What is chiropractic ?

Functioning, research and effectiveness of chiropractic

What is chiropractic role ? chiropractor give the person all the tools they need to reach their full health potential.

More precisely, he insists on the relationship between structure (mainly the spine) and function as coordinated by the nervous system.

The chiropractor will therefore focus on the biomechanics and proper functioning of the spine and all joints in order to eliminate irritations of the nervous system.

To do this, it will mainly use chiropractic adjustments, a particular form of joint manipulations.

Chiropractic care is scientifically well documented for many ailments including lumbar pain (lower back), sciatic pain, headache (headache), migraine and neck pain (neck pain).

Some examples of studies

Back pain

A meta-analysis reported that spinal manipulation treatments (chiropractic adjustments) are more effective than comparable treatments in cases of back pain:

Anderson, R., Meeker, W., Wirick, BE, Mootz, RD, Kirk, DH, and Adams, A. A meta-analysis of clinical trials of spinal manipulation. J Manipulative Physiol Ther 1992; 15 (3): 181-194.

Systematic reviews of the literature show that vertebral manipulations (chiropractic adjustments) are also, if not more effective, than conventional medical treatments (anti-inflammatory, analgesic), rest, massage therapy or physiotherapy to relieve back pain Acute or chronic:

Bronfort, G., Haas, M., Evans, RL, and Bouter, LM Efficacy of spinal manipulation and mobilization for low back pain. Spine J 2004; 4 (3): 335-356.
Van Tulder, MW, Koes, BW, and Bouter, LM Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine 9-15-1997, 22 (18): 2128-2156.

A randomized double-blind clinical trial demonstrates that chiropractic adjustments are superior to muscle relaxants in relieving lower back pain:

Hsiriis, KT, Pfleger, B., McDuffie, FC, Cotsonis, G., Elsangak, O., Hinson, R., and Verzosa, GT A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. J Manipulative Physiol Ther. 2004; 27 (6): 388-398.

Sciatic pain

A recent cohort study found that patients with acute lower back pain with sciatic nerve pain returned to work more quickly when treated with chiropractic than when receiving conventional medical treatment:

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. J Manipulative Physiol Ther. 2007 Feb; 30 (2): 135-9.

A double-blind, randomized clinical trial demonstrates the effectiveness of chiropractic adjustments in patients with acute lower back pain and sciatica pain caused by disc protrusion:

Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006 Mar-Apr; 6 (2): 131-7.

Headache (Headache)

Systematic reviews in the literature report that manipulations of the cervical vertebrae (chiropractic adjustments) are not only effective in the treatment of migraines and cervical headaches in the short and long term, but also that these treatments are safe and Associated with few serious side effects:

Cassidy, JD, Boyle, E., Côté, P., He, Y., Hogg-Johnson, S., Silver, FL and Bondy, SJ Risk of vertebrobasilar stroke and chiropractic care: Control and case-crossover study. Spine 2008; 33 (4S): S-176-S183.
Bronfort, G., Nilsson, N., Haas, M., Evans, R., Goldsmith, CH, Assendelft, WJ, and Bouter, LM Non-invasive physical treatments for chronic / recurrent headache. Cochrane Database Syst Rev 2004 (3).
Vernon, H., McDermaid, CS, and Hagino, C. Systematic review of randomized clinical trials of complementary / alternative therapies in the treatment of tension-type and cervicogenic headache. Complement Ther Med 1999; 7 (3): 142-155.
Shekelle, PG and Coulter, I. Cervical spine manipulation: summary report of a multidisciplinary expert panel. J Spinal Disord 1997; 10 (3): 223-228.

Cervical Pain

Systematic reviews of the literature report that manipulations of the cervical vertebrae (chiropractic adjustments) offer relief from cervical pain and that this type of treatment is superior to conventional medical treatment:

Bronfort, G. Nilsson N. Haas M. Evans R. Goldsmith CH Assendelft WJ and Bouter LM Non-invasive physical treatments for chronic / recurrent headache. Cochrane Database Syst Rev 2004 (3).
Shekelle, PG and Coulter, I. Cervical spine manipulation: summary report of a multidisciplinary expert panel. J Spinal Disord 1997; 10 (3): 223-228.

