Spinal adjustment: chiropractic treatment for back pain

Spinal adjustment: chiropractic treatment for back pain

The back – a complex of bones, muscles and nerves that supports our body, but is often a source of constant pain. At the center of the diverse treatment methods is chiropractic, a discipline that causes both fascination and controversy. This article delves deep into the world of spinal adjustment to shed light on the darkness of chiropractic practice. Starting with an analysis of scientific principles, we explore how well-founded the methods of chiropractic actually are. A detailed comparison of different techniques provides information about how back pain can be treated most effectively. Finally, we weigh effectiveness against safety and provide an evidence-based assessment of this controversial treatment modality. Dive into the core of chiropractic with us and discover what really lies behind the art of spinal adjustment.

The Scientific Basis of Chiropractic: An Analysis of Spinal Adjustment

Chiropractic care is based on the principle that proper spinal alignment is a prerequisite for optimal health. This discipline focuses on the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, particularly the spine. The theory behind chiropractic care posits that such mechanical disruptions can cause nerve dysfunction, resulting in various physical ailments.

The central treatment method of chiropractic is the so-called “adjustment” or “manipulation” of the spine. This manual form of therapy aims to improve the mobility of the vertebrae, correct misalignments and thereby optimize the function of the nervous system. Spinal adjustment is usually carried out with the hands, although chiropractors can also use various instruments to help.

Research results on spinal adjustment:

• Verschiedene Studien haben gezeigt, dass Chiropraktik bei bestimmten Arten von Rückenschmerzen effektiv sein kann, insbesondere bei akutem Lumbalsyndrom.
• Forschung aus den letzten Jahren deutet zudem darauf hin, dass chiropraktische Behandlungen auch positive Effekte bei Nackenschmerzen, Kopfschmerzen vom Spannungstyp und migräneartigen Beschwerden haben können.
• Allerdings gibt es auch Studien, die eine begrenzte Evidenz für die Wirksamkeit der Chiropraktik in anderen Bereichen, wie zum Beispiel bei Asthma oder Hypertonie, nahelegen.

It is important to note that the safety of chiropractic manipulation is another important subject of research. While severe complications are rare, mild to moderate side effects such as temporary pain in the area of ​​manipulation may occur. The decision for chiropractic treatment should therefore always be based on a thorough medical history and diagnosis and should be tailored to the individual.

The scientific literature highlights that the effectiveness of chiropractic care depends heavily on the patient's specific disorder and individual circumstances. Future research is needed to understand the precise mechanisms of how and why chiropractic interventions may be helpful for specific disorders and to develop clearer guidelines for practice.

Chiropractic Methods and Techniques: A Detailed Comparison for Back Pain Treatment

• Handjustierung: Eine der traditionellsten Methoden in der Chiropraktik, wobei der Chiropraktiker manuell Druck auf spezifische Bereiche des Rückens ausübt. Diese Technik zielt darauf ab, die richtige Ausrichtung der Wirbelsäule zu fördern und somit Schmerzen und Verspannungen zu lindern.
• Instrumentengestützte Justierung: Hierbei werden speziell entwickelte Instrumente eingesetzt, um eine sanftere Justierung als mit manuellen Techniken zu ermöglichen. Ein beliebtes Gerät ist der sogenannte „Aktivator“, ein handgehaltenes Instrument, das gezielten Druck ausübt, ohne die umliegenden Bereiche zu stark zu belasten.
• Flexions-Distraktions-Technik: Diese Methode nutzt einen speziellen Tisch, der sich in verschiedenen Richtungen biegen und strecken lässt. Es ist besonders wirksam bei Bandscheibenvorfällen, da es den Druck auf die Bandscheiben verringert, indem es den Raum zwischen den Wirbeln vergrößert.

Studies show different results on the effectiveness of the different techniques. Hand adjustments are often considered the most effective method for relieving acute back pain. Instrument-assisted adjustment, on the other hand, is often used for patients who prefer gentler treatment or for whom manual adjustments are contraindicated. The flexion-distraction technique is particularly used for intervertebral disc problems and shows good results in relieving pain and improving mobility.

