Evidence for Chiropractic Care Helping? . . . Maybe.

I will be back to the five reasons some people don’t get better for Part II in a few days.  This morning the most recent headache studies were published and one (out of about 20) caught my eye and I wanted to share it.

Background: I would say that over 50% of my patients have tried chiropractic care for their headaches before coming to us.  For most of them, it has not work or worked well. But this is a biased group because if it had worked for them they would not be coming here for more help. I certainly don’t have any problem with patients seeking chiropractic care and would be delighted if they did get help from it.  The only problem is that the patient is given mixed messages. The chiropractor will say that the “cause” of the headaches is a neck that is too straight or an atlas bone that is tilted. There is no scientific support for those theories, but sometimes those patients become disappointed when we don’t do similar X rays.  Some interpret this as we don’t care, which could not be further from the truth.

For reasons that are not clear to me, chiropractors have avoided doing good research into their treatments, figuring out from a scientific base what works and what doesn’t work. They do use testimonials as their supporting “evidence.”  If you watch any infomercial about rapid weight loss supplements you will quickly see that testimonials are not very reliable.

I can only think of one good chiropractic headache study, before now. In that study, chiropractic care was compared to one medication for preventing migraines, amitriptyline. In that study, patients were divided into two groups, one getting the chiropractic care and one taking amitriptyline. Both groups did better, with the amitriptyline group doing slightly better than the chiropractic group. But then after the treatments were discontinued, about three months later, the chiropractic group was doing slightly better than the amitriptyline group.

New Chiropractic Study. The Italians just published a new study of one hundred and five patients. They were divided into three groups. They called the treatment in Italy “Osteopathic Treatment” (OT) but is very similar to chiropractic treatment here in the U.S.. In that study patients were divided into three groups. One group was OT (chiropractic equivalent) + medications. The second group had fake OT + medications and the last group was medication only.

In the study both the OT + medication and the fake OT + medication did about 20% better than the medication group alone.

There is a take away here that chiropractic care does have merit, especially when combined with a holistic approach the includes medications. It is not clear why both the real OT and fake OT gave additional benefit.

I will add that no treatments are 100% safe.  I have seen two patients over the past 35 years who had devastating strokes directly related to aggressive chiropractic manipulation of their necks.  Of course medications can have nuisance side effects.  I have also seen deaths from medications in my career, always related to the over-use of narcotics.  So medications are not completely safe either, especially narcotics and narcotics plus benzodiazepines.  In the past two years, our most serious scare was the use of natural supplements, precisely butterbur. Sixty-five people in Europe, who were taking butterbur, had liver toxicity.  But the most dangerous of all treatments is no treatment at all.  Migraine, when left unchecked, can get worse and ruin someones entire life.

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