Cervical Disc Herniation Eased by Chiropractic
A study by Swiss chiropractors published in the JMPT entitled “Outcomes from Magnetic Resonance Imaging-Confirmed Symptomatic Cervical Disk Herniation Patients Treated with High-Velocity, Low-Amplitude Spinal Manipulative Therapy: A Prospective Cohort Study with 3-Month Follow-Up.” This was an uncontrolled study of 50 patients. 55% were “improved” at 2 weeks, 69% at 1 month and 86% at 3 months, according to the patients’ own global impressions; there were no objective measurements. Improvement was greater in patients with acute pain than in those with chronic pain. The treatment is exactly the kind of neck manipulation that has been associated with strokes.
How many of these patients would have improved with no treatment at all, due to the natural course of the disease? The authors say it is virtually impossible to extract reliable figures on the natural history of this condition, so a control group is crucial to interpreting the significance of their findings, and it’s hard to understand why they failed to use one. While double blinding with a credible placebo control would be difficult, they might at least have compared HVLA manipulation to gentle mobilization with exercise and physical therapy modalities like heat.
SchluterChiropractic.com
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