Posted on 03/29/2007 7:03:28 AM PDT by Uncledave
Chiropractic Adjustment Lowers Blood Pressure Among Hypertensive Patients
The decrease was equal to taking two blood-pressure drugs at once. The results are published in the online March 2 issue of the Journal of Human Hypertension.
According to lead author George Bakris, MD, director of the hypertension center at the University of Chicago Medical Center, unlike other vertebrae, which interlock one to the next, the Atlas (also known as C-1) relies solely upon soft tissue (muscles and ligaments) to maintain alignment; therefore is uniquely vulnerable to displacement. Displacement of C-1 can occur without pain and thus, often goes undetected and untreated.
A small cadre of chiropractic specialists have foregone typical "full-spine manipulations," limiting their practice to precise, delicate manual alignment of a single vertebra, C-1. These practitioners make up the National Upper Cervical Chiropractic Association (NUCCA).
Patients were referred to a Chicago NUCCA practitioner, Marshall Dickholtz Sr., DC, for cervical assessment that included: paracervical skin temperature determination; postural analysis; pre-alignment craniocervical X-rays; and supine leg-length check. (A misaligned Atlas results in leg-length disparities, apparent when comparing heel positions while the patient lies in a supine position. When the patient is instructed to turn his/her head to the left or right, the heel-position disparity changes. Heels that appear parallel to one another or that don't change on head-turning signal that the Atlas is not misaligned.)
Those with high blood pressure and misaligned C-1 were enrolled in the study. Data from the assessment were used by the chiropractor to plan the alignment. Half of the patients received a carefully tailor-made adjustment based on their results. Half received a "sham intervention," which was designed to be indistinguishable to the patient from an authentic alignment, possible only because of the delicacy of the procedure.
Participants were fully assessed again after the alignment as well as at the end of eight weeks.
The authors say the improvement in blood pressure (both systolic and diastolic readings) following the correction of Atlas misalignment is similar to that seen by giving patients two different blood pressure-lowering drugs simultaneously. The reduction in blood pressure continued into the eighth week. There was no significant change in participants' heart rate.
"The mechanism as to why this improvement in blood pressure occurs is unknown and cannot be determined by this study," the authors wrote. "The data presented, however, raise a number of important questions including: a) How does misalignment of C1 affect hypertension?; and b) If there is a cause and effect relationship between C1 misalignment and hypertension, is malposition of C1 an additional risk factor for the development of hypertension?"
A larger trial involving multiple practitioners is being planned.
Authors: G. Bakris, Director, Hypertension Center, Univ. of Chicago Medical Center; M. Dickholtz Sr., Chiropractic Health Center, Chicago, IL; P. M. Meyer, Hypertension Center, Rush Univ. Med. Center; G. Kravitz, Hypertension Center, Rush Univ. Med. Center; E. Avery, Hypertension Center, Rush Univ. Med. Center; M. Miller, Barrington Family Medical Clinic, Barrington, IL; J. Brown, Barrington Family Medical Clinic, Barrington, IL; C. Woodfield, Atlas Research Foundation, Barrington, IL, B. Bell, Barrington Family Medical Clinic, Barrington, IL.
This trial was an investigator-initiated study funded by the ATLAS Research Foundation and the NIH K25, HL68139-01A1 who supported Meyer's effort.
Abstract: http://www.nature.com/jhh/journal/vaop/ncurrent/abs/1002133a.html
"We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy."
I know there's many chiropractic fans on FR so I thought they'd find this interesting.
(Disclosure: my wife is a chiropractor)
Interesting. What's the peer review status?
Check the abstract post above -- I presume the Journal of Hypertension is peer reviewed.
bump
I'm not surprised. Acupuncture or even acupressure can lower it, too. I once shocked my MD during a visit by lowering my bp 20 points in under five minutes, using Jin Shin, which is a form of acupressure (really, more like acu-touch).
