Lehigh Valley Chiropractic in Bethlehem PA utilizes the latest scientific literature to inform research-based diagnostic decision making and implement best practice into patient case management.
(we work hard so you feel better)
Disc Herniation with Radiating Leg Pain
Commonly patients with disc herniation also suffer from radiating leg pain. A study published in December 2009, looked at a non-surgical approach to managing patients with disc herniation and radiculopathy (common cause of radiating leg pain). Often, surgery is recommended for this disorder; however, only a small percentage of patients have indications for surgery. This means a non-surgical approach is generally the best approach. This particular study looked at conservative treatments such as distraction manipulation, neurodynamic techniques, end-range loading maneuvers, joint manipulation, and myofascial techniques. These are all treatment options offered at Lehigh Valley Chiropractic. The results of this study indicate the following: “Mean self-rated improvement at the end of treatment was 77.5%. Improvement was described as ‘good’ or ‘excellent’ in nearly 90% of patients…Clinically meaningful improvements in pain and disability were seen in 79% and 71% of patients, respectively. Mean number of visits was 13.2. After an average long-term follow-up of 14.5 months, mean self-rated improvement was 81!%. ‘Good’ or ‘excellent’ improvement was reported by 80% of patients.” If you are suffering from radiating leg pain secondary to disc herniation, the evidence based approach offered at Lehigh Valley Chiropractic may be the non-surgical solution you need.
Spinal Manipulation for Low Back Pain in Pregnancy
Pregnant women often suffer from low back pain; chiropractic care is an effective non-pharmacologic way to control back pain in pregnancy. An article published in 2006 examined the efficacy of chiropractic for low-back pain in pregnancy. Researchers studied a group of pregnant women who were treated with spinal manipulation (chiropractic adjustment). Seventeen cases were evaluated. Participants in this study decreased their pain scale. On average, the time it took for participants to note relief was 4.5 days. Participants underwent (on average) 1.8 treatments. The researchers concluded the following: “No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.”
Lisi AJ. Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health. 2006 Jan-Feb;51(1):e7-10.
Low Back Pain Management: Chiropractic Pain Management vs. Pain Management Clinic
A study published in 2009 examined chiropractic management vs. pain clinic management for chronic low back pain. This pragmatic randomized, controlled trial was conducted in the United Kingdom at a National Health Service (NHS) outpatient clinic. For 8 weeks, 30 subjects were studied. Participants were randomized into two groups; 18 were placed into a chiropractic group, and 12 were assigned to a “pain clinic” group. Researchers discovered the following: “At 8 weeks, the mean improvement in RMDQ (a questionnaire used to assess improvement in back pain) was 5.5 points greater for the chiropractic group than for the pain clinic group. Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group.” The authors concluded that “chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment.”
Wilkey A, Gregory M, Byfield D, McCarthy PW. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2009 Jun;14(5):465-73.
Hospital-Based Chiropractic Management of Low Back Pain
A 2007 study conducted at the Department of Orthopedics, Central Hospital of Sogn and Fjordane in Norway, evaluated chiropractic management of acute low back pain/sciatica. 44 subjects who presented with “sudden and painful low back pain” were followed for 2 years. The chiropractors who participated in the study had the “full support” of the orthopedic department staff. The results of this study showed, “All but two patients returned to work. The period of sick leave among patients was reduced by two-thirds as compared with that associated with conventional medical treatment.” The authors concluded the following: “The results support the initiative of the Norwegian government to increase reference to chiropractors in treating patients with neuromuscuoskeletal dysfunctions. Based on our experience, we believe that the inclusion of chiropractors within hospital orthopedic departments is feasible and provides a patient care resource that may benefit not only the patients but also the department as a whole.”
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.
Evaluation of CVA Risk
An interesting article published in Spine, evaluated the relationship between a visit to a chiropractor or a primary care physician and the risk of suffering from a stroke (specifically vertebrobasilar artery stroke-VBA). Critics of cervical spine manipulation (neck adjustment) link the procedure to an increased risk of a rare form of stroke. However, data supporting this connection is sparse and not definitive. This study evaluated patient Ontario hospital records from April 1, 1993 to March 31, 2002. The authors of this study concluded the following: “VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP (primary care physicians) visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care.”
Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2009 Feb 15;33(4 Suppl):S176-83.
Chiropractic Manipulation for Neck Pain, a Prospective Observational Study
Neck pain is a common condition that, in many cases, responds favorably to chiropractic management. A 2007 study conducted in the Netherlands evaluated the benefits vs. the risks for chiropractic care in cases of neck pain. 529 subjects participated in this prospective, multicenter, observational cohort study. A total of 4891 treatments were provided to these 529 individuals. Although minor side-effects were recorded, no major incidence or adverse events were reported. The authors found, “Of the patients who returned for a fourth visit, approximately half reported to be recovered, whereas approximately two-thirds of the cohort were recovered at 3 and 12 months.” The researchers concluded the following: “…Most of the patients report recovery, particularly in the long term. Therefore, the benefits of chiropractic care for neck pain seem to outweigh the potential risks.”
Rubinstein SM, Leboeuf-Yde C, Knol DL, de Koekkoek TE, Pfeifle CE, van Tulder MW. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther. 2007 Jul-Aug;30(6):408-18.
Chiropractic Management of Headaches
In an Evidence Report published by Duke University Evidence-Cased Practice Research Center for Clinical Health Policy Research, the effects of drug-free options for headache are discussed. The authors concluded the following: “Cervical spine manipulation was associated with improvement in headache outcomes in two trials involving patients with neck pain and or/neck dysfunction and headache. Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headache when compared with an attention-placebo control. Furthermore, when compared to soft tissue therapies, a course of manipulation treatments resulted in sustained improvement in headache frequency and severity.”
McCrory DC, Penzien DB, Hasselblad V, Gray RN. Evidence Report: Behavioral and Physical Treatment for Tension-Type and Cervicogenic Headache. Duke University Evidence-Cased Practice Research Center for Clinical Health Policy Research.
Conservative Management of Lumbar Spinal Stenosis
A study published in BMC Musculoskeletal Disorders evaluated the effect of distraction manipulation and neural mobilization on lumbar spinal stenosis. The study indicates that a combination of distraction manipulation and neural mobilization “may be a useful [safe and effective] approach for patients with lumbar spinal stenosis.” The practitioners at Lehigh Valley Chiropractic utilize both distraction manipulation and neural mobilization for the treatment of lumbar spinal stenosis.
A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study. Murphy DR, Hurwitz EL, Gregory AA, Clary R. BMC Musculoskelet Disord. 2006 Feb 23;7:16.