General Health, Wellness and Chiropractic This section was compiled by Frank M. Painter, D.C.
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The World Health Organization defines health as being “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”. [ 1 ]
Given this broad definition of health, epistemological constructs borrowed from the social sciences may demonstrate health benefits not disclosed by randomized controlled trials. Health benefits, such as improvement in self-reported quality-of-life (QOL), behaviors associated with decreased morbidity, patient satisfaction, and decreased health care costs, are reported in the following articles, and they make a compelling statement about the effects of chiropractic on general health.
Despite the historic emphasis on treatment, prevention and health promotion are receiving increased attention within the US health care system. These same health promotion tasks are considered by the National Academy of Science and others as essential components of health services delivered by primary care providers. Chiropractors are viewed by many as capable of and actively delivering prevention and health promotion in addition to providing other primary care services.
Prevention and health promotion activities administered by chiropractors fall into 2 general categories: those considered orthodox by the medical community (eg, weight loss, exercise, smoking cessation) and those that are not (eg, soft-tissue and osseous manual procedures and some dietary supplementation). Previous research demonstrates that the orthodox activities used by primary care medical providers are also used by chiropractors. The concept that chiropractic care is of value in maintaining health and preventing disease began with the work of Palmer. This preventive treatment is traditionally referred to as maintenance care (MC). MC has been defined as “a regimen designed to provide for the patient's continued well-being or for maintaining the optimum state of health while minimizing recurrences of the clinical status.” Many chiropractors believe that periodic patient visits permit the doctor to identify joint dysfunction or subluxations and make corrections with spinal manipulation or other manual procedures. These treatments are believed to prevent disease of both neuromusculoskeletal and visceral origin. [ 2 ]
These improvements were maintained at the 1-year follow-up assessment. You can review many other articles on chiropractic and Asthma in the Research Section.
Health Promotion & Wellness Articles
Enjoy this series of articles by Meridel I. Gatterman, MA, DC, MEd as she reviews how DCs have traditionally counseled patients on health promotion and wellness. You will find these articles most interesting!
This page reviews the impact of the chiropractic adjustment on immune function.
Review how supplementation can support a healthy lifestyle.
Does Maintained Spinal Manipulation Therapy for Chronic Non-specific Low Back Pain Result in Better Long Term Outcome?
Spine (Phila Pa 1976) 2011 (Aug 15); 36 (18): 1427–1437
This new, single blinded placebo controlled study, conducted by Mansoura Faculty of Medicine at Mansoura University, conclusively demonstrates that maintenance care (aka Preventive Care) provides significant benefits for those with chronic low back pain. This study also re-confirms the findings of a virtually identical study by Descarreaux (JMPT 2004) and Rupert's ground-breaking JMPT article, titled:Maintenance Care: Health Promotion Services Administered to US Chiropractic Patients Aged 65 and Older, Part II.
J Manipulative Physiol Ther 2007 (Mar); 30 (3): 165–170
Patients of low socioeconomic status face barriers to accessing chiropractic services. This study suggests that chiropractic care reduces pain and disability as well as improves general health status in patients with MSK conditions. Further studies using a more robust methodology are needed to investigate the efficacy and cost-effectiveness of introducing chiropractic care into publicly funded health care facilities.
A Strategy for Enhancing Evidence Based Wellness Care
Chiropractic & Osteopathy 2005 (Sep 8) Volume 13 (1): 19 ~ FULL TEXT
Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system.
A Multination Survey
J Manipulative Physiol Ther 2005 (Jun); 28 (5): 294–302
Positive reactions were reported by 2% to 10% of all patients and by 3% to 27% of those who reported to have such problems. Most common were improved breathing (27%), digestion (26%), and circulation (21%).
Journal of Vertebral Subluxation Research 2005 (Apr 15): 1–3
SF-36 mean scores of patients from the shelter increased in each of the scales and summary scores. Results must be interpreted cautiously because of the small number of participants, but it is interesting to note that the vitality scale (VT) score improved 22 points. This increase was enough to achieve statistical significance (p equals 0.02) despite the small numbers of patients involved. It appears that chiropractic care holds promise and merits further investigation as one means of enhancing the quality of life in the homeless population studied in this case series report.
J Manipulative Physiol Ther 2005 (Feb); 28 (2): 136–142
The patient appeared to experience improvement in quality of life while showing signs suggestive of improved spinal function. The relationship between indicators of vertebral subluxation and quality of life deserves further investigation using a research design that allows for exploration of possible causal relationships.
J Manipulative Physiol Ther 2004 (Oct); 27 (8): 509-514
This study demonstrated two important points: (1) Chiropractic is effective for chronic low back pain (LBP), and (2) that ongoing supportive care can reduce disability levels, as measured by the Oswestry Low Back Pain Disability questionnaire.
Journal of Vertebral Subluxation Research 2004 (Apr 26): 1–9
The data reviewed lend support to the contention that chiropractic adjustments, often for the purpose of correcting vertebral subluxation, confer measurable health benefits to people regardless of the presence or absence of symptoms. A significant amount of preliminary evidence supports that people without symptoms can benefit from chiropractic care. Improved function can be objectively measured in asymptomatic individuals following chiropractic care in a number of body systems often by relatively non-invasive means. It is plausible that chiropractic care may be of benefit to every function of the body and have the potential for long-term, overall health benefit to those receiving chiropractic care.