Do you think "major medical research centers" would be open to further studying this in coordination with chiropractors?
Egads! a controlled study conducted by M.D.'s showing chiropractic has benefits to conditions not obviously caused by spinal misalignment!
I've always been an advocate of chiropractic as a superior approach to curing ills that are plainly caused by spinal misalignment--at least since my stepmother, who had gone through years of fruitless medical interventions of sciatica (muscle relaxants, pain killers, traction, . . .) was permanently cured by a three month series of chiropractic adjustments (I think two the first month, and one each of the next two).
I suppose all the outlandish claims the 'quack' variety of chiropractor who claim all manner of ailments are caused by spinal misalignment should be put up for controlled studies now. It would be good for health care (and slightly amusing) if some besides hypertension also turned out to be true.
Interesting
CRACK ping
This was "funded by the ATLAS Research Foundation and the NIH"
I'm sure there will be more studies & research done, now that NIH has funded this one.
I gotta admit here and now that I think chiropractors are quacks.Obviously you and I will never agree on this so there's no sense in debating it.
He explained that ALL nerves in the body must pass through the C-1 vertebrae on their way to the organs, extremities of their function. So if C-1 is out-of-line, it impacts the whole body. It made sense.
As long as I worked there, whenever I felt the onset of a migraine, he would stop the office and give me an adjustment. I could work the rest of the day - at 70% or so, not 100% - but certainly not incapascitated (sp?) as I had been all my life.
Adjusting C-1 impacting blood pressure makes sense to me!
I let a massage therapist do that to me once. I had a very unpleasant out-of-body experience. Never again.
Two months ago my wife had a new patient, a 20 year old woman suffering from chronic seizures, about 3 or 4 per day since she was a young girl. A friend of hers dragged her in to my wife's office. She was rather debilitated and consequently depressed, couldn't drive, etc. She'd been treated by numerous neurologists who tried many drug regimens and treatment plans. Nothing was helping.
She recently got back from a week of in-patient care at Duke Univ Hospital under the care of their neurology team. No improvement.
After my wife treating her for two weeks she is 100% seizure free and feels like she's been given a new life. I could tell hundreds of these stories I see all the time. Heck, my 20 years of chronic migraines vanished when I started dating my wife and getting treated by her.
I come from a family of MD's, and have a very good working knowledge of statistics and scientific method from my higher education work. Mind you, I'm not one of those who's saying that all of medicine is bad -- obviously medicine has some incredible benefits in millions of ways -- but I'm convinced of chiropractic's efficacy in many areas.
Also, Bakris is a very well-respected clinical researcher in hypertension, so this cannot be easily dismissed.
Worked for my headaches, too (see my #16). You had a good chiropractor who practiced based on proper chiropractic philosophy.
(There's a lot of "back pain" and shady workers comp mills run by chiropractors out there. It's awful for the profession)
Really? Wow. Never had that happen, ever. But I have made migraines go away, gotten rid of flu symptoms, and lowered my blood pressure.
Were you on some kind of medication at the time?
Just my antihypertensives. No sleep meds or narcs.
Well, your report suggests a place to get started with the controlled studies: see whether chiropractic improves various neurological conditions.
I've always thought chiropractors were legitimate when they kept to mechanical things like aligning the spine. When one told me he could cure my cold by spinal manipulation I was, how to say, less than impressed.
The ones that used to adjust the spine where you heard an explosion in your back have been giving way to ones using gentle manipulation.
It does need to be confirmed and re-confirmed, but there is no way to do it in a double-blind fashion. Double-blind would mean that the practitioners doing the manipulation themselves wouldn't know which patient was getting the treatment. That's the way drug studies are done. But you can't have a practitioner give a treatment and not know he's giving a treatment. The inherent flaw in this sort of study is that it can only be done single-blind, with the patients not knowing which of them are receiving the real treatment.
