Both Safe and Effective
by Dr. John Grandominico
Integrative healthcare services and education, such as chiropractic care, are not often found in traditional medical centers. Chiropractic treatment can be a safe and effective treatment for reducing spine and musculoskeletal pain. It can reduce the use of medication and, with rehabilitative exercises, prevent patients from becoming deconditioned and help return them to an active lifestyle.
A 2002 paper, published in the American Journal of Public Health, concluded: “Chiropractic patients were found to be more satisfied with their care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.”
During an initial visit with a chiropractic physician, a thorough history and exam is performed. The patient is then classified into one of three categories: serious disease, back pain associated with nerve compression, and “nonspecific low back pain”. If a serious disease is suspected, the patient is referred for appropriate diagnostic testing with an appropriate specialist. In the instance of the other two categories, the chiropractor should first reassure the patient as to the absence of severe disease. The chiropractor can then encourage the patient to resume normal activities after modification, if needed to reduce strain.
Treatment usually consists of manipulation with one or more modalities such as rehabilitative exercises, myofascial techniques, ultrasound or muscle stimulation. A typical initial therapeutic trial of chiropractic care may consist of up to six visits over a two-to-four week period, with the goal of decreasing pain and restoring function. The patient’s progress can be monitored using outcome tools such as a visual analog pain scale and/or outcomes questionnaires. If the patient does not improve, he or she is re-evaluated to determine if there is a need for medication, imaging, identifying psychosocial factors or referral to a subspecialist.
A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, reported, “Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.” Patients also had significantly fewer side effects and longer-lasting relief of tension-type headaches than when using a commonly prescribed medication.
Chiropractors often work as part of a team with other health care professionals. At The Ohio State University Integrative Medicine Clinic, for example, chiropractors work alongside medical doctors, acupuncturists, massage therapists, dietitians and behavioral therapists to provide evidence-based, patient-centered care for the whole person—mind, body and spirit—to treat and prevent disease and encourage patients to create a condition of optimal health.
John Grandominico, DC, DACRB (Diplomat American Chiropractic Rehabilitation Board) is a Clinical Assistant Professor who practices at the OSU Integrative Medicine Clinic. For more information about integrative health at The Ohio State University, visit MedicalCenter.OSU.edu/go/Integrative.