Top 10 Research Breakthroughs to Support Chiropractic Care in theLast Decade

Dr. Christopher Kent

One of the pleasant tasks I have in editing “On Purpose” is the opportunity to review hundreds ofchiropractic research articles each month which have a direct bearing on health issues. From these, 60-to-80 per month are judged to be of particular interest to practicing chiropractors. Some studies, particularlythose relating to back pain, are well-known to most D.C.s.

Yet, there are fascinating papers which have been largely ignored by the profession. I offer ten of myfavorites from the last ten years. They are not in any particular order. Each has tremendous potential forfurther investigation.

1. Decreased Costs and Utilization of Medical Services with Chiropractic Care

Spectacular decreases in the utilization of medical services and their attendant costs were observed whenDoctors of Chiropractic were used as first contact providers. In an Independent Practice Association (IPA)which permitted patients to select a doctor of chiropractic as their primary care physician, clinical and costutilization based on 70,274 member-months over a seven-year period demonstrated decreases of 60.2percent in hospital admissions, 59 percent hospital days, 62 percent outpatient surgeries and procedures,and 85 percent pharmaceutical costs when compared with conventional medicine. These were across theboard savings, not merely back and neck cases.

Sarnat RL, Winterstein J, Cambron JA: Clinical utilization and cost outcomes from an integrativemedicine independent physician association: an additional 3-year update. J Manipulative Physiol Ther.2007 May;30(4):263-9.

http://www.ncbi.nlm.nih.gov/pubmed/17509435

2. Blood Pressure Regulation and Upper Cervical Chiropractic Adjustment

The scope of chiropractic is as broad as the scope ofinfluence of the human nervous system. This landmarkstudy was a randomized, controlled trial of hypertensivepatients. Those in the intervention group received a formof upper cervical chiropractic care (NUCCA). The authorswrote, “We conclude that restoration of Atlas alignmentis associated with marked and sustained reductions in BPsimilar to the use of two-drug combination therapy.” Thisstudy received extensive positive exposure in the media.

Bakris G, Dickholtz M Sr, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell B: Atlasvertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J

Hum Hypertens. 2007 May;21(5):347-52. Epub 2007 Mar 2.

http://www.ncbi.nlm.nih.gov/pubmed/?term=dickholtz+hypertension

3. Benefits of a Comprehensive Wellness Program Implemented by Chiropractors

A retrospective study of a standardized, 18 week wellness protocol was shown to improve weight, heartrate, blood pressure, strength, body-mass index, and forced vital capacity. The wellness protocol (CreatingWellness) focused on diet, exercise, nutritional supplementation, and one-on-one coaching. The authoralso reported, “All of the participating clinics practice a form of chiropractic that involves management ofvertebral subluxation. This application of chiropractic is not solely directed at spinal manipulation for thetreatment of neuromusculoskeletal pain syndromes. It is based on the contention that misalignmentsand/or abnormal motion of vertebral motion units may compromise neural integrity and may influenceorgan system function and general health and well-being.”

McCoy M: Evaluation of a standardized wellness protocol to improve anthropometric and physiologicfunction and to reduce health risk factors: a retrospective analysis of outcome. J Altern Complement Med.2011 Jan;17(1):39-44. doi: 10.1089/acm.2010.0113. Epub 2011 Jan 3.

http://www.ncbi.nlm.nih.gov/pubmed/21198363

4. Mental Health and Chiropractic

From the establishment of in-patient chiropracticsanitariums to publication of a text with contributionsfrom two Nobel Laureates, doctors of chiropractic have along history of providing care for persons with mentalhealth issues. The PRISM (Psychological response inspinal manipulation) study was a systematic review ofpsychological outcomes in twelve randomised controlledtrials. The authors reported a small improvement inpsychological outcomes after spinal manipulationcompared with verbal interventions and other physicaltreatments, with small and medium sized standardized mean differences (SMDs) in favor of manipulationcompared to primary care and advice. The potential of chiropractic care to improve psychologicaloutcomes deserves further exploration.

Williams NH1, Hendry M, Lewis R, Russell I, Westmoreland A, Wilkinson C: Psychological response inspinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled

trials. Complement Ther Med. 2007 Dec;15(4):271-83. Epub 2007 Mar 8.

http://www.ncbi.nlm.nih.gov/pubmed/18054729

5. Surgery Less Likely if a Doctor of Chiropractic is Seen First

A study looking at 1885 workers, 174 of which had lumbar spinesurgery in the last three years, sought to identify early predictors ofhaving lumbar spine surgery. The authors reported “Approximately42.7% of workers who first saw a surgeon had surgery, in contrast toonly 1.5% of those who saw a chiropractor. The area under thereceiver operating characteristic curve of the multivariate model was0.93 (95% confidence interval, 0.92-0.95), indicating excellent abilityto discriminate between workers who would versus would not havesurgery.”

http://www.ncbi.nlm.nih.gov/pubmed/23238486

6. Chiropractic Care Associated with Satisfaction, Functional and Self-RatedHealth of Medicare Patients.

This study used a model to determine “the effect ofchiropractic relative to medical care on decline in 5functional measures and 2 measures of self-rated healthamong 12,170 person-year observations.” The authorsconcluded that “chiropractic is significantly protectiveagainst 1-year decline in activities of daily living, lifting,stooping, walking, self-rated health, and worseninghealth after 1 year. Persons using chiropractic are moresatisfied with their follow-up care and with theinformation provided to them.”

