 2003 study in the journal Spine looked at people with 4.5-8.3 years of chronic spinal pain. All participants were evaluated with standard measurement outcome questionnaires. Those people that received the anti-inflammatory drugs (Celebrex or Vioxx) had 4.5-6.4 years of chronic spinal pain. Only 5% were asymptomatic within 9 weeks, 6.1% suffered an adverse event, and only 18% reported improvement in general health status. In the needle acupuncture group, the participants also had 4.5-6.4 years of chronic spinal pain. 9.4% were asymptomatic within 9 weeks, none of them suffered an adverse event, and 15% reported improvement in general health status. The group receiving chiropractic care had 8.3 years of chronic spinal pain. 27.3% were asymptomatic within 9 weeks, none of them suffered an adverse event, and 47% reported improvement in general health status! A year after the completion of this study the participants were re-evaluated and the results published in the Journal of Manipulative and Physiologic Therapeutics. In this follow-up study, results showed that neither the drugs Celebrex/Vioxx nor needle acupuncture afforded a long term therapeutic benefit to the chronic spinal pain patients (only one improvement outcome out of 7 for both groups). In contrast, chiropractic spinal adjustments did show a significant long term therapeutic benefit (statistically significant improvement in 5 of 7 outcomes).

Neck adjustments provide relief for chronic headaches. The Journal of Chiropractic published a pilot study by Wittingham in 1994 in which 26 patients with headaches participated. Each patient received neck adjustments over a 2 week period. All but 2 of the patients experienced significant improvement in headache frequency, duration and severity. The overall duration of headaches decreased by 77%, the overall score for severity showed a 60% improvement in perceived pain, and the frequency of the headache also improved by 62%.

Chiropractic adjustments more effective that other treatments for headaches. In a study conducted by the Duke University Evidence-Based Practice Center, researchers assessed evidence from a large number of randomized controlled trials for the effectiveness of chiropractic adjustments and other treatments for tension-type and cervicogenic headaches. The study showed that chiropractic adjustments resulted in a 49% decrease in severity compared to no change in rest period groups. Also when compared to soft-tissue therapy (massage), chiropractic adjustments reduced headache frequency by 69% and severity by 36%, compared to the respective soft-tissue reductions of 37% and 17%. Chiropractic adjustments also showed better results that the headache drug amitriptyline. This study showed that 82% of patients taking amitriptyline report adverse side effects from the drug, while only 4% report any adverse effects to chiropractic care.

Immune System

Chiropractic adjustments have been shown to have a significant effect on the function of the immune system. In fact, the World Chiropractic Alliance lists over 100 references which highlight the positive relationship between chiropractic care and immune function. According to the research, those who have regular chiropractic care will tend to experience fewer acute ailments (colds, flu, etc.) and less chronic illness (allergies, asthma, eczema, etc.) http://www.worldchiropracticalliance.org/news/immunityreferences.htm

A single chiropractic adjustment reduces inflammatory cytokines in asymptomatic people. The January 2006 issue of the Journal of Manipulative and Physiologic Therapeutics published a research study that demonstrated that a single chiropractic adjustment in the thoracic spine reduces the inflammatory cytokines TNF-alpha (tumor necrosis factor alpha) and IL-1beta (interleukin- 1beta). 64 asymptomatic patients were assigned to 3 groups: chiropractic adjustment, sham adjustment, or control group. Blood and serum samples were obtained before and at 20 and 120 minutes after treatment. Whole blood cultures were activated with lipopolysaccharide. A significant proportion of the sham and control group participants demonstrated progressive increases in the synthesis of TNF- alpha and IL-1beta. Conversely, in the group that received a chiropractic adjustment, the production of both cytokines decreased gradually. Note: TNF- alpha is associated with rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, psoriasis and asthma. It has also been implicated in cancer. IL-1beta leads to chronic pain.

