Science
The general principle of Chiropractic science:
In Quebec, section 6 of the Chiropractic Act defines the practice in the following terms:
“The practice of chiropractic is any act to practice correction of the spine, bones of the pelvis and other joints of the human body with the help of the hands. “
As a result and considering the above principles, chiropractic is both a science and an art that utilizes the inherent natural powers of recovery inherent in the organism and the relationship that exists between the musculoskeletal system and the functions of the organism. in particular, that of the spine and the nervous system, with a view to ensuring the recovery and maintenance of health.
The role of the chiropractor is to give the person all the tools they need to reach their full health potential. More specifically, he emphasizes the relationship between the structure (mainly the spine) and the function as coordinated by the nervous system.
The chiropractor will focus on the biomechanics and proper functioning of the spine and all joints to eliminate irritation of the nervous system. To do this, he will mainly use chiropractic adjustments, a particular form of joint manipulation.
The benefits of chiropractic care are well documented from a scientific point of view for many conditions, including lower back pain, sciatica pain, headache (headache), migraines, and neck pain (neck).
Here are some examples of studies proving these benefits (see below for more information on the different types of studies mentioned):
Lower back pain:
- Anderson, R., Meeker, W.C., Wirick, B.E., Mootz, R.D., Kirk, D.H., and Adams, A. Meta-analysis of clinical trials of spinal manipulation. J Manipulative Physiol Ther 1992; 15 (3): 181
- Bronfort, G., Haas, M., Evans, R.L., and Bouter, L. M. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J 2004; 4 (3): 335-356.
- van Tulder, M.W., Koes, B.W., and Bouter, L. M. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine 9-15-1997; 22 (18): 2128-2156.
- Hoiriis, K.T., Pfleger, B., McDuffie, F.C., Cotsonis, G., Elsangak, O., Hinson, R., and Verzosa, G. T. A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. J Manipulative Physiol Ther. 2004; 27 (6): 388-398.
Sciatic pain:
A recent cohort study found that patients with acute lower back pain and sciatic nerve pain returned to work more quickly when treated with chiropractic than when they received conventional medical treatment:
- Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. J Manipulative Physiol Ther. 2007 Feb; 30 (2): 135-9.
A randomized, double-blind clinical trial demonstrates the effectiveness of chiropractic adjustments in patients with acute low back pain and sciatic pain caused by disc protrusion:
- SSantilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.Spine J. 2006 Mar-Apr; 6 (2 ): 131-7.
Headache (headache):
- Cassidy, JD, Boyle, E., Côté, P., He, Y., Hogg-Johnson, S., Silver, FL, and Bondy, SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case -control and case-crossover study. Spine 2008; 33 (4S): S-176-S183.
- Bronfort, G., Nilsson, N., Haas, M., Evans, R., Goldsmith, C.H., Assendelft, W.J., and Bouter, L. M. Non-invasive physical treatments for chronic / recurrent headache. Cochrane.Database.Syst.Rev 2004; (3).
- Vernon, H., McDermaid, C.S., and Hagino, C. Systematic review of randomized clinical trials of complementary / alternative therapies in the treatment of tension-type and cervicogenic headache. Complement Ther Med 1999; 7 (3): 142-155.
- Shekelle, P.G. and Coulter, I. Cervical spine manipulation: a report of a systematic review of the literature and a multidisciplinary expert panel. J Spinal Disord 1997; 10 (3): 223-228.
Cervical pain:
Systematic reviews of the literature report that cervical vertebrae manipulations (chiropractic adjustments) provide relief from neck pain and that this type of treatment is superior to conventional medical treatme
- Bronfort, G., Nilsson, N., Haas, M., Evans, R., Goldsmith, C.H., Assendelft, W.J., and Bouter, L. M. Non-invasive physical treatments for chronic / recurrent headache.Cochrane Database Syst Rev 2004; (3).
- Shekelle, P.G. and Coulter, I. Cervical spine manipulation: a report of a systematic review of the literature and a multidisciplinary expert panel. J Spinal Disord 1997; 10 (3): 223-228.
