Healing With Chiropractic Medicine
Can someone with arthritis benefit from a visit to a chiropractor? It depends.
People with arthritis can agree that sometimes medication alone doesn’t alleviate the pain of arthritis. But how they go about managing the pain varies from person to person. There are some who swear by the benefits of chiropractic, a field that has not been without controversy since its founding more than a century ago. Today, it’s the third-largest primary health care profession (after medicine and dentistry).
Can chiropractic really help people with arthritis, including autoimmune forms of the disease like rheumatoid arthritis (RA)? While certain people may get relief, rheumatologists are careful to caution people with arthritis, particularly RA, who seek relief through chiropractic. Because in some conditions and circumstances, chiropractic techiques – especially the use of spinal manipulation – can actually worsen symptoms of arthritis.
The Chiropractic Approach
First, a little background on chiropractic, a word of Greek origin meaning “done by hand.” Chiropractic medicine deals with treating and preventing musculoskeletal system disorders and the effects of those disorders on the nervous system and general health. Doctors of chiropractic must complete four years of specialized training at an accredited chiropractic college on top of undergraduate work before they can become licensed to practice.
People have long been wary of chiropractors because they “crack your back” or “snap the neck.” Chiropractors will tell you that, although the field does rely primarily on manual manipulations, drop table adjustments and instrument adjustments are done in a calculated way and are intended to restore mobility in joints. Manipulations can be by hand or by using an instrument.
In such treatment, an essential first step is to take an X-ray to get a good look at the spine and neck. “A reputable chiropractor will always take an X-ray before an adjustment,” says Jane Dinerman, a chiropractor in Atlanta.
But chiropractic can involve more than adjusting the spine, neck and other joints, says Scott Bautch, chairman and CEO of Wisconsin-based Allied Health Chiropractic Centers.
“We look at a broad spectrum of issues and address them in various ways to minimize damage, slow the pace of the condition and ease pain,” he says. “We want to get the joint as comfortable as possible.”
Among the techniques that Bautch refers to:
• Ultrasound therapy. Many think of ultrasound as imaging technology, but when applied to soft tissues and joints, sound waves can also produce a massaging effect that helps reduce swelling and decrease pain and stiffness.
• Trigger-point therapy. Applying gentle pressure to a specific area of muscle where a patient experiences pain to alleviate that pain.
• Low-level laser therapy, or “cold laser.” This technique uses a non-heat-producing laser or light that penetrates deep into the tissue, sometimes reducing inflammation.
• Therapeutic exercises and stretches. Physical activities designed to promote strength and endurance.
Who Should Be Cautious
Much about chiropractic is aimed squarely at the joints, which of course is where arthritis typically wreaks havoc. So when a person experiences a flare, manipulations shouldn’t be attempted.
“If a patient has joints that have active swelling, I would not recommend going to a chiropractor,” says Alyce Oliver, MD, PhD, assistant professor of rheumatology at the Medical College of Georgia. “If you can’t get swelling under control, it would be dangerous to get an adjustment.”
People with alignment issues might benefit from spinal manipulation, says rheumatologist Gregory Middleton, MD, an associate clinical professor at the University of California, San Diego School of Medicine. But manipulation can be dangerous for people with RA who have upper neck instability, “which is usually a complication of long-standing, severe RA,” he says.
Chiropractic care may also help people with early OA or ankylosing spondylitis. But for people who have ankylosing spondylitis that has advanced to the point where joints are fused or who have osteoporosis, manipulation could lead to fracture, he adds.
What to Look for in Chiropractic Care
Dr. Oliver says the risks involved in going to a chiropractor include aggravating inflammation, increasing pain and inviting potential dangers specifically related to cervical manipulation. However, she doesn’t rule out the possibility that a patient with arthritis may be helped by a chiropractor.
“If the disease is under control with medication and the patient has no cervical involvement, it could be OK to go,” she says. “It also could be beneficial for lower back pain.” She strongly recommends discussing the possibility of seeing a chiropractor with your rheumatologist before going.
To find a chiropractor, it’s a good idea to ask friends and family for referrals. Look for a reputable chiropractor who has experience treating people with arthritis and who “takes a multidisciplinary approach, such as using physical therapy, nutritional counseling and neuromuscular treatments,” advises chiropractor Geoff Tanner, who runs Tanner Chiropractic in Sandy Springs, Ga.
On your initial visit, expect the chiropractor to take a thorough history, including your experiences with arthritis. Be sure to ask about his or her approach to treatment, philosophy of care and success rate in working with patients with symptoms that match yours. Since the symptoms of arthritis affect everyone differently, the decision to see a chiropractor must be made on an individual basis.
After clearance from your doctor, the most important thing is to go into a chiropractor’s office informed and make sure you feel comfortable with the recommended treatment plan. Although chiropractic care will not cure arthritis, it might bring some relief.