Newsletter Articles
November 2022

• Opioid Usage Reduced with Chiropractic According to Study
• Chiropractic with Exercise Yield Best Results for Scoliosis
• Chiropractic Delivered to Pregnant Mothers is Safe for Their Fetuses
• Resolution of Infertility with Successful Conception & Birth Following Chiropractic Care

Opioid Usage Reduced with Chiropractic According to Study

A study published on November 3, 2022, in BMC Health Services Research showed that people with chronic pain who were prescribed opioids reduced or eliminated their opioid intake when under chiropractic care as opposed to those not receiving chiropractic. The study was conducted over a six year period on patients at a Ontario community health center.

There have been a number of studies that show that people who are under chiropractic care for chronic pain issues are less likely to get or take a opioid prescription. This study looked at people who were already taking opioids who then began chiropractic care. The study stated, "Emerging evidence suggests that access to chiropractic care may reduce the likelihood of initiating an opioid prescription for spinal pain; however, the impact of chiropractic care for patients already prescribed opioids is uncertain."

In this study, researchers looked at the records of 210 patients between January 1, 2014, and December 31, 2020. All the patients were at the  Ontario community health centre (CHC) and receiving opioid therapy for chronic spinal pain that was not coming from cancer of any type. The number of refills and strength of dosages was reviewed for all patients. Of specific interests was the usage and dosage of opioids being used by those patients who started chiropractic care after having been on opioid therapy.

A 12 month follow-up with all the patients clearly showed that there were lower rates of opioid prescriptions being filled by those under chiropractic care when compared to those who did not receive chiropractic. Additionally, the researchers found that the strength of the opioid prescriptions were either not increased, were decreased, or even discontinued for the group of patients who started chiropractic care.

In addition to the overall positive results for those under chiropractic care, the researchers conducted selective interviews with 14 patients and 9 general practitioners from the CHC to see their comments of the introduction of chiropractic care. One of the patients commented, "When I first started coming [to see the chiropractors at Langs] I couldn’t hardly walk and get in my car, to get in and out of the car, it was a challenge. And after a few chiropractor treatments, it got much better. And some days I couldn’t even turn my head sideways to see driving the car, and that got fixed. It’s gone well." 

Many of the general practitioners involved in the study also had positive comments about chiropractic care. One stated, "It really brings home this message of – a chemical going into your body is only one way to influence this. So, if somebody’s having a positive experience [with chiropractic treatment], and we have had lots of people who’ve had positive experiences, it can mean the difference between not increasing a dose [versus increasing a dose]. Not starting a dose? I would say that there probably are situations where we’ve had that as well."

In their discussion, the researchers summed up the results and explained some of the overall patient understanding of opioid verses chiropractic care. Among patients receiving long-term opioid therapy for chronic non-cancer spinal pain, we found that initiating chiropractic care was associated with fewer fills and refills for prescription opioids and, when prescribed, reduced dosage of opioids. Based on our qualitative findings, use of opioids was influenced by patients’ self-efficacy and concerns about opioid-related harms, recognition of the limited effect that opioids may have on chronic pain, increasing stigma regarding use of opioids, and access to non-pharmacological treatment options."

Chiropractic with Exercise Yield Best Results for Scoliosis

The British Journal of Healthcare and Medical Research published the results of a narrative review on October 25, 2022, describing the findings from multiple scientific studies documenting that chiropractic combined with spinal exercises showed the best results for Adolescent Idiopathic Scoliosis (AIS).

The National Institute of Arthritis and Musculoskeletal and Skin Diseases describes this condition on their website by saying, "Scoliosis is a sideways curve of the spine. Everyone has normal curves in the spine, and when looked at from behind, the spine appears straight. However, children and teens with scoliosis have an abnormal S-shaped or C-shaped curve of the spine."

Typical medical care for scoliosis begins with watching and waiting. If the curvature continues to worsen, then a brace is, many times, the common recommendation. For the more severe cases, surgery may be recommended. Both bracing and surgery are difficult steps for an adolescent. It has long been felt that more conservative means of care for scoliosis should be considered before bracing or surgery.

The authors of this study stated their purpose for doing this investigation. "This narrative review aimed to investigate the efficacy of chiropractic treatments and scoliosis-specific exercise (SSE) for adolescent idiopathic scoliosis (AIS) as an alternative treatment for bracing."

The researchers conducted an exhaustive search for scientific articles on chiropractic care for scoliosis. The search included the sources PubMed, Index to Chiropractic Literature, Spine Journal, BioMed Central, Google Scholar, and Research Gate databases. In total, they found 156 articles on the subject. From this total, they selected six papers that represented the highest scientific standard and credibility. One additional paper was included because of the value of the information.