A single chiropractic adjustment enhances the production of a substance that improves immune function. 76 asymptomatic patients participated in this study. 29 received chiropractic adjustments with audible release in the upper thoracic spine, 23 received sham chiropractic adjustments without audible release in the upper thoracic spine, and 24 comprised the control group. Blood and serum samples were obtained before and at 20 and 120 minutes after treatment. Blood cultures were induced by activation with Staphylococcal protein. Compared to the control group, the blood taken at 20 minutes post- treatment from both of the chiropractic adjustment groups demonstrated significantly increased secretion of IL-2. With samples taken at 2 hours post-treatment, significant elevation of IL-2 synthesis was still apparent in the group that received a chiropractic adjustment with audible release, but IL-2 synthesis became attenuated in the group that received a chiropractic adjustment without an audible release. These results were published in the May 2008 issue of Chiropractic & Osteopathy. Note: IL-2 is type of cytokine immune system signaling molecule that is instrumental in the body's natural response to microbial infection and in discriminating between foreign (non-self) and self. IL-2 is known to fight cancer.

Vertebral Alignment involved in allergic diseases like eczema & asthma. Japanese researchers published this research in 2004 in the Internet Journal of Orthopedic Surgery. They worked with over 2700 patients who had either bronchial asthma or atopic dermatitis. It was noted that the majority of these patients had misalignments in lower thoracic spine. In addition, the muscular system that supports and maintains the spine was in noticeably poor condition in atopic dermatitis and bronchial asthma patients alike. Among the atopic dermatitis patients that received frequent spinal correction treatments for 3-6 months, 88% showed improvement in skin itching and 72% showed improvement in overall skin condition. Among the asthma patients, 86% showed improvement in symptoms. In addition, the most significant asthma improvements were made in kids ages 6-20, with 92% of them showing symptom improvement!

Chiropractic care improves CD4 count of patients. 10 HIV positive patients were randomly assigned to two groups. One group received specific upper cervical chiropractic adjustments and the other group received sham adjustments. The study lasted for 6 months. CD4 count was measured at the beginning and end of the study because a decline in the white blood cell level is an essential immunodeficiency measure in HIV positive people. In the control group, CD4 count decline by a mean of 7.96%, while in the group received chiropractic adjustments, CD4 count increased by a mean of 48%! This research was published in the Chiropractic Research Journal in 1994.

Increased serum immunoglobulin levels and increased lymphocyte counts after chiropractic adjustments. A review of the literature at the time was published in the Chiropractic Journal of Australia in 1993. The author described several studies that indicated increased serum immunoglobulin levels and increased lymphocyte counts after chiropractic adjustments.
 
Polymorphonuclear neutrophils and monocytes demonstrate increased functional activity after chiropractic adjustments. In the 1991, the Journal of Manipulative and Physiologic Therapeutics published a study in which the participants were divided into three groups. They either received chiropractic adjustments to the thoracic spine, had a sham adjustment (light force with no joint release), or had soft tissue manipulation (light massage). Blood was drawn before and after their treatments and it was found that the people in the group receiving chiropractic adjustments showed increased functional activity of polymorphonuclear neutrophils and monocytes, whereas the people in the other two groups did not demonstrate this increased immune activity. Note: Polymorphonuclear neutrophils are phagocytic white blood cells. Monocytes are also phagocytic and are involved in the process that activates lymphocytes to produce antibodies when non-self proteins are present.

Wellness, Prevention and Asymptomatic Care

4/04 Health benefits of chiropractic care for asymptomatic persons. An article published in the Journal of Vertebral Subluxation Research provided a literature review that looked at objective physiologic changes and associated health benefits of chiropractic adjustments in patients without any symptoms. The author reported improvements in ranges of motion, muscle strength, immunological responses, beta-endorphin levels, blood pressure, papillary cycle time, heart rate variability, and spirometry. Significant changes were also reported in studies assessing agility, balance, kinesthetic perception, power, speed reaction, and athletic performance. The study also citied various studies that showed objective improvements in symptomatic subjects. They included improvements in neurocognitive function, visual field blind spot analysis, visual acuity, salivary cortisol levels, muscle strength, health-related behaviors, and savings in health care costs. In addition, there were many immune system studies that reported increases in immunoglobulins IgA, IgG, IgM, improved CD4 cell counts in HIV+ subjects, as well as decreased triglyceride levels, decreased blood pressure in persons with hypertension, improved cardiac function, and remission of duodenal ulcers confirmed by endoscopy.
 