Recent randomized clinical trials promote the use of vertebral manipulations (chiropractic adjustments) in the treatment of acute and chronic neck pain, reducing both pain and functional disability:
- Cleland JA, Glynn P, Whitman JM, Eberhart SL, MacDonald C, Childs JD. Short-term effects of thrust versus nonthrust mobilization / manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther. 2007 Apr; 87 (4): 431-40.
- González-Iglesias J, Fernández-de-las-Peñas C, Cleland JA, Gutiérrez-Vega Mdel R. Thoracic spine manipulation for the management of patients with neck pain: a randomized clinical trial.J Orthop Sports Phys Ther. 2009 Jan; 39 (1): 20-7.
- Palmgren PJ, Sandström PJ, Lundqvist FJ, Heikkilä H. Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective bread intensity in patients with nontraumatic chronic neck pain. J Manipulative Physiol Ther. 2006 Feb; 29 (2): 100-6.
Research in chiropractic sciences
The effervescence of basic research in chiropractic sciences now allows the chiropractic profession a better understanding of the neurophysiological mechanisms that favor the use of vertebral manipulations (chiropractic adjustments) in the treatment of various visceral conditions such as asthma, ear infections, gastrointestinal disorders, etc.
It is from this deep knowledge in basic research that the chiropractic scientific community will be able to conduct sound clinical studies from a methodological point of view, in order to determine in particular which types of patients will be the most important. able to benefit from chiropractic care for these specific conditions.
All this research in chiropractic sciences provides an undeniable advantage for the health of the Quebec population!
Many chairs and chiropractic research programs at several Canadian universities are driving the scientific advancement of our profession1. The creation of the Chair of Research in Chiropractic at the University of Quebec at Trois-Rivières (UQTR) in 2006, and the inauguration of the 2009 McGill University Chiropractic, Epidemiology and Rehabilitation Research Program, are concrete examples that will make the importance and repercussions of chiropractic research even more visible to the people of Quebec and the world.
The Québec government recognizes the contribution of chiropractic research to the Quebec population, as demonstrated by the conclusion in 2009 of a partnership between the Fonds de recherche en santé du Québec (FRSQ), the Ordre chiropractors from Quebec and the Quebec Chiropractic Research Foundation (FRCQ). Thanks to this agreement, chiropractic research will be able to benefit from the financial contribution of the Government of Quebec over the next three years (2010-2013).
1 For details on chiropractic research chairs and research programs, please visit http://www.chiropracticcanada.ca/en-us/Research.aspx. Accessed November 23, 2009.
You can consult the list of publications of the UQTR Chair in Chiropractic Research at the following address: http://www.uqtr.ca/chairechiropratique.
To better understand the different types of studies:
Meta-analysis:
Statistical analysis process gathering the results of a series of comparable and independent studies on a given problem. The meta-analysis allows for a more in-depth analysis of the data because of the increase in the number of cases studied, resulting in a stronger overall conclusion than is possible in the individual studies. This approach is widely used for the global interpretation of sometimes contradictory clinical studies.
Systematic review:
The rigorous scientific approach of critical review of the literature. This process consists of several steps:
- The first step is to search for all studies, clinical trials, or other appropriate studies, published or unpublished, that responded to the same specific clinical question; for example, all clinical trials conducted to evaluate the effectiveness of a treatment.
- Then, the quality of each study is evaluated and the synthesis of the results obtained in the selected studies is carried out. Finally, if the data permit, a statistical analysis, called meta-analysis, is performed. (source: Cochrane Francophone Network).
Clinical test :
A scientific study intended mainly for evaluating the safety and / or efficacy of a diagnostic method or a treatment. The scientific quality of clinical trials depends on a rigorous and proven methodology to avoid biases and errors in the collection or interpretation of results. Randomized: The (random) distribution between the experimental group and the control or control group is performed in a way that gives everyone an equal chance of ending up in one or other of the groups.
Double-blind: The subject does not know if he is in the control group or the experimental group while the experimenter does not know which group the subject belongs to.