Positive brain changes from chiropractic care?

Chronic pain (pain lasting longer than three months) causes changes in the brain. A new study shows that adjusting people with chronic neck pain has some effect on these areas of their brains. A control group doing neck motion exercises showed no changes.

The researchers looked at somatosensory evoked potentials (SSEP) from the median nerve (the nerve that goes through the carpal tunnel). SSEP’s are a measure of the brain activity from a particular area. In areas with chronic pain, the brain tends to be overactive. So less SSEP’s is good.

In the group that got neck adjustments, they had lower measured SSEP activity. The group that did range-of-motion exercises showed no change. They only looked at these patients after one treatment. The effect lasted about 20 minutes.

This is great news for chiropractors everywhere. No more three times per week treatment schedules – we need to see you every 20 minutes (at least during office hours). : – P

This study adds to our understanding of how adjustments, or spinal manipulation (the technical term), work. However, many questions still need to be answered.

What’s really going on here?

Ok, so we know that we don’t know for sure, blah, blah, disclaimer, disclaimer. What’s really going on here? (Editors note: The following is opinion – a good one, though.)

I think it boils down to (mostly) motion. What we are trying to do when adjusting a neck or back is get a joint that has dysfunctional movement, to move normally. Joints that are not moving normally cause problems. We have studies showing that joints start to degenerate quickly when they are not allowed to move.

The lack of normal motion causes different information to be sent to the brain (for nerds only: less mechanoreceptor input, stopping the spinal gating theory from helping out). This contributes to changes in our movement patterns and keeps the pain around longer, even without anything still broken, or torn or obviously inflamed.

Increasing the motion with a spinal adjustment (or manipulation for those terminology sticklers), reverses these changes. After one treatment the changes only lasted for 20 minutes.

I don’t think this means we need to treat patients 72 times per day. After an adjustment, you get lots of extra motion for about 20 minutes or so. This is partly related to some muscular reflex relaxation and the gas bubble that pops (that’s what makes the “crack”).

To provide meaningful change, we need to keep this motion normal. Having a course of treatments along with some specific exercises and postural advice can accomplish this.

How many treatments do you need? It really depends a lot on your spine and how well you do your home-exercises, etc. It could be 4-6 or 12 or 20.

As we saw in this study, changes were made in one treatment. If you need spinal manipulation you should see some change, not perfect or permanent – but some definite relief within 4 treatments.