The best you can do in the design of a study like this is to not have anybody who is handling the data--those taking the blood pressure readings, recording the data, or doing the data analysis--knowing which patients got the treatment. But i don't know how to erase the confound of having the chiros aware of which patients they are manipulating correctly.
Ha! Ha!
There are plenty of ways to get reliable studies besides double blind placebo studies: for instance have three groups, one of which get full chiropractic adjustments, one of which gets adjustments that leave out the alignment of the pairs of vertebrae chiropractic theory implicates in the disorder, and one of which is a simple no-treatment control.
One could also design studies to compare a chiropractic based treatment with drugs, and have a placebo drug condition in addition to an actual drug condition.
Sure, it's not the norm in medical research, because the usual model is drug trials in which double-blind placebo studies are actually feasible (and, when feasible are the most sound experimental design).
Trials for surgical procedures can't use a double-blind protocol because it would be unethical to subject a patient to a placebo surgery (or even anesthesia without treatment), so plainly the medical community recognizes the validity of other experimental designs as a basis for accepting treatments.
I assume that you do know what "placebo" means and how powerful the placebo effect can be for certain people.
I suppose a debate about chiropractic would be fruitless since we don't agree about it.
But I'm curious why you or anyone would dismiss out of hand this report from a highly respected medical research institution. (See Pharmboy's #17 -- he's an MD). How can you be certain it's quackery when the physicians who conducted the study don't think so, nor the peer-reviewed medical journal who published the study?
Great tag line...I'd been thinking of one along similar lines for a bumper sticker.
The cure for Hillary... an eye of Newt.
Needs work.
How 'bout: "...an aye for Newt."
That's great. Thanks.
So what they are saying then, is that I should trade in my generic blood pressure meds that cost me $5 per month for a lifetime of chiropractic adjustments at $30 to $40 a pop?
"When one told me he could cure my cold by spinal manipulation I was, how to say, less than impressed."
Those are the sorts of claims that always made suspicious of the whole profession.
You're paying $5 out of pocket for the meds, but who's paying for the balance of it?
"I assume that you do know what "placebo" means and how powerful the placebo effect can be for certain people."
No, I do - but I'll assume you didn't want to answer my question.
How do you propose we do a double blind, placebo controlled study when it would involve two people touching each other?
Those are the sorts of claims that always made suspicious of the whole profession.
I've been around Chiro's my whole life and have *never* heard one say Chiropractic can cure a cold. That's just silly. Granted, being in good alignment may benefit one's Immune System, but cure a cold? Hmmm.
Do you remember a few years back all the talk about "cold water fusion"? Some scientist declared that he had succeeded in in discovering this process which would give mankind an unlimited amount of nearly free energy from sea water.The press went ga ga! No more oil! No more nuke plants! Just clean,cheap power for everyone!
In time it was discovered that no other researcher could duplicate the first scientist's results.
When I see this in the New England Journal of Medicine,the Journal of the American Medical Association, The Lancet and the Journal of the American College of Cardiology I may well be willing to listen.But not a moment before.
In this type of situation it may not be possible.But post #36 states my attitude on this particular issue (and every other issue concerning "chiropractic" for that matter).
In your cold fusion example, a scientist made a pronouncement -- no prototype or data to follow -- and the media went ga ga. So what. Totally different.
This is a case where a team of physicians at a respected medical center made a finding in a controlled study. Group A had lower BP than Group B. This is encouraging news, period. I agree more study is warranted however, I see no reason to discount the facts presented here. (I can also point you to many other controlled studies involving chiropractic).
I don't have much faith that JAMA will print this without being dragged into it somehow. They'd have a revolt on their hands from 90% of their members. Maybe lancet. (My brother is a cardiologist -- he was intrigued by this study when I sent it to him. Wants to see more data and study of course, but intrigued nevertheless)
Anyway, I see this debate won't budge for now. Peace out!
-Dave
The laying on of hands ............. Hmmmmm ............
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