Weigel PA, Hockenberry JM, Wolinsky FD: Chiropractic use in the medicare population: prevalence,patterns, and associations with 1-year changes in health and satisfaction with care. J Manipulative PhysiolTher. 2014 Oct;37(8):542-51. doi:10.1016/j.jmpt.2014.08.003. Epub 2014 Sep 16.

http://www.ncbi.nlm.nih.gov/pubmed/?term=25233887

7. Asymptomatic Persons Benefit from Chiropractic Care

A review of literature was conducted using the terms“asymptomatic” “normal” “pain-free” “healthy” or “freefrom physical injury.” The author concluded, “The datareviewed lend support to the contention that chiropracticadjustments, often for the purpose of correcting vertebralsubluxation, confer measurable health benefits to peopleregardless of the presence or absence of symptoms. Asignificant amount of preliminary evidence supports thatpeople without symptoms can benefit from chiropractic

care. Improved function can be objectively measured in asymptomatic individuals following chiropracticcare in a number of body systems often by relatively non-invasive means. It is plausible that chiropracticcare may be of benefit to every function of the body and have the potential for long-term, overall healthbenefit to those receiving chiropractic care.”

Hannon SM: Objective physiologic changes and associated health benefits of chiropractic adjustments inasymptomatic subjects: A review of the literature. Journal of Vertebral Subluxation Research ~ April 26,2004 ~ Pages 1-9.

http://vertebralsubluxation.sharepoint.com/Pages/2004_1043_hannon.aspx

8. Neurovertebral Influence Upon the Autonomic Nervous System

In a 2 part series, Rome assessed nearly 500 papers addressingspine-related neural reflexes upon organic symptoms, signs andconditions and the somato-autonomic influence. This incredibleresource should be read by every practicing chiropractor,particularly those who see the value of chiropractic care as limited tomusculoskeletal pain syndromes. The review includes visceral,immune, endocrine, and cognitive issues.

Rome PL: Neurovertebral influence upon the autonomic nervoussystem: Some of the somato-autonomic evidence to date. Chiropr JAust 2009; 39: 2-17.

www.chiroindex.org/wp-content/uploads/2010/11/Rome_PL_2009.pdf

9. Reorganizational Healing and Chiropractic

Reorganizational healing offers a new paradigm or world view. It is described as an approach to personalawareness, acceptance, and transformation spanning the spectrum from illness to new levels of wellnessin behavior and consciousness. The authors state, “Reorganizational Healing emerged from threedisciplines developed by Donald Epstein: 1) Network Spinal Analysis (NSA) care, 2) Somato RespiratoryIntegration (SRI) exercises, and 3) an energetic educational discipline (EED) that is in an informal stage ofdevelopment. These three disciplines arose from practical application, qualitative and empirical research,as well as a broad theoretical base including Integral Theory. Some major developments from thesemethodologies are described below in order to show the transdisciplinary roots of ROH. While ROHdeveloped from these three methodologies, it transcends and includes them.” This is a very heady work,and offers an exciting model for discovery, transformation, awakening, or integration.

Epstein DM, Senzon SA, Lemberger D: Reorganizational healing: a paradigm for the advancement ofwellness, behavior change, holistic practice, and healing. J Altern Complement Med. 2009 May;15(5):475-87. doi: 10.1089/acm.2009.0043.

http://www.ncbi.nlm.nih.gov/pubmed/19450165

10. Heart Rate Variability (HRV) and Chiropractic

Decreased heart rate variability is associated with all-cause mortality, depression, diabetes, air pollution,impaired cognitive performance, and memory retrieval. Agrowing body of evidence from across disciplinessuggests the HRV may be used to address adaptivecapacity and autonomic nervous system balance. Theauthors wrote, “Heart rate variability (HRV) analysis hasbeen used extensively as a measurement of fitness level,and recent studies now indicate that it may be a usefultool in detecting and following disease processes. Heartrate variability analysis determines the balance betweenPNS and SNS using time and frequency domainmeasurements. Heart rate variability has been used

clinically to determine the balance of the autonomic nervous system.” In this study, the authors collectedpre and post HRV data on 625 patients in 96 chiropractic practices. 132 patients were followed for a fourweek period. The authors reported that “The chiropractic care group showed a significant improvement inHRV on both the single-visit and the 4-week visit groups, but not in the control group.”

Zhang J, Dean D, Nosco D, Strathopulos D, Floros M: Effect of chiropractic care on heart rate variability

and pain in a multisite clinical study. J Manipulative Physiol Ther. 2006 May;29(4):267-74.

http://www.ncbi.nlm.nih.gov/pubmed/16690380

I hope that these articles inspire you, and bring you to a higher level of certainty. The common message:

Chiropractic care affects every dimension of the human experience.

Written by Dr. Christopher Kent

Christopher Kent is a chiropractor and an attorney. He is the owner of On Purpose, LLC, and presidentof the Foundation for Vertebral Subluxation. A 1973 graduate of Palmer College of Chiropractic, he is aDiplomate and Fellow of the ICA College of Chiropractic Imaging. Dr. Kent is known within thechiropractic profession for his dedication to integrating the science, art, and philosophy of chiropractic fordoctors and students of chiropractic. He was awarded Life University’s first Lifetime Achievement Awardin 2007. Dr. Kent is former chair of the United Nations NGO Health Committee, the first chiropractorelected to that office.

To learn more about the On Purpose program and what it can do for you, visithttp://www.chiroonpurpose.com. For information concerning the online Advanced Subluxation Trainingcourse, visit http://www.claast.com.