Top Chiropractic Research from 2023
Do you ever feel inspired but overwhelmed by the vast ocean of chiropractic research? Don't worry; your ChiroUp research team is here to be your life raft! We navigate the ever-growing waves of scientific knowledge (over 30 million references and counting!) and deliver the essential chiropractic clinical pearls directly to your door.
Our latest research roundup has hand-picked this year’s ten top SMT research studies to elevate your knowledge and supercharge your patient care. Get ready to dive into the most cutting-edge chiropractic best practices and know-how.
This blog will relay the findings and, more importantly, will provide the associated resources to put this research into action! Up your game in under 5 minutes with valuable tools to improve patient outcomes:
5 new infographics
2 useful new tests
2 popular clinical webinars
2 Chiropractic toolkits to help make our profession the undeniable best choice for patients and payors alike!
1. WHO Research Recommends SMT
The World Health Organization commissioned an analysis to develop recommendations from high-quality clinical practice guidelines for patients with non-specific low back pain with and without radiculopathy:
“Recommended interventions included:
Education about recovery expectations, self-management strategies, and maintenance of usual activities.
Multimodal approaches incorporating education, exercise, and spinal manipulation.
NSAIDs combined with education in the acute stage.
Intensive interdisciplinary rehabilitation that includes exercise and cognitive/behavioral interventions for persistent pain.”
Zaina F, Côté P, Cancelliere C, Di Felice F, Donzelli S, Rauch A, Verville L, Negrini S, Nordin M. A systematic review of Clinical Practice Guidelines for persons with non-specific low back pain with and without radiculopathy: Identification of best evidence for rehabilitation to develop the WHO's Package of Interventions for Rehabilitation. Archives of Physical Medicine and Rehabilitation. 2023 Mar 23. Link
Deeper Dive: SMT is endorsed by multiple authoritative LBP clinical practice guidelines. Spread the word with ChiroUp’s Natural Solution toolkit, including a potent video, newsletter, and infographic.
2. SMT Does Not Cause Strokes (again)
"The association between cervical spinal manipulation and cervical artery dissection is not causal in nature. It is more likely that in the period leading up to their diagnosis of cervical artery dissection, patients with neck pain and related symptoms seek out care from a cervical spinal manipulation provider, a medical provider or both, rather than having a specific risk for cervical artery dissection imparted by receipt of cervical spinal manipulation."
Whedon JM, Petersen CL, Schoellkopf WJ, Haldeman S, MacKenzie TA, Lurie JD. The association between cervical artery dissection and spinal manipulation among US adults. European Spine Journal. 2023 Jul 8:1-8. Link
Related Research: Several other recent studies have concurred.
A 2022 BMC Geriatrics study showed that "Among [53 million patients] aged 65 and older who received cervical spinal manipulation, the risk of cervical artery dissection is no greater."
A 2022 JMMT study reported vertebral arteries “were not stretched” during HVLA.
A 2023 Journal of Chiropractic Medicine study showed “[upper cervical manipulation] did not appear to alter blood flow parameters of the vertebral artery and internal carotid arteries."
A 2023 Scientific Reports study of nearly one million manipulations reported that “severe SMT-related adverse events were reassuringly very rare.”
Deeper Dive: There is abundant data to refute SMT as a cause of stroke. Check out the ChiroUp Safety of Cervical Manipulation infographic for details. Or download our Chiropractic Safety Toolkit for additional patient and provider resources, including our most popular webinar.
3. SMT is Effective for Neck Pain & Radiculopathy
A Clinical Journal of Pain systematic review of 59 prior studies on the management of cervical radiculopathy found:
"Evidence supporting the use of acupuncture, prednisolone, cervical manipulation, and low-level laser therapy for pain and disability in the immediate to short-term, and thoracic manipulation and low-level laser therapy for improvements in cervical range of motion in the immediate term."
Plener J, Csiernik B, To D, da Silva-Oolup S, Hofkirchner C, Cox J, Cancelliere C, Chow N, Hogg-Johnson S, Ammendolia C. Conservative Management of Cervical Radiculopathy: A Systematic Review. The Clinical Journal of Pain. 2023 Mar 1;39(3):138-46. Link
Related Research: A Complementary Therapies in Clinical Practice systematic review concluded:
"Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity."
Liu Z, Shi J, Huang Y, Zhou X, Huang H, Wu H, Lv L, Lv Z. A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain. Complementary Therapies in Clinical Practice. 2023 Apr 7:101751. Link
Deeper Dive: Check out the Mic’d Up with ChiroUp podcast on Cervical Radiculopathy. And while you’re there, be sure to subscribe so you don’t miss a single episode of the top chiropractic podcast.
4. Sciatica Systematic Reviews: SMT Validated, But PT is Not
A European Spine Journal systematic review of 18 trials with 2699 sciatica participants concluded:
"For disability [and pain,] there was no difference in the short, medium, or long term between physiotherapy and control interventions. Based on currently available... data, there is inadequate evidence to make clinical recommendations on the effectiveness of physiotherapy interventions for people with clinically diagnosed sciatica."
Dove L, Jones G, Kelsey LA, Cairns MC, Schmid AB. How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. European Spine Journal. 2022 Dec 29:1-7. Link
However, an earlier Spine Journal systematic review concluded that five interventions were effective for sciatica: Manipulation, Acupuncture, Non-opioid analgesia, Epidural injections, and Disc surgery.
Deeper Dive: PCPs need to know that DCs are one of the few proven options for sciatica. Each month, ChiroUp’s ChiroUp Premium subscribers receive a PCP newsletter to relay the facts that change attitudes and referral patterns. If you’re not a Premium subscriber, upgrade your account today, or email info@chiroup.com for more information or a sample newsletter.
