Chiropractic and Osteoarthritis

Numerous studies have shown that chiropractic can be an effective treatment for lumbar spinal pain. A new study1 describes the previously reported benefits of chiropractic:
“Giles and Muller compared the outcomes of acupuncture, medication, and spinal manipulation on spinal pain syndromes. Only spinal manipulation led to significant improvement. Rao et al. reported that 73% of the patients who sought pain relief treatment from both a rheumatologist and an alternative form of medicine found chiropractic care to be helpful. It may be reasonably concluded that chiropractic care is a successful treatment for lower back pain.” ¹
No previous study, however, has examined the effectiveness of chiropractic for back pain symptoms in patients with osteoarthritis. This current report set out to do just that, by comparing chiropractic treatment to moist heat treatment. Previous studies² have shown that application of heat to the affected area is an effective self-management tool for arthritis symptoms.
The authors of this study recruited 252 patients with osteoarthritis of the lumbar spine; subjects were excluded if they were currently receiving chiropractic care, physical therapy, or were using anti-inflammatory medications.
The patients were divided into two groups: the treatment group received 20 chiropractic treatments with 15 minutes of moist heat; the control group received only the moist heat treatments. The subjects were evaluated at 1, 5, 10, 15, and 20 weeks for pain levels, activities of daily living (ADL), and range of motion.
The study found significant improvements in the patients who were given the chiropractic/moist heat treatments, as illustrated by the following graph that shows average extension of the spine measured at each evaluation point:

Here is a summary of the other findings:

• Chiropractic was significantly more effective in reducing pain than moist heat alone, even though both treatments reduced pain to some degree.
• The study examined right and left lateral flexion, average flexion, and average extension. “Chiropractic care plus moist heat is more effective than moist heat alone for improving ROM, as measured by these particular tests.”
• Chiropractic care was also more effective in improving daily activities, while moist heat alone did not improve ADL.

The authors conclude:
“There are no studies in the literature that evaluate the effectiveness of chiropractic care in the treatment of OA. We found that chiropractic care was significantly better than moist heat alone for the treatment of OA. Although moist heat did improve low back pain, there is a more rapid and greater decline in pain under the treatment condition than with moist heat alone. The chiropractic treatment group also showed a more rapid and greater increase in range and flexion scores. With the exception of standing, sleeping, and sexual activity, chiropractic treatment participants reported a statistically significant improvement in their ADL.”

1. Beyerman KL, Palmerino MB, Zohn LE, Kane GM, Foster KA. Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. Journal of Manipulative and Physiological Therapeutics 2006;29:107-114.
2. Veitiene D, Tamulaitiene M. Comparison of self-management methods for osteoarthritis and rheumatoid arthritis. Journal of Rehabilitation Medicine 2005;(37)1:58-60.