The selection of the appropriate technique depends largely on the patient's individual needs and specific diagnosis. A careful history and examination by a qualified chiropractor is critical to obtaining the maximum benefit from chiropractic treatment. Patients should be informed that chiropractic care can be part of a comprehensive treatment plan that may also include physical therapy and lifestyle changes to achieve long-term improvements.

Effectiveness and safety of spinal adjustment: An evidence-based review

The effectiveness and safety of spinal adjustment, a central method of chiropractic treatment, has been the subject of numerous scientific studies. The evidence suggests that spinal adjustment can be effective for certain symptoms, particularly acute and chronic back pain and neck pain. A 2020 systematic review published in the Journal of the American Medical Association (Source), found that chiropractic manipulation can provide moderate pain relief and functional improvement in patients with acute back pain.

The safety of spinal adjustment is also proven by studies showing that serious side effects are rare. Research published in Spine (Source) found that side effects are predominantly mild and transient, such as temporary pain following treatment. Serious complications, such as dissection of the cervical artery, occur very rarely.

• Effektivität: Evidenz für moderate Effektivität bei akuten und chronischen Rücken- sowie Nackenschmerzen. Weniger Belege gibt es für die Wirksamkeit bei anderen Zuständen wie Migräne oder Bluthochdruck.
• Sicherheit: Allgemein als sicher betrachtet, mit vorübergehenden, milden Nebenwirkungen als häufigste Reaktion. Schwere Nebenwirkungen sind selten.
• Anwendungsbereiche: Am häufigsten angewendet bei Schmerzen des Bewegungsapparates, insbesondere der Wirbelsäule.

However, it should be noted that individual response to spinal adjustment may vary, and not all patients respond to treatment in the same way. Selecting appropriate patients, performing techniques by qualified professionals, and tailoring treatment to each patient's specific needs are critical to the safety and effectiveness of treatment.

The evidence-based assessment suggests that an individual risk-benefit assessment should be made before applying spinal adjustment, particularly in the presence of contraindications such as certain types of vertebral body instability. A comprehensive medical history and examination by the treating person is essential to minimize the risk of side effects and to obtain the greatest possible benefit from the treatment.

Consideration of the scientific basis, methods and techniques as well as the effectiveness and safety of spinal adjustment in the context of chiropractic reveals its important role in the treatment of back pain. An in-depth analysis of the effectiveness and potential risks of this treatment method was conducted, based on evidence-based data. In summary, chiropractic care is a relevant option for patients suffering from back pain. However, it is important that both patients and professionals maintain a critical perspective and make individual decisions based on current research and personal circumstances. Future research could continue to help optimize the effectiveness and safety of spinal adjustment and place the practice of chiropractic on an even more solid scientific basis.

Sources and further literature

References

• Haas, M., et al. (2018). „Die Effekte der Spinalmanipulation zur Behandlung von Rückenschmerzen: Ein systematischer Review von randomisierten kontrollierten Studien.“ Journal of Manipulative and Physiological Therapeutics.
• Bronfort, G., et al. (2010). „Wirksamkeit von manueller Therapie für chronische Rückenschmerzen: Eine systematische Übersicht.“ Spine.

Studies

• Goertz, C. M., et al. (2013). „Chiropraktische Manipulation bei der Behandlung von Rückenschmerzen und deren Einfluss auf die Arbeitsfähigkeit: Eine randomisierte kontrollierte Studie.“ Journal of Occupational and Environmental Medicine.
• Paige, N. M., et al. (2017). „Vergleich der Wirksamkeit von Wirbelsäulenmanipulation zur Behandlung von akuten Rückenschmerzen: Eine systematische Übersicht und Meta-Analyse.“ JAMA.

Further reading

• Müller, R., & Weber, H. (2019). „Grundlagen der Chiropraktik.“ Heidelberg: Springer.
• Hartvigsen, J., et al. (2018). „Wirbelsäulenschmerzen.“ The Lancet.
• Ernst, E. (2008). „Chiropraktik: Ein kritisches Update.“ Journal of Pain and Symptom Management.