A majority of individuals often prefer finding alternative
therapies to achieve relief from their pain without the use of medications and
chiropractic care is often the favored choice.
Many clinicians at the VA frequently argue whether
chiropractic treatment methods, such as spinal adjustments and manual
manipulations, are actually effective towards improving injuries and conditions
causing chronic back pain. A new research was conducted to determine the
effects chiropractic care had with chronic pain symptoms. While the study concluded
that spinal adjustments and manual manipulations were similarly as effective as
placebo for pain relief, the study did find that individuals demonstrated an
increased improvement in disability at 12 weeks after receiving consistent chiropractic
treatment, according to a report published in the journal, “Geriatric Orthopedic
Surgery & Rehabilitation”.
Veterans with Back Pain
With the contribution of Paul
Dougherty, DC, a staff chiropractor at the Canandaigua VA Medical Center in
upstate New York, the authors of the study described that the almost identical
improvements between the individuals of the different study groups suggested
the presence of a non-specific therapeutic effect from the treatments.
For the study, researchers classified
136 veterans, 65 years old or older, with lower back pain whom had never
received chiropractic treatment. The individuals were then divided into two
separate groups, with 69 of the veterans receiving spinal adjustments and manual
manipulations.
Dougherty explained, “spinal
manipulative therapy, or SMT, is where you take a joint to its end range. When
you crack your knuckles and squeeze them together, you hear the pop. That pop
is the joint changing pressure. SMT is basically doing that, taking a joint
that isn’t moving enough and trying to maneuver it to where it moves normally
again and changes pressure.”
The other 67 veterans
participating in the study were enrolled in a procedure known as sham
intervention, where a water-based ultrasound gel is spread across the lower
back while the individuals lay face down, followed by the chiropractor rubbing
a detuned ultrasound machine across the affected area for approximately 10
minutes. The ultrasound machine made noise but did not transmit any sound
waves.
Additionally, the participating
veterans from both groups were given an educational pamphlet from the Arthritis
Foundation on different varieties of back pain and other symptoms.
After four weeks of twice-a-week
treatment, the individuals were evaluated on the fifth week to rate their pain
on a standardized scale. Both groups showed comparable pain improvement. Paul
Dougherty explained that pain is perception-based, originating equally from the
mind as it does from the body, but that disability is a better measure of
effectiveness. Dougherty quoted, “Twice a week for four weeks, we met with
these patients. We talked to them about their pain. They were touched in a
caring and meaningful way. It comes down to this: If people believe they’re
going to get better, it changes the way they thing about pain.”
Chiropractic care started being
offered at a limited number of Veterans Affairs Medical Clinics in 2004. In
2009, the VHA announced a directive to further accommodate chiropractic care
into the healthcare system based on congressional action. According to the
American Chiropractic Association, or ACA, chiropractic care is now being
provided at 47 major VA treatment facilities.
In a letter to the chairmen of the
House and Senate Veterans Affairs committee, the ACA indicated that a
tremendous majority of America’s eligible veterans had been denied access to
the services supplied by chiropractors due to the VA being unable to provide
effective action to offer access to chiropractic care at approximately 100
additional VA treatment facilities. The group also mentioned its plan to push
for the reintroduction of a bill in Congress to implement chiropractic
treatment at all major Veterans Affairs facilities.
By Dr. Alex Jimenez
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