As part of the researchers review, the authors of this study noted that, "All the reviewed papers reported the benefits of exercise and chiropractic as part of AIS management. Only one study showed that SSE alone slows curve progression, whereas the other six papers (four papers investigating chiropractic intervention alone and two investigating SSE alone) showed significant curve reduction after analyzing the X-ray findings."

From this data, the researchers concluded, "The results obtained from these six papers showed that only two were able to demonstrate help with scoliosis through exercise only. The other four papers showed that chiropractic, either alone or in combination with exercise were able to help those with AIS."

Chiropractic Delivered to Pregnant Mothers is Safe for Their Fetuses

The Journal of Pediatric, Maternal & Family Health Chiropractic published the results of a study on October 18, 2022, documenting that chiropractic care did not have any adverse effect on the fetal heart rate when chiropractic care was administered to their pregnant mothers. The title of the study is "Fetal Heart Rate Monitoring of 33 Pregnant Women Undergoing Chiropractic & Midwifery Care."

John Hopkins Medicine describes Fetal Heart Rate Monitoring by stating "Fetal heart rate monitoring measures the heart rate and rhythm of your baby (fetus). This lets your healthcare provider see how your baby is doing. Your healthcare provider may do fetal heart monitoring during late pregnancy and labor. The average fetal heart rate is between 110 and 160 beats per minute. It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems."

The purpose of this study was to see if chiropractic care had a negative impact on the fetus by measuring the fetal heart rate. If chiropractic were having a negative effect, the results should be picked up in an abnormal fetal heart rate.

In this study, 33 women met the criteria for inclusion in this study. The criteria for inclusion was, (1) the woman underwent a complete history and physical examination with their respective provider, (2) the patient attended consistent and continuous care with both a midwife and chiropractor, (3) the patient provided consent for the review of both the chiropractic and midwifery patient records, and (4) fetal heart rate monitoring was performed and recorded. The records from these women were reviewed and correlated to give a full picture of their chiropractic care and any effect on the women’s fetuses.

The results showed the average age of the women in this study was just over 30 years. These women averaged almost 20 chiropractic visits during their pregnancy in addition to over 11 prenatal visits. In all, there were a total of 216 fetal heart rate monitoring recordings performed with about 99% of them occurring after the woman’s chiropractic visit.

The results showed no adverse effects to the fetal heart rate of any of the fetuses. This showed that chiropractic care did not have a negative impact on this major fetal health measure. In addition, all pregnant women delivered healthy babies without any complications.

In their discussion, the study authors commented, "The safety of the chiropractic care of pregnant women and the unborn fetus is a concern not only among chiropractors19 but also by other healthcare providers involved in prenatal care." They concluded, "The use of spinal/pelvic chiropractic adjustments during pregnancy did not result in adverse events for the fetus as measured by FHR, a major indicator of fetal health in obstetric care."

Resolution of Infertility with Successful Conception & Birth Following Chiropractic Care

The above is the title of a case study documenting the successful results of chiropractic care in a case of infertility. The study was published on November 1, 2022, in the Journal of Pediatric, Maternal & Family Health Chiropractic.

The study authors noted that 20% of couples in the United States have had an issue with infertility. Of those, they estimate that 60% of those cases are related to female factors as the primary causation leading to infertility. They define infertility by saying, "Infertility is described as the inability to achieve pregnancy while having unprotected intercourse for a period of 12 months."

Common medical care for infertility can involve in vitro fertilization (IVF), surgery, drugs, and other assisted reproductive therapies (ART). One of the big hurdles of these medical procedures is that they are expensive, making them cost prohibitive to many couples.

In this case, a 31-year-old woman originally sought chiropractic care for help with migraine headaches and neck pain. She had been receiving chiropractic for help with these issues intermittently for the previous seven years. Two years later, the woman returned to her chiropractor seeking help for her wrist pain and infertility.

Her history revealed that she had been trying to get pregnant for over a year with no success. She also reported that prior to trying to conceive she had been taking oral birth control pills for 10 years.

A chiropractic examination was performed which included a postural analysis, both motion and static palpation, surface electromyography (sEMG), thermal imaging, and spinal x-rays. From this examination, it was concluded that the woman had multiple areas of vertebral subluxation. Specific chiropractic adjustments were then started to address the subluxations found during the examination.

After the woman had received six chiropractic adjustments, she reported that she had become pregnant. Chiropractic care was continued on a regular basis though her pregnancy. The woman gave birth to healthy baby girl weighing 7lbs, 9oz, and both the mother and the new infant remained under chiropractic care.

In their conclusion, the study authors summed up their results and recommendations by saying, "The current medical model for infertility of drugs and surgery has helped many couples conceive but is quite invasive and expensive. As demonstrated by this case, after experiencing infertility, this woman was able to conceive and successfully carry a full-term pregnancy without any other medical interventions. Subluxation based chiropractic care should be considered as potential management of patients experiencing infertility prior to more costly and invasive procedures."