Joint Pain
BACK PAIN
Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence).
Patients with chronic low-back pain treated by chiropractors show greater improvement and satisfaction at 1 month than patients treated by family physicians. Nonclinical factors may play an important role in patient progress. Findings from the Health Resources and Services Administration-funded project will include a report on the influence of practice activities, including more frequent visits by chiropractic patients, on the clinical course of low-back pain and patient outcomes.
NECK PAIN
This study demonstrates that a single cervical manipulation is capable of producing immediate and short-term benefits for MNP (Mechanical Neck Pain). The study also demonstrates that not all manipulative techniques have the same effect and that the differences may be mediated by neurological or biomechanical factors inherent to each technique.
In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.
HEADACHE
Six weeks of drug therapy were compared to six weeks of chiropractic adjustments. The drug therapy was considered slightly more effective than chiropractic however 82% of the patients had side effects which included drowsiness, weight gain and dry mouth. Cardiac problems and glaucoma were also associated with amitriptyline use. Chiropractic patients had no side effects (apart from slight neck stiffness in the first two weeks of the study that 5% of the patients reported). After four weeks, chiropractic and drug therapy was halted in both groups. The patients who used drugs began having headaches again while the chiropractic group continued to express headache relief, as well as higher levels of energy and vitality than the drug therapy group.
Six to eight sessions of upper cervical and upper thoracic manipulation were shown to be more effective than mobilization and exercise in patients with CH, and the effects were maintained at 3 months.
CHIROPRACTIC CARE FOR KIDS
Both sets of responders indicated a high rate of improvement with respect to the children's presenting complaints, in addition to salutary effects unrelated to the children's initial clinical presentations.
The combination of pediatric chiropractic care and primitive reflex work may be of great benefit to the increasing population of children with neurological issues.
Recurring chiropractic care may benefit children with chronic ear infections.
PREGNANCY
Women experiencing musculoskeletal pain related to pregnancy can greatly benefit from manual therapies, including spinal manipulation, acupuncture, and massage therapy.
All of the included studies reported positive results for chiropractic care of LBP (Low Back Pain) during pregnancy.
Most pregnant patients undergoing chiropractic treatment reported clinically relevant improvement at all time points