Regular chiropractic care is beneficial in maintaining functional improvements. 30 people who were suffering from long term back problems were divided into two groups. The first group received intensive chiropractic care for one month, followed by a reduced schedule ("maintenance care") of once every three weeks for 9 months after the initial intensive care. The second group received nothing for the first month, to establish a baseline, then one month of initial intensive care. They did not receive any care after this month of intensive care. The two groups were evaluated with the Oswestry Disability Index, a scientifically designed questionnaire used to measure a person's function as related to their daily activities. It was found that both groups maintained their pain reduction after the study was completed, regardless of whether or not they had the maintenance care. However, the patients in the group that received maintenance care were able to maintain the functional improvement they made during the initial care and the patients who did not receive maintenance care returned to the same levels of functional impairment that they were experiencing prior to the initial chiropractic care. These results were published in the October 2004 issue of the Journal of Manipulative and Physiological Therapeutics.

Pediatrics & Pregnancy

A comparative study was done by Drs. van Breda in the Journal of Chiropractic Research 1989 which looked at the health status of children raised under the health care models of chiropractic care versus medical care. The study showed, for instance, that 69% of the 'chiropractic' children were otitis media (middle ear infection) free, while only 20% of the medical children were free of ear infections. The chiropractic children were much more likely to have never had an antibiotic prescription and tended to utilize fewer vaccinations. If the chiropractic children did get measles, mumps or rubella, it was reported that the diseases were quite mild compared to those exhibited by their classmates.
 
1/03 Chiropractic Care for Kids with Low Back Pain: A study of lower back pain in children was published in the January 2003 issue of the Journal of Manipulative and Physiological Therapeutics. The authors noted that about 50% of children suffer from lower back pain at one time or another and about 15% of children experience frequent or continual pain. In a period of 30 days, 82% of the children in the study, ages 4-18, who received chiropractic care reported they were "much improved".

Kids can suffer from disc degeneration. A 2003 British study found that one in 10 children show signs of asymptomatic disc degeneration. This was assessed with the use of MRI scans. The study author commented that this was a surprise, as previous thinking was that disc degeneration occurred after puberty.

Chiropractic adjustments have a positive effect on children with acute ear infections. The Journal of Vertebral Subluxation Research 2004 published a study that looked at 21 children with acute otitis media (ear infection). All of the children had acute inflammation in the inner ear with a red and bulging tympanic membrane (ear drum) accompanied by an increased average oral temperature of over 100 degrees F. After the chiropractic adjustments, the red and bulging tympanic membrane returned to normal in 95% of the children and a decrease in average oral temperature to 98.6 degrees F.

Parents report improvement of colic symptoms when their babies received chiropractic care. A study of 316 infants suffering from infantile colic showed positive results with chiropractic care in 94% of the cases. The results occurred within 2 weeks and after an average of 3 visits.

Asthmatic children under chiropractic care self-report significant improvements. Published in the Journal of Vertebral Subluxation Research 1997, this study was an impairment rating analysis of 81 asthmatic children before and 2 months after chiropractic care. Significantly lower impairment rating scores (improvement in symptoms) were reported for 90% of the subjects. In addition, 31% of the children voluntarily decreased their dosage of medication by an average of 66.5% while under chiropractic care.
 
Babies can have suboccipital strain (neck) from the birth process alone. A. Towbin recognized and published in 1969 that forceful traction during childbirth causes brainstem bleeding and is associated with SIDS. In addition, he states that respiratory depression in the newborn is a commonly overlooked sign of cervical (neck) injury. In addition, Manual Medicine 1992 published a study by Biedermann in which 600 babies were treated for suboccipital (upper neck) strain. The main symptoms included torticollis, fever of unknown origin, loss of appetite, swelling of one side of the facial soft tissues, asymmetric development of skull, crying when the mother tried to change the child's position, and extreme sensitivity of the neck when touched. Most patients required one to three adjustments before returning to normal.
 
