Functional Changes due to Adjustments

Functional Changes due to Chiropractic Adjustments

Janda V. Treatment of chronic back pain. J Manual Medicine 1992; 6:166-8.

 “The rational approach {in the treatment of chronic low back pain should be based on at least three principles: 1) achievement of good function of all peripheral structures (skin, tissue, muscles, fascia, and joints); 2) development of reasonable good muscle balance; and 3) activation of the spino-cerebello-vestibular circuits on the sense of sensory motor stimulation, thus facilitating the most important afferent pathways and centers."

Herzog,W., Scheele,D., Conway,P.J., 1999. Electromyographic responses of back and limb muscles associated with spinal manipulative therapy. Spine, 24(2), 146-152.

Colloca CJ. Keller TS. Electromyographic reflex responses to mechanical force, manually assisting spinal manipulative therapy. Spine. 2001 May 15;26(10):1117-24.

Colloca,C.J., Keller,T.S., Fuhr,A.W., Muscular and mechanical behavior of the lumbar spine in response to dynamic posteroanterior forces Proceedings of the 26th Annual Meeting of the International Society for the Study of the Lumbar Spine, Kona, Hawaii. Toronto: ISSLS: 1999. p.136A. Significant neuromuscular reflex responses in the adjacent and sometimes distant spinal musculature have been recorded in numerous studies.

Gillette R.G., Potential antinocieptive effects of high level somatic stimulation - chiropractic manipulation therapy may coactivate both tonic and phasic analgesic systems. Some recent evidence. Trans Pac Consortium Res, 1, 1986. A4(1)-A4(9).

Gillette R.G., A speculative argument for the co activation of diverse somatic receptor populations by forceful chiropractic adjustments. A review of the neurophysiologic literature. Manual Medicine, 1987. 3, 1-14.

Gillette,R.G., Kramis,R.C., Roberts,W.J. Suppression of activity in spinal nocireceptive 'low back' neurons by paravertebral somatic stimuli in the cat. Neurosci.Lett., 1998. 241,(1), 45-48.

It is thought that such reflexogenic stimulation is a plausible explanation of the mechanisms of spinal manipulation/chiropractic adjustment. Research has found that mechanical stimulation of mechanosensitive afferents have been found to inhibit nociception in interneuronal pools in the spinal cord and consequently inhibiting pain perception.

Wyke, B., 1980. Articular Neurology and Manipulative Therapy. In: Idczak, R.M., Dewhurst,D., Glasgow,E.F., Tehan,P., Ward,A.R. (Eds.), Apects of Manipulative Therapy. Proceedings of a Multidisciplinary International Conference on Manipulative Therapy, Melbourne, August, 1979, pp. 67-72. Lincoln Institute of Health Sciences, Carlton, Victoria.

Willis W. & Coggeshall R., Sensory mechanisms of the spinal cord. Plenum Press, New York. 1991.

Herzog,W., Mechanical, Physiologic, and Neuromuscular Considerations of Chiropractic Treatments. In: Lawrence,D.J., Cassidy,J.D., McGregor,M., Meeker,W.C., Vernon,H.T. (Eds.), Advances in Chiropractic, 1996.pp. 269-285. Mosby-Year Book, Inc., St. Louis.

Thabe,H., Electromyography as a tool to document diagnostic findings and therapeutic results associated with somatic dysfunctions in the upper cervical spinal joints and sacroiliac joints. Manual Medicine, 1986, 2, 53-58.

Meade,T.W., Dyer,S., Browne,W., Frank,A.O., Randomized comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up. BMJ, 1995. 311, 349-351.

Shekelle,P.G.,. Spinal manipulation. Spine, 1994. 19(7), 858-861.

Triano,J.J., McGregor,M., Hondras,M.A., Brennan,P.C., Manipulative therapy versus education programs in chronic low back pain. Spine, 1995. 20, 948-955.

Beneficial effects of chiropractic adjustments are thought to be associated with mechanosensitive afferent stimulation and presynaptic inhibition of nociceptive afferent transmission in the modulation of pain inhibition of hypertonic muscles and improved functional ability.

Bigos,S.J., Bowyer O., ,B.G., ,et.al., 1994.Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publication No. 950642. Proceedings of Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services.

Shekelle,P.G., Adams,A.H., Chassin,M.R., Hurwitz,E.L., Brook,R.H. Spinal manipulation for low-back pain. Ann Intern Med, 1992. 117(7), 590-598.

Skargren,E.I., Carlsson,P.G., Oberg,B.E. One-year follow-up comparison of the cost and effectiveness of chiropractic and physiotherapy as primary management for back pain. Subgroup analysis, recurrence, and additional health care utilization. Spine, 1998. 23(17), 1875-1883.

