Old School versus New School Chiro: Not Your Dad's Chiropractor
Are you wondering if Chiropractic Treatment for Neck Pain can help you? Neck pain is second only to low back pain as the most common thing people seek chiropractic treatment for. It kind of begs the question, does the treatment help? The short answer is YES! But we need to dive into that a bit more.
Old school chiro basically meant getting your neck and back cracked (manipulated or adjusted). Lots of research showed that this was pretty effective in relieving your neck pain, however, the problem became that the relief was only temporary, which created the situation of having to keep going back for treatment to feel good. Not ideal…
More recent research showed that adding exercise to the traditional chiro treatments helped that much more. Better pain relief and longer-lasting results. Oh ya, and don’t forget, it gave people the tools to help themselves, which reduced dependency on always having to go back for treatment.
So building on a good thing, modern chiro treatment combines that manual therapy (mobilization, manipulation) with exercise. The research now embraces this approach and tells us it is the way to go.
It makes sense right? Step one is to relieve the pain and get the area moving properly again. Step two is to show you things you can do to keep it that way. This is where chiropractic treatment shines!
What Kind of Neck Pain Does It Help?
How long have you had the problem?
Time frames are defined by the terms acute and chronic. These terms are often confused to mean severity of the pain but this is wrong. Acute means something that has been present less than 2-4 weeks. Chronic means the problem has been going on for more than 12 weeks (3 months).
Take-Home Message: Acute and chronic refer to how long you have had the problem. Those terms do not refer to the severity or intensity of the pain.
The good news is that chiropractic treatment has been scientifically shown to help both acute and chronic neck pain. It also helps sub-acute problems, which can be thought of as halfway between acute and chronic.
What does a good treatment plan look like?
How do you know whether the chiropractor you are seeing is recommending good care for your neck pain? Well, when in doubt, let’s look at what science tells us.
Remember that modern Chiropractic treatment does not just mean adjustments. The research is very clear that good treatment should include adjustments, soft tissue work AND exercise (Damn you exercise!)
When In Doubt, Ask The Swiss. They weren't just great Mountaineers!
This research project combined the efforts of a whole bunch of Swiss chiropractors to study how their treatment worked to relieve both acute and chronic neck pain. They followed 529 patients over several months to track how those patient’s neck pain changed as they went through treatment. They also continued to follow them after they concluded their initial treatment to see if pain relief lasted. Here is what they found:
- 78% of acute and 38% of chronic reported that they were ‘significantly improved’ at 1 week;
- 87% of acute and 62% of chronic reported that they were ‘improved’ at 1 month; and
- 84% of acute and 70% of chronic reported that they were ‘improved’ at 3 months
Is Chiropractic Treatment Safe?
A summary of the current literature shows that the most common negative side effect associated with treatment is a temporary worsening of pain or discomfort. This can happen approximately 50% of the time and typically resolves within 24-48 hours. It is also typically only experienced in the first one or two treatments. Reminds us of going back to exercise for the first time in 6 months. You’re sore for a few days but then you get used to it and then you start to improve.
This was reflected in the Swiss study just described. The researchers watched for any negative outcomes that resulted from treatment. Less than 4% of acute patients and less than 9% of chronic patients reported ‘worsening’ of their condition at any time.
Do Neck Adjustments cause strokes?
Shocking question for sure if you think about how such a simple and gentle treatment that benefits so many people could potentially have such catastrophic consequences.
Over approximately the past two decades, concerns have been raised that neck adjustments (Cervical Spinal Manipulation or C-SMT) can cause a stroke. The current research says that Cervical SMT is a safe treatment and recent research points to no increased risk of vertebral artery injury (cause of stroke) for neck pain patients that receive chiropractic manipulation versus those who seek care from physicians (family doctors) who do not utilize neck manipulation (1-3).
Watch for future posts where we will cover this in more detail. For now, if you are concerned about the risks associated with this treatment, be sure to contact us. One of our Doctors would be happy to discuss it further with you.
Bottom Line
If all your chiropractor is doing is cracking your back and neck and telling you to come back, it may be time for a second opinion. Neck adjustments (manipulation) are good to relieve pain, but research tells us this treatment needs to be combined with exercises you do to regain your strength and mobility. Without the second part, you will likely continue to struggle with recurrent problems.
References
- Rubinstein SM, Knol DL, Lebouef-Yde C, de Koekkoek TE, Pfeifle CE, van Tulder MW: Predictors of a favorable outcome in patients treated by chiropractors for neck pain. Spine 2008, 33:1451–1458.
- Thiel HW, Bolton JE: Predictors for immediate and global responses to chiropractic manipulation of the cervical spine. J Manipulative Physiol Ther 2008, 31:172–183.
- Cassidy JD, Boyle E, Côté P et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case–control and case-crossover study. Spine 2008, 33: S176–183.
- Tseng YL, Wang WTJ, Chen WY, Hou TJ, Chen TC, Lieu FK: Predictors for the immediate responders to cervical manipulation in patients with neck pain. Manual Therapy 2006, 11:306–315.
- Kongsted A, Leboeuf-Yde C. The Nordic back pain subpopulation program—individual patterns of low back pain established by means of text messaging: a longitudinal pilot study. Chiropr Osteopat 2009;17:11.
- Kongsted A, Leboeuf-Yde C. The Nordic back pain subpopulation program: course patterns established through weekly follow-ups in patients treated for low back pain. Chiropr Osteopat 2010;18:2.
- Axén I, Rosenbaum A, Röbech R, Wren T, Leboeuf-Yde C. Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain? J Manipulative Physiol Ther 2002;25:450-4.
