Primarily, chiropractic focuses on the diagnosis and treatment of neuromuscular disorders with an emphasis on treatment utilizing manual adjustments and other types of manipulation and/or mobilization of the spine. Chiropractic is classified as a form of primary care, as anyone can choose to see a doctor of chiropractic without a referral.

A 2010 meta analysis reviewed a number of published studies to determine the strength of scientific evidence regarding the effectiveness of manual treatment for both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) conditions.

Lead author Dr. Gert Bronfort reviewed 49 relevant systematic reviews and 16 evidence-based clinical guidelines and concluded that he and the other authors of the analysis found SMT/mobilization to be effective in adults for the following: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; and several extremity joint conditions. Interestingly, Dr. Bronfort and his team noted thoracic manipulation/mobilization as effective for acute and subacute neck pain, but the evidence available at the time was inconclusive for cervical manipulation/mobilization alone for neck pain of any duration.

The evidence was also inconclusive for SMT/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Additionally, they found SMT/mobilization was not effective for asthma, dysmenorrhea (when compared to sham SMT), or stage 1 hypertension when added to an antihypertensive diet. In children, the evidence was inconclusive regarding the effectiveness of SMT/mobilization for otitis media and enuresis, and they also noted SMT/mobilization was not effective for infantile colic and asthma when compared with sham SMT.

In a 2014 follow-up study, lead author Dr. Christine Clar confirmed most of the previously “inconclusive” or “moderate” evidence ratings of the 2010 evidence report. However, the availability of new research motivated Dr. Clar to note moderate evidence for these conditions: manipulation/mobilization (with exercise) for rotator cuff disorders, spinal mobilization for cervicogenic headache, and mobilization for miscellaneous headache.

These two meta-analyses are significantly helpful for those considering chiropractic care for specific conditions. Reviews like this are planned for the future, and the list of conditions that respond well to chiropractic care should expand as areas that need further study are determined and more research is published.

Neck pain can arise from a multitude of causes, from trauma like sports injuries and car accidents to just sleeping in an awkward position. It can also arise from non-traumatic causes like stress, anxiety, or depression. In the past, we’ve noted how forward head posture can increase the risk of neck pain and headaches. Suffice it to say, neck pain can arise from almost anything, and many times it’s very challenging to figure out the origin!

A recent study involved 272 nonspecific neck pain patients between the ages of 18-65 years who received twelve weeks of one of three treatments: spinal manipulative therapy (SMT); medication; or home exercise with advice (HEA). The primary method of assessing change involved tracking self-reported pain levels at 2, 4, 8, 12, 26, and 52 weeks and secondary measures included self-reported disability, global improvement, medication use, satisfaction, general health status, and adverse effects.

The results showed that SMT had a statistically significant advantage over medication regarding pain relief after 8, 12, 26, and 52 weeks, and HEA was superior to medication at 26 weeks. The study concluded that SMT was more effective than medication in both the short and long term for those with acute and subacute neck pain.

The research team added that 60% of participants in the medication group reported side effects—of which gut irritation and drowsiness were the most common. The SMT group experienced no significant adverse effects, but 46% of the SMT and HEA groups equally reported short-term soreness or achiness.

Another study showed for that for chronic neck pain patients, the COMBINATION of SMT and HEA yielded the best long-term outcomes compared to either one alone, with SMT favored in the acute stage (initial stage) of care. The challenge for doctors is to get people to continue with their exercises after their pain subsides, as studies show the dropout rate can be as high as 90%!