Studies have demonstrated the functional benefit of patients undergoing spinal manipulation in terms of outcome in acute, sub-acute, and chronic low back pain in randomized controlled clinical trials

Additional Research on Functional Responses of Chiropractic Adjustments

Cassidy, J.D., Lopes,A.A., Yong-Hing,K., 1992. The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial [see comments]. J Manipulative.Physiol Ther., 15,(9), 570-575.

Cassidy, J.D., Quon, J.A., LaFrance,L.J., Yong-Hing,K., 1992. The effect of manipulation on pain and range of motion in the cervical spine: a pilot study [published erratum appears in J Manipulative Physiol Ther 1992 Nov-Dec;15 (9):following table of contents] [see comments]. J Manipulative.Physiol Ther., 15,(8), 495-500.

Cassidy, J.D., Lopes,A.A., Yong-Hing,K., 1993. The immediate effect of manipulation vs. mobilization on pain and range of motion in the cervical spine: a randomized controlled trial [letter; comment]. J Manipulative.Physiol Ther., 16,(4), 279-280.

Floman, Y., Liram,N., Gilai,A.N., 1997. Spinal manipulation results in immediate H-reflex changes in patients with unilateral disc herniation. Eur.Spine J, 6, (6), 398-401.

Herzog, W., Nigg,B.M., Robinson,R.O., Read,L.J., 1987. Quantifying the effects of spinal manipulations on gait, using patients with low back pain: a pilot study. J.Manipulative.Physiol Ther., 10, (6), 295-299.

Herzog,W., Nigg,B.M., Read,L.J., 1988. Quantifying the effects of spinal manipulations on gait using patients with low back pain. J.Manipulative.Physiol Ther., 11, (3), 151-157.

Herzog,W.  The relation between the resultant moments at a joint and the moments measured by an isokinetic dynamometer. J.Biomech., 1988. 21, (1), 5-12.

Johnson,H.H.,. The effect of manipulation on pain and range of motion in the cervical spine: a pilot study [letter; comment]. J Manipulative.Physiol Ther., 1993. 16,(3), 193.

Lehman,G.J. & McGill,S.M.,. The influence of a chiropractic manipulation on lumbar kinematics and electromyography during simple and complex tasks: a case study. J Manipulative Physiol Ther., 1999. 22,(9), 576-581.

McMorland, G. & Suter,E. Chiropractic management of mechanical neck and low-back pain: a retrospective, outcome-based analysis. J Manipulative Physiol Ther, 2000. 23,(5), 307-311.

Nall,S.K.,. The role of specific manipulation towards alleviating abnormalities in body mechanics and restoration of spinal motion. J Manipulative.Physiol Ther, 1982. 5,(1), 11-15.

Nilsson,N., Christensen,H.W., Hartvigsen,J.,. Lasting changes in passive range motion after spinal manipulation: a randomized, blind, controlled trial.

J Manipulative.Physiol Ther., 1996. 19,(3), 165-168.

Osterbauer,P.J., De Boer,K.F., Widmaier,R., Petermann,E., Fuhr,A.W., Treatment and biomechanical assessment of patients with chronic sacroiliac joint syndrome. J.Manipulative.Physiol.Ther., 1993. 16,(2), 82-90.

Pollard,H. & Ward,G., The effect of upper cervical or sacroiliac manipulation on hip flexion range of motion. J Manipulative.Physiol Ther., 1998. 21, (9), 611-616.

Pope,M.H., Phillips,R.B., Haugh,L.D., Hsieh,C.Y., MacDonald,L., Haldeman,S.  A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine, 1994. 19, (22), 2571-2577.

Suter,E., Herzog,W., Leonard,T.R., Nguyen,H., One-year changes in hind limb kinematics, ground reaction forces and knee stability in an experimental model of osteoarthritis. J.Biomech., 1998. 31,(6), 511-517.

Suter,E., McMorland,G., Herzog,W., Bray,R., Decrease in quadriceps inhibition after sacroiliac joint manipulation in patients with anterior knee pain.

J Manipulative.Physiol Ther., 1999. 22, (3), 149-153.

Wood,T., Mathews,R., A clinical trial investigating the relative effect of an instrumental as opposed to a manual thrust manipulation in the treatment of cervical spine dysfunction-a pilot study. Proceedings of Foundation for Chiropractic Research and Education. 1999.

Wood,T.G., Colloca,C.J., Matthews,R., A pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction. 2001. J Manipulative Physiol Ther.