Should I Consider Chiropractic or Physical Therapy? - by The Evidence Based Chiropractor

Patients suffering from spine pain can often be unsure of the best treatment available.  Two of the most common choices are chiropractic care and/or physical therapy.  In this blog we will investigate the differences between these two options and learn which may help you the most.  

Physical therapy for spine complaints generally includes passive modalities (ice, heat, electrical stimulation, ultrasound, etc) combined with stretching and strengthening exercises.  Research shows moderate evidence (depending on the longevity and region of complaint) for these adjunctive treatment modalities.  Physical therapy is usually performed by a physical therapist or physical therapy assistant under a script from your primary care physician.  Interestingly, many health professionals have found that these modalities are best used after proper biomechanics have been established.  

The hallmark of chiropractic care is spinal manipulation or adjustments.  Chiropractors are the undisputed experts in this form of treatment due to their extensive training. This is one of the reasons chiropractic care and spinal manipulative therapy have a distinct advantage over physical therapy for the conservative care of spine complaints.  Adjustments provide a direct effect on biomechanics of the spine and as we touched on earlier; establishing improved biomechanics is the first step in spine care. Of specific note is not all adjustments are high velocity.  Many adjustive techniques utilize slower movements.  Your chiropractor can speak with you regarding which adjustive technique will best serve your needs.  Chiropractic care is administered by a Doctor of Chiropractic.  Your chiropractor is able to diagnose, evaluate, treat or refer without the aide of another physician; although they may communicate and work with many primary care providers in your area.  

After establishing an improvement in segmental motion (biomechanics of the spine) your chiropractor may choose to use some passive modalities.  Additionally, he/she may provide you with instruction for stretching and strengthening exercises.  In many research studies chiropractic care and spinal manipulative therapy have resulted in superior outcomes when compared against physical therapy for spine complaints.  In my opinion this is for two distinct reasons.  First- the adjustment or spinal manipulation is one of the most powerful, safe, and effective tools for influencing the spine.  Second- chiropractors have the training and expertise to not only provide a spinal adjustment, but also to tailor either passive modalities or an exercise program to your exact needs (if necessary).  

For many patients, chiropractic care is the best choice possible for conservative spine care.  The information above is just the tip of the iceberg regarding conservative care of the spine, but highlights the major differences between physical therapy and chiropractic care.

 A growing body of research continues to show the safety and efficacy of chiropractic care for various spine conditions.  Reputable primary care physicians are referring to chiropractors each and every day but remember, you don't need a script to make an appointment with a doctor of chiropractic today! 

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-The Evidence Based Chiropractor is the leading DC/MD marketing and outreach group in the world.  Our service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together

Decreasing Intradiscal Pressure in the Cervical and Lumbar Spine through Chiropractic- by The Evidence Based Chiropractor

Traction, as a treatment, has been used for centuries in an attempt to relieve radiculopathy and pain.  Seated, standing, supine, mechanical, manual; there are a vast variety of options when performing traction on a vertebral region.

Nearly every primary care physician and orthopedist refer daily to physical therapy for some form of traction.  They refer for traction because they are attempting to decrease intradiscal pressure.  What many of them don't know is that a chiropractic technique called flexion/distraction is a far superior treatment choice.  It is our responsibility, as chiropractors, to promote and emphasize the effectiveness and safety of this treatment.  

Over 65% of chiropractors report using flexion/distraction in their practice.  Research studies have proven that flexion/distraction of the cervical and lumbar spine decreases intradiscal pressure with clinical significance.  Decreased intradiscal pressure is thought to improve tissue flow gradients, alter nociception, and allow retraction of prolapsed disc material.  We have randomized controlled trials (RCT) which have demonstrated the effectiveness of flexion/distraction for treating radiculopathy.  Additionally, the traction which many physical therapists use is void of any localizing effect!  Essentially, a little bit of the force/traction is applied everywhere; whereas with chiropractic flexion/distraction, we are able to focus at individual vertebral levels with much greater specificity.  

The Evidence Based Chiropractor's February 2014 MD Research Brief is going to focus on a piece of research supports the specificity and effectiveness of chiropractic flexion/distraction.

Intradiscal Pressure Changes During Manual Cervical Distraction: A Cadaveric Study.  Evidence Based Complementary and Alternative Medicine. Volume 2013, Article ID 954134

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Is Chiropractic Care for Neck Pain Safe? by The Evidence Based Chiropractor

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An on-going topic of discussion, political posturing, and research is the safety of cervical spine manipulation.  Throughout the years this has been a hot button issue filled with pseudo-science, myth, and exaggeration. 

One of the most thorough research articles relating to the safety of cervical spine manipulation came from the esteemed SPINE Journal in 2007.  It obtained data from over 50,000 cervical spine manipulations and showed NO SERIOUS ADVERSE events for up to 7 days post-treatment.  

They found that "the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low".  Additionally, they stated "risk rates described in this study compare favorably to those linked to drugs routinely prescribed for musculoskeletal conditions in general practice".  

In essence, they concluded that cervical spine manipulation is at least, if not more, safe than the medication you would receive from your primary care physician for neck pain.  

- Safety of Chiropractic Manipulation of the Cervical Spine.  SPINE Volume 32, Number 21, pp 2375-2378 @2007 

Interested in more?  See the Top 10 Chiropractic Research Articles which every chiropractor should know about HERE.

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-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together.

Cervical Spine Adjustment Safety

Do you have patients who are concerned with the safety of having their necks adjusted?

This article touches on why cervical spine adjustment safety remains misunderstood. As a note, you are at least 500x more likely to be struck by lighting than have a vertebral artery compromise due to adjustment.

http://www.ncbi.nlm.nih.gov/pubmed/14589464