Chronic pain is a complex and challenging condition to manage, often requiring a multidisciplinary approach. Chiropractic has emerged as a potential non-pharmacological intervention for managing chronic musculoskeletal pain.
Several studies have investigated the association between chiropractic stream of care and the management of chronic pain. Emary et al. (2021) highlighted that integrating chiropractic services into chronic pain management is associated with improved clinical outcomes, reduced use of analgesics, and decreased physician visits. In addition, it was projected that diverting patients with non-malignant musculoskeletal pain early to chiropractic care could yield the most promising results, and that the role of chiropractic care in managing chronic pain posed as a strong contender for further clinical research (McGregor et al., 2019).
The effects of chiropractic on central integration of dual somatosensory input in chronic pain patients were explored by Haavik et al., 2017, suggesting that chiropractic care may improve function and reduce pain for chronic pain patients. Spritzer et al. (2019) reported that chiropractic was associated with significant improvement in health-related quality of life for patients with chronic low back or neck pain. Additionally, Fleming et al. (2007) documented a significant percentage of chronic low back pain patients reporting effectiveness in utilising chiropractic treatment, which further supported the role of chiropractic care in managing chronic pain.
The potential benefits of chiropractic care in managing chronic pain extend beyond musculoskeletal conditions. For instance, the use of chiropractic manipulative therapy in patients with hereditary spastic paraplegia and chronic pain potentially normalises muscle tone and inhibits spasms (Chu et al., 2023). Furthermore, Navid et al. (2022) investigated the effects of chiropractic spinal adjustment on the cortical drive to lower limb muscles in chronic stroke patients, indicating the broader applicability of chiropractic treatment.
In addition to clinical value, the economic implications of chiropractic care in chronic pain have also been explored. Herman et al. (2019) conducted an economic evaluation, reporting lower back-related healthcare costs for patients using chiropractic compared to medical providers for managing low back pain, highlighting the potential cost-effectiveness of chiropractic in chronic pain management.
Overall, current evidence suggests that chiropractic care potentially offers a cost-effective and non-pharmacological approach in managing chronic pain, thus improving clinical outcomes and quality of life for patients with chronic musculoskeletal pain.
Sincerely,
Dr Kevin Ivins
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References
Chu, E., Huang, K., Cheng, K., Chu, V., & Lin, A. (2023). Chiropractic care in a patient with hereditary spastic paraplegia and chronic pain. Cureus. https://doi.org/10.7759/cureus.36602
Emary, P., Oremus, M., Mbuagbaw, L., & Busse, J. (2021). Association of chiropractic integration in an ontario community health centre with prescription opioid use for chronic non-cancer pain: a mixed methods study protocol. BMJ Open, 11(11), e051000. https://doi.org/10.1136/bmjopen-2021-051000
Fleming, S., Rabago, D., Mundt, M., & Fleming, M. (2007). Cam therapies among primary care patients using opioid therapy for chronic pain. BMC Complementary and Alternative Medicine, 7(1). https://doi.org/10.1186/1472-6882-7-15
Haavik, H., Niazi, I., Holt, K., & Murphy, B. (2017). Effects of 12 weeks of chiropractic care on central integration of dual somatosensory input in chronic pain patients: a preliminary study. Journal of Manipulative and Physiological Therapeutics, 40(3), 127-138. https://doi.org/10.1016/j.jmpt.2016.10.002
Herman, P., Yuan, A., Cefalu, M., Chu, K., Zeng, Q., Marshall, N., … & Taylor, S. (2019). The use of complementary and integrative health approaches for chronic musculoskeletal pain in younger us veterans: an economic evaluation. Plos One, 14(6), e0217831. https://doi.org/10.1371/journal.pone.0217831
McGregor, M., Nielsen, A., Chung, C., Fillery, M., Wakeland, W., & Mior, S. (2019). System dynamics to investigate opioid use and chiropractic care for chronic musculoskeletal pain. Journal of Manipulative and Physiological Therapeutics, 42(4), 237-246. https://doi.org/10.1016/j.jmpt.2018.11.007
Navid, M., Niazi, I., Lelic, D., Amjad, I., Kumari, N., Shafique, M., … & Haavik, H. (2022). Chiropractic spinal adjustment increases the cortical drive to the lower limb muscle in chronic stroke patients. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.747261
Prater, C., Tepe, M., & Battaglia, P. (2020). Integrating a multidisciplinary pain team and chiropractic care in a community health centre: an observational study of managing chronic spinal pain. Journal of Primary Care & Community Health, 11, 215013272095368. https://doi.org/10.1177/2150132720953680
Spritzer, K., Sherbourne, C., Ryan, G., & Coulter, I. (2019). Group and individual-level change on health-related quality of life in chiropractic patients with chronic low back or neck pain. Spine, 44(9), 647-651. https://doi.org/10.1097/brs.0000000000002902
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