Health Notes

Chiropractic and Chronic Pain

An article published in the Journal of Neuroscience found that there are significant changes in the brains of individuals who suffer from chronic pain. The researchers isolated their pain group to chronic back pain patients only. Chronic meant the pain had to be there for six months or more. It was found that these patients had a reduction in the size of their brain. There was a 5 - 11% decrease in gray matter when compared with control subjects. This equates to a gray matter volume loss of ten to twenty years of normal aging. In other words, these individuals who were suffering with chronic back pain had brains that aged ten to twenty years beyond where they should be. This brain atrophy was significant when compared with normal aging, which is 0.5% per year. Once again, chronic back pain patients lost 5 to 11% per year.

As an aside, back problems cause 25% of all disabling occupational injuries. Furthermore, these researchers found that in 85% of back pain cases, “no definitive diagnosis can be made.”

Chronic back pain, according to these researchers, greatly diminishes quality of life and increases anxiety and depression. The good news is that these researchers found that if the chronic back pain is treated successfully and quickly, the gray matter shrinkage is reversible. However, with more prolonged pain, in other words longer-standing, the atrophy may not reverse.

The authors also found that a contributing cause of chronic back pain is exotoxicity. For example, exposure to substances such as aspartame which is commonly added to foods to enhance their flavor. Also, inflammatory agents cause or contribute to chronic back pain.

A study published in 1985 in the journal Canadian Family Physician looked at 283 chronic, disabled and prior treatment failed low back pain patients. These patients were given a two to three week regimen of daily spinal adjustments by a chiropractor. The results indicated an essentially resolved condition in 81% of the patients diagnosed with referred pain syndromes. This meant they were either symptom free without any work loss or activity restrictions, or experienced mild, intermittent pain with no work or activity restrictions.

48% of these patients were diagnosed with nerve root compression syndromes, i.e., a lumbar disc condition. An article published in 1990 in the British Medical Journal evaluated 741 back pain patients who were either placed in hospital or chiropractic treatment programs for back pain. This study concludes that “chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain.”

In 1990, an editorial published in the Lancet commenting on the British Medical Journal study states, “This highly significant difference occurred not only at six weeks, but also for 1.2 and even 3 years after treatment. Surprisingly, the difference was seen most strongly in patients with chronic symptoms.” This same editorial article notes that 84% of patients from the British Medical Journal study treated in a hospital actually received manipulation from staff physiotherapists as part of the management. Therefore, the beneficial effects in the chiropractic patient group are not credited to manipulation, but specifically to chiropractic adjustments.

In 1995, the British Medical Journal did a three year follow-up study to the 1990 British Medical Journal study of these same patients, comparing the hospital and chiropractic management of back pain. After three years the chiropractic patients maintained a 29% improvement over hospital managed patients. The conclusion of this article was that “at three years, the results confirm the findings of an earlier report that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice, those treated by chiropractors derived more benefit and long term satisfaction than those treated by hospitals.”

Another study was performed in 2003 and published in the journal Spine. This compared chiropractic spinal adjusting to needle acupuncture and the drugs Celebrex and Vioxx for treatment of chronic spine pain. This research article found that chiropractic spinal adjusting was over five times more effective than the drugs, and nearly three times more effective than the needle acupuncture.

A percentage of patients were found to be asymptomatic after nine weeks of treatment were as follows: 5% with Celebrex or Vioxx; 9.4% using needle acupuncture; 27.3% using chiropractic treatment. Interestingly, the patients that were adjusted by the chiropractors had suffered from their symptoms almost twice as long as some of the patients who were in the acupuncture or drug groups. Those individuals who suffered adverse affects from these three forms of treatment were as follows: drugs, 6.1%; acupuncture and chiropractic, 0%. The percentage of improvement in general health status in these individuals were as follows: the drug group, 18%; acupuncture group, 15%; chiropractic adjustment group, 47%. In other words, 47% of the individuals treated for chronic low back pain in this study had an improvement in their general health status.