A Prospective Clinical Series and Randomized Clinical Pilot Study
J Manipulative Physiol Ther 2001 (July); 24 (6): 369—377
After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower.
Developing an Evidence-based Approach
Proceedings of the World Federation of Chiropractic Congress 2001 (May); 6: 245–246
This study indicated that, as a profession, chiropractic has recognized the importance of geriatric education. Several articles indicate that the utilization of chiropractic services of older patients is increasing, and other articles indicate that many different conditions have been successfully resolved by chiropractic care. Although the results of this article are encouraging, continued research is necessary to further develop an evidence-based approach to chiropractic geriatric care, especially in the areas of maintenance care and the management of non-musculoskeletal conditions.
J Manipulative Physiol Ther 2000 (Jan); 23 (1): 1–9
Despite educational, philosophic, and political differences, US chiropractors come to a consensus about the purpose and composition of MC. Not withstanding the absence of scientific support, they believe that it is of value to all age groups and a variety of conditions from stress to musculoskeletal and visceral conditions. This strong belief in the preventive and health promotion value of MC motivates them to recommend this care to most patients. This, in turn, results in a high level of preventive services and income averaging an estimated $50,000 per chiropractic practice in 1994. The data suggest that the amount of services and income generated by preventive and health-promoting services may be second only to those from the treatment of low-back pain. The response from this survey also suggests that the level of primary care, health promotion and prevention activities of chiropractors surpasses that of other physicians.
J Manipulative Physiol Ther 2000 (Jan); 23 (1): 10–19
Rupert, Manello, and Sandefur surveyed 311 chiropractic patients, aged 65 years, who had received “maintenance care” for 5 years. Chiropractic patients receiving maintenance care, when compared with US citizens of the same age, spent only 31% of the national average for health care services and reported a 50% reduction in medical provider visits. The health habits of patients receiving maintenance care were better overall than the general population, including decreased use of cigarettes and nonprescription drugs. Furthermore, 95.8% believed the care to be either “considerably” or “extremely” valuable.
J Manipulative Physiol Ther 1999 (Nov); 22 (9): 559–564
A retrospective study conducted in Sweden [1] has determined that about one in four chiropractic patients experiences some form of "positive nonmusculoskeletal side effect" after spinal manipulative therapy (SMT). In addition, the percentage of patients who experience positive side effects increases with the number of spinal regions adjusted. The Swedish researchers asked all members of the Swedish Chiropractors Association (SCA) to participate in the study. Eighty-one percent of the SCA membership complied. Each doctor of chiropractic gathered data from 20 patients over a three-week period for a total of 1,504 valid patient questionnaires. Patients were included if they had been previously adjusted within the last two weeks for musculoskeletal complaints. The patients were asked if after their previous visit they ìexperienced any positive changes that do not seem to have anything to do with your back problem?
J Manipulative Physiol Ther 1999 (Jul); 22 (6): 395–398
Of the 138 patients attending 1 of 10 participating chiropractic clinics, more than 30% regarded themselves as moderately to severely stressed, and over 50% felt that stress had a moderate or greater effect on their current problem. Some 71% of patients felt it would be helpful if their chiropractic care included strategies to help them cope with stress, and 44% were interested in taking a self-development program to enhance their stress management skills. Patient perceptions are known to be important in health care. A number of chiropractic patients perceive they are moderately or severely stressed. Interventions that reduce stress, or even the patient's perception of being stressed, may be construed as valid, non-specific clinical interventions. It may be timely for chiropractors to actively contemplate including stress management routinely in their clinical care protocols.
Topics In Clinical Chriopractic 1996 (Jun): 3 (2): 46–55
Coulter et al performed an analysis of an insurance database, comparing persons receiving chiropractic care with nonchiropractic patients. The study consisted of senior citizens >75 years of age. Recipients of chiropractic care reported better overall health, spent fewer days in hospitals and nursing homes, used fewer prescription drugs, and were more active than the nonchiropractic patients.
J Chiropractic Research 1989 (Summer); 5: 101–103
This 1989 study compared the health of two hundred children under chiropractic care and two hundred children under medical care. The chiropractic children had fewer ear infections, fewer allergies, fewer cases of tonsillitis, and needed less medical treatment (antibiotics and other medications). The authors noted that there is a “definite correlation between chiropractic care and superior health.” In fact, this study “has shown that children raised under chiropractic care are less prone to infectious processes such as otitis media and tonsillitis, and that their immune systems are better able to cope with allergens such as pollen,weeds, grasses, etc. compared to children raised under allopathic care. There is also a significant decreased history of antibiotic use among the ‘Chiropractic’ children, indicating a lower susceptibility to bacterial infections as a result of their greater immune system response.”
Most studies of chiropractic efficacy have been limited to low back pain, neck pain or headaches. The notion that chiropractic may enhance one's life experience if used on an ongoing basis has been largely ignored in the literature. In that sense, chiropractic care, aimed at the removal of vertebral subluxation, may be of benefit to a wider proportion of the population, besides those complaining of specific illness or pain. Evidence is needed to justify the use of long-term chiropractic care in a population in which the main goals of care are the advancement of health and human potential rather than the treatment of disease or the alleviation of pain.
Review abstracts about chiropractic and a variety of organic and visceral disorders at the wonderful International Chiropractic Pediatric Association (ICPA) website
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