Upper cervical adjustments to infants may reduce SIDS risk. A study was published in Forensic Science International 2002 in which 695 infants between 1 - 12 months of age were given upper cervical (neck) chiropractic adjustments if they exhibited posture & motion disturbances in the upper neck. In addition, the infants' heart rates were monitored before, during, and after the adjustment. A notable change in the heart rate (bradycardia) was evident in 47% of all examined infants compared to control conditions. The authors believe that since SIDS may be caused by bradycardia apnea, and bradycardia apnea can be caused by irritations to the upper cervical spine, children with a disturbed symmetry of the upper neck could be of higher risk for SIDS and should be evaluated for chiropractic adjustments.

Chiropractic care during pregnancy reduces labor time. Joan Fallon, DC, found a 36% reduction of labor time in first time mothers and a 42% reduction in women with 1+ other children. 1991.

For more research about chiropractic care and pediatric, pregnancy & female health go to: http://www.icpa4kids.org/research/chiropractic.htm

Objective Testing: Blood tests, Blood pressure, etc.

A group of researchers in Australia recently found that chiropractic adjustments lead to a dramatic decrease in cortisol levels. Cortisol is a hormone produced in the adrenal glands in response to stress. With chronic stress, cortisol contributes to a weakened immune system, increased fat storage, fatigue, high blood pressure, and a whole host of undesirable side effects. Chronic stress has been implicated by health experts as an underlying factor in up to 90% of all doctor visits and can contribute to cardiovascular disease (atherosclerosis, heart attack, stroke), osteoporosis, asthma, diabetes, depression, ulcers, ulcerative colitis, and the progression of Alzheimer's disease.

Regular chiropractic care promotes health and lifespan. A research report measured serum thiol levels in 3 groups of people: those with active disease, those with less than one year of chiropractic care and those with 1-6 years of regular chiropractic care. Serum thiols are primary antioxidants and are a measure of human health status. They also give an estimate of DNA repair activity, which has been shown to correlate with lifespan and aging. Those subjects who had 1-6 years of chiropractic care had the highest levels of serum thiols, more than those with short term chiropractic care or those with active disease, who had the lowest levels.

Decrease in blood pressure in patients with hypertension. A 1988 study in the Journal of Manipulative and Physiological Therapeutics looked at 21 hypertensive patients. They received chiropractic adjustments in the T1-T5 area of the spine. Systolic and diastolic blood pressure readings decreased significantly in the group receiving real chiropractic adjustments, but not in the placebo or control groups.

Chiropractic adjustments affect the autonomic nervous system. The September 2000 issue of the Journal of Manipulative and Physiological Therapeutics published a study in which researchers measured the change in "Edge Light Pupil Cycle Time" (one of the light reflexes of the eye) in response to chiropractic adjustments. The results showed a decrease in ELPCT which demonstrates the direct link between a chiropractic adjustment and a response in the Automonic Nervous System. The ELPCT reflex is controlled by the Autonomic Nervous System, which is that part of the nervous system responsible for the control and function of internal body organs.

Other

Elderly patients derive quality of life benefits from chiropractic care. A study conducted by the Foundation for Chiropractic Education and Research found that elderly chiropractic patients report better overall health, have fewer chronic conditions, spend fewer days in nursing homes and hospitals, are more mobile in their communities and are less likely to use prescription mediations than non-chiropractic patients.

Chiropractic care shows positive results in the care of individuals with depression. A study published in the Journal of Vertebral Subluxation Research 2005 demonstrated this finding. 15 clinically depressed adults participated in this study. They were given a standardized test known as the Beck Depression Inventory (BDI-II) both before and after receiving chiropractic care. The results showed a significant improvement of the average BDI-II scores of the group. The group as a whole scores a 17 before chiropractic care and averaged an 8 after care (The higher the score, the more severe the depression).

Related Links

http://www.chiro.org/research/
http://www.icpa4kids.org/research/chiropractic.htm