Recent randomized clinical trials favor the use of vertebral manipulations (chiropractic adjustments) in the treatment of acute and chronic cervical pain, reducing both pain and functional disability:

Cleland JA, Glynn P, Whitman JM, Eberhart SL, MacDonald C, Childs JD. Short-term effects of thrust versus nonthrust mobilization / manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther. 2007 Apr; 87 (4): 431-40.
González-Iglesias J, Fernández-de-las-Peñas C, Cleland JA, Gutiérrez-Vega Mdel R. Thoracic spine manipulation for the management of patients with neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2009 Jan; 39 (1): 20-7.
Palmgren PJ, Sandström PJ, Lundqvist FJ, Heikkilä H. Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain in patients with nontraumatic chronic neck pain. J Manipulative Physiol Ther. 2006 Feb 29 (2): 100-6.

What is chiropractic science researchs ?

The thrill of basic research in the chiropractic sciences now allows the chiropractic profession to better understand the neurophysiological mechanisms that could indicate the use of vertebral manipulations (chiropractic adjustments) in the treatment of various visceral conditions such as asthma, otitis media , Gastrointestinal disorders, etc.

It is on the basis of this in-depth knowledge of basic research that the chiropractic scientific community will be able to carry out clinically sound studies from a methodological point of view, with a view to determining in particular which types of patients will be most Able to benefit from chiropractic care for these specific conditions.

All this research in chiropractic sciences provides an undeniable advantage for the health of the Quebec population!

Many chairs and chiropractic research programs at several Canadian universities are driving the scientific advancement of our profession. The creation of the chair of chiropractic research at the Université du Québec à Trois-Rivières (UQTR) in 2006, the chair of research in neurophysiology of pain at the UQTR in 2010 and the inauguration of the research program In chiropractic, epidemiology and rehabilitation at McGill University in 2012 are concrete examples that will make the importance and impact of chiropractic research even more visible to the people of Quebec and around the world.

The Québec government has acknowledged the contribution of chiropractic research to the Quebec population, as evidenced by the conclusion in 2009 of a partnership between the Fonds de recherche en santé du Québec (FRSQ), l Ordre des chiropraticiens du Québec and the Chiropractic Research Foundation of Quebec (FRCQ).

You can consult the list of publications of the chair of research in chiropractic of the UQTR.

What is chiropractic lexical references to better understand the different types of studies ?

Meta-analysis

Statistical analysis approach combining the results of a series of comparable and independent studies on a given problem. The meta-analysis allows for more in-depth analysis of the data due to the increased number of cases studied, resulting in a more robust overall conclusion than individual studies permit. This approach is widely used for the overall interpretation of sometimes contradictory clinical studies.

Systematic review

Good science critical review of the literature. This process consists of several stages:

The first step is to look for all the studies, clinical trials or other appropriate study, whether published or not, that have answered the same exact clinical question. For example, all clinical trials performed to evaluate the effectiveness of a treatment.
Then, the quality of each study is evaluated and the synthesis of the results obtained in the selected studies is carried out. Finally, if the data allow, a statistical analysis, called meta-analysis, is performed (source: Francophone Cochrane Network).

Clinical trial

Scientific study designed primarily to evaluate the safety and / or efficacy of a diagnostic method or treatment. The scientific quality of clinical trials depends on a rigorous and proven methodology to avoid bias and errors in the collection or interpretation of results.

Randomized

Distribution (randomly) between the experimental group and the control group or control is performed in a way that gives everyone an equal chance to be in one or other of the groups.

Double-blind

The subject is not known if he is part of the control group or the experimental group while the experimenter unaware of which group the subject belongs.

Cohort study

Generally projected observational study on the future and in which two groups (cohorts) of subjects are compared either: a group exposed to a risk factor or a particular treatment and other non-exposed group. This type of study generally aims to establish an association between the occurrence of a phenomenon present at the time of the study and exposure to the risk factor or treatment of interest. With the passage of time, the changes that appear in the subjects of the two groups are observed.