5. Two More Studies Confirm Most Disc Herniations Resorb
“The existing evidence shows that the overall resorption incidence of lumbar disc herniation (LDH) was 70.39%, the resorption incidence of ruptured LDH is higher than that of contained LDH."
Zou T, Liu XY, Wang PC, Chen H, Wu PG, Feng XM, Sun HH. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Clinical Spine Surgery. 2023 Jul 31:10-97. Link
“The probabilities of spontaneous regression [were)]:
Bulging - 13.3%
Protruded - 52.5%
Extruded - 70.4%
Sequestered - 93.9%
Extruded and sequestered discs were also significantly more likely to completely regress than smaller morphologies."
Rashed S, Vassiliou A, Starup-Hansen J, Tsang K. Systematic review and meta-analysis of predictive factors for spontaneous regression in lumbar disc herniation. Journal of Neurosurgery: Spine. 2023 Jul 14;1(aop):1-8.
Deeper Dive: An inflammatory reaction ensues whenever nuclear material exits the avascular center of the disc and meets the immune system- and more significant herniations trigger larger immune responses with quicker resorption times. Watch the ChiroUp Masterclass on Disc Lesions and Degeneration to learn more.
6. LBP Systematic Reviews: Drugs Fail; SMT is Safer
A Cochrane Database of Systematic Reviews concluded:
"We found no high- or moderate-certainty evidence that any investigated pharmacological intervention provided a large or medium effect on pain intensity for acute or chronic LBP compared to placebo."
Cashin AG, Wand BM, O'Connell NE, Lee H, Rizzo RR, Bagg MK, O'Hagan E, Maher CG, Furlan AD, van Tulder MW, McAuley JH. Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews. 2023(4). Link
Related Research: A Spine Journal systematic review concluded, "...nonpharmacological interventions of acupuncture and spinal manipulation provide safer benefits than pharmacological or invasive interventions."
Feise RJ, Mathieson S, Kessler RS, Witenko C, Zaina F, Brown BT. Benefits and harms of treatments for chronic non-specific low back pain without radiculopathy: Systematic review and meta-analysis. The Spine Journal. 2022 Nov 17. Link
Deeper Dive: Subscribers can share the news with this ChiroUp infographic. (Search the Forms Library for “Medication”)
7. Neurodynamic Mobilization Eases CTS
"Our systematic review demonstrates significant benefits of neurodynamic modulation techniques to treat carpal tunnel syndrome and specifically that it reduces symptom severity, pain, and motor latency, while at the same time improving nerve conduction velocities.”
Zaheer SA, Ahmed Z. Neurodynamic Techniques in the Treatment of Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2023 Jul 25;12(15):4888. Link
Deeper Dive: Check out our popular Carpal Tunnel Nerve Floss blog for a detailed tutorial. ChiroUp subscribers can review a simple median nerve floss here.
8. Lateral Epicondylopathy: Manipulate the Wrist
“The evidence is convincing that wrist joint manipulations positively affect pain in the short term, compared to comparison groups in the management of lateral epicondylitis.”
Eapen C, Rosita R, Sohani MS, Patel VD. A systematic review of the effectiveness of wrist manipulative therapy in patients with lateral epicondylitis. Journal of Hand Therapy. 2023 Mar 12. Link
Related Research: Check out these two new valuable tests for diagnosing lateral epicondylopathy:
Free Test for Lateral Epicondylopathy
"The [Free test] presented very good sensitivity and good accuracy (0.79) in patients with lateral elbow tendinopathy.”
Greene C, Droppelmann G, García N, Jorquera C, Verdugo A. A New Test for the Advanced Diagnosis of Lateral Elbow Tendinopathy with Concomitant Intrasubstance Tear: Failure to Resist Extension Effort (the Free Test). Orthopedic Research and Reviews. 2022 Dec 31:495-503. Link
Selfie Test for Lateral Epicondylopathy
“Reproduction of lateral elbow pain [via the Selfie test] suggests lateral epicondyle involvement [with a reported sensitivity of 0.93].”
Factor S, Snopik PG, Albagli A, Rath E, Amar E, Atlan F, Morag G. The “Selfie Test”: A Novel Test for the Diagnosis of Lateral Epicondylitis. Medicina. 2023 Jun 16;59(6):1159. Link
Deeper Dive: ChiropUp subscribers can review the new Free test and Selfie Test in their Clinical Evaluations library.
9. Thoracic Manipulation Eases Neck Pain
A Journal of Pain research systematic review concluded:
“Thoracic spine manipulation was effective in reducing pain and neck disability in all adults with chronic mechanical neck pain compared to other interventions."
Tsegay GS, Gebregergs GB, Weleslassie GG, Hailemariam TT. Effectiveness of Thoracic Spine Manipulation on the Management of Neck Pain: A Systematic Review and Meta-Analysis of Randomized Control Trials. Journal of Pain Research. 2023 Dec 31:597-609. Link
Deeper Dive: Looking to Up your skills on the best ways to manipulate challenging areas like the cervicothoracic junction? Consider a Motion Palpation Institute skills course in 2024!
10. Chiropractic: Affordable, Efficient, and Less Invasive
"Within a large, national cohort, chiropractors were the initial provider for… new-onset neck pain. Compared to patients initially seen by physician providers, patients with chiropractor initial providers received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up."
Fenton JJ, Fang SY, Ray M, Kennedy J, Padilla K, Amundson R, Elton D, Haldeman S, Lisi A, Sico J, Wayne PM. Longitudinal Care Patterns and Utilization Among Patients with New-Onset Neck Pain by Initial Provider Specialty. Spine.:10-97. Link
Deeper Dive: ChiroUp subscribers can share the facts with patients and social media followers. (Search your Forms Library for any of the following infographics)
Proven Benefits of SMT
Manipulation & More
Healthcare Affordability
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