Vertebral Subluxation and Systems Biology: An Integrative Review Exploring the Salutogenic Influence of Chiropractic Care on the Neuroendocrine-Immune System.

In this paper we synthesize an expansive body of literature examining the multifaceted influence of chiropractic care on processes within and modulators of the neuroendocrine-immune (NEI) system, for the purpose of generating an inductive hypothesis regarding the potential impacts of chiropractic care on integrated physiology. Taking a broad, interdisciplinary, and integrative view of two decades of research-documented outcomes of chiropractic care, inclusive of reports ranging from systematic and meta-analysis and randomized and observational trials to case and cohort studies, this review encapsulates a rigorous analysis of research and suggests the appropriateness of a more integrative perspective on the impact of chiropractic care on systemic physiology. A novel perspective on the salutogenic, health-promoting effects of chiropractic adjustment is presented, focused on the improvement of physical indicators of well-being and adaptability such as blood pressure, heart rate variability, and sleep, potential benefits that may be facilitated through multiple neurologically mediated pathways. Our findings support the biological plausibility of complex benefits from chiropractic intervention that is not limited to simple neuromusculoskeletal outcomes and open new avenues for future research, specifically the exploration and mapping of the precise neural pathways and networks influenced by chiropractic adjustment.

The effects of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with attention deficit hyperactivity disorder: a pilot RCT.

Background: Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder characterized by inattention, hyperactivity, and impulsivity. We hypothesized that chiropractic adjustments could improve these symptoms by enhancing prefrontal cortex function. This pilot study aimed to explore the feasibility and efficacy of 4 weeks of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with ADHD. Methods: 67 children with ADHD were randomly allocated to receive either chiropractic adjustments plus usual care (Chiro+UC) or sham chiropractic plus usual care (Sham+UC). The Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS), Swanson, Nolan and Pelham Teacher and Parents Rating Scale (SNAP-IV), and ADHD Rating Scale-IV were used to assess outcomes at baseline, 4 weeks, and 8 weeks. Feasibility measures such as recruitment, retention, blinding, safety, and adherence were recorded. Linear mixed regression models were used for data analysis. Results: 56 participants (mean age ± SD: 10.70 ± 3.93 years) were included in the analysis. Both the Chiro+UC and Sham+UC groups showed significant improvements in total and subscale ADHD scores at 4 weeks and 8 weeks. However, there were no significant differences between the two groups. Conclusion: This pilot study demonstrated that it was feasible to examine the effects of chiropractic adjustment when added to usual care on ADHD outcomes in children. While both groups showed improvements, the lack of significant between-group differences requires caution in interpretation due to the small sample size. Further research with larger samples and longer follow-up periods is needed to conclusively evaluate the effects of chiropractic adjustments on ADHD in children.

Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals.

Background and Aims: Spinal manipulation (SM) is currently recommended for the management of back pain. Experimental studies indicate that the hypoalgesic mechanisms of SM may rely on inhibition of segmental processes related to temporal summation of pain and, possibly, on central sensitization, although this remains unclear. The aim of this study was to determine whether experimental back pain, secondary hyperalgesia, and pain-related brain activity induced by capsaicin are decreased by segmental SM. Methods: Seventy-three healthy volunteers were randomly allocated to one of four experimental groups: SM at T5 vertebral level (segmental), SM at T9 vertebral level (heterosegmental), placebo intervention at T5 vertebral level, or no intervention. Topical capsaicin was applied to the area of T5 vertebra for 40 min. After 20 min, the interventions were administered. Pressure pain thresholds (PPTs) were assessed outside the area of capsaicin application at 0 and 40 min to examine secondary hyperalgesia. Capsaicin pain intensity and unpleasantness were reported every 4 min. Frontal high-gamma oscillations were also measured with electroencephalography. Results: Pain ratings and brain activity were not significantly different between groups over time (p > 0.5). However, PPTs were significantly decreased in the placebo and control groups (p < 0.01), indicative of secondary hyperalgesia, while no hyperalgesia was observed for groups receiving SM (p = 1.0). This effect was independent of expectations and greater than placebo for segmental (p < 0.01) but not heterosegmental SM (p = 1.0). Conclusions: These results indicate that segmental SM can prevent secondary hyperalgesia, independently of expectations. This has implications for the management of back pain, particularly when central sensitization is involved.

Cervicogenic dizziness.

Cervical muscles have numerous connections with vestibular, visual and higher centres, and their interactions can produce effective proprioceptive input. Dysfunction of the cervical proprioception because of various neck problems can alter orientation in space and cause a sensation of disequilibrium. Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain in patients with cervical pathology. Here, we report a 24-year-old female, who was diagnosed with CGD based on the correlating episodes of neck pain and dizziness. Both symptoms improved with targeted chiropractic adjustment and ultrasound therapy. CGD is a seemingly simple complaint for patients, but tends to be a controversial diagnosis because there are no specific tests to confirm its causality. For CGD to be considered, an appropriate management for the neck pain should not be denied any patient.

Relationship between craniocervical orientation and center of force of occlusion in adults.

OBJECTIVE: Clinical observation and anecdotal reports suggest changes can occur to dental occlusion following intervention with the National Upper Cervical Chiropractic Association (NUCCA) procedure. This case controlled study discerned if occlusion changes are measurable using a dental force plate (T-Scan®) following an adjustment to the craniocervical junction (CCJ). METHODS: A degree of case control was established by active patients being assessed twice prior to and following intervention. Before-after intervention assessment included posture evaluation and dental occlusion (T-Scan®). RESULTS: Findings suggest that changes in posture and occlusion can be observed after the NUCCA chiropractic procedure. Not all patients demonstrated a more balanced contact pattern following the adjustment, indicating a need for further investigation. DISCUSSION: These findings may suggest interconnectivity between the CCJ and an individual's occlusal contacts and support the need for further integration between chiropractors and dentists seeking to co-manage temporomandibular joint disorders.

Craniocervical chiropractic procedures - a précis of upper cervical chiropractic.

Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources.

Examen narratif de procédures de la cervicale supérieure afin de faciliter la compréhension et d'améliorer la connaissance des soins chiropratiques des cervicales supérieures. L'innocuité, l'efficacité, les méconnaissances courantes et la recherche font l'objet de discussion, ce qui permet aux praticiens, aux étudiants en chiropratique, et au public de prendre des décisions éclairées concernant l'utilisation et les recommandations pour ce type particulier de soins chiropratiques.Les techniques de la cervicale supérieure ont le même paradigme théorique, car les subluxations primaires existent dans la colonne cervicale supérieure. Ces procédures ont recours à des évaluations semblables pour déterminer si une intervention vertébrale est nécessaire et si elle est réussie une fois effectuée. La différence principale concerne l'utilisation soit d'une analyse radiographique articulaire ou orthogonale au moment de déterminer la présence d'un désalignement. Des évènements indésirables à la suite d'un ajustement de la cervicale supérieure consistent en des réactions symptomatiques légères de courte durée (< 24 heures).Étant donné le manque de références indexées et de qualité, les renseignements contenus aux présentes sont limités par l'importance des documents cités, qui comprennent des sources non indexées ou non révisées par des pairs.

Efeitos do tratamento quiroprático na concentração sérica de proteína C-reativa e nos sintomas de indivíduos com cervicalgia / Effects of chiropractic treatment on serum C-reactive protein and in the symptoms of individuals with neck disorders

Introdução: cervicalgia é a segunda queixa principal mais prevalente relatada pelos pacientes que procuram tratamento quiroprático, e acomete 55% da população (KNOPLICH, 2003; LEAVER et al., 2007). A manipulação vertebral altera a entrada dos sinais sensórios dos tecidos paraespinhais de maneira a melhorar a função fisiológica 3. A função da proteína C-reativa (PCR) in vivo não está bem definida e os resultados de estudos com animais experimentais têm produzido resultados contraditórios. Métodos: em um estudo quase experimental, a concentração sérica de proteína C-reativa após tratamento quiroprático foi determinada em 12 pacientes, sendo seis sintomáticos à cervicalgia e seis assintomáticos. Foram realizadas coletas sanguíneas. A partir das amostras foi dosada a concentração plasmática de proteína C-reativa. Resultados: os resultados sugerem que a manipulação quiroprática estimula a produção de interleucinas que, por sua vez, aumenta a produção da PCR para combater a inflamação. Dessa forma, a melhora do processo inflamatório provocada pelo procedimento quiroprático pode reduzir a descarga dos aferentes nociceptivos e, desta forma, reduzir a sensação de dor. Conclusão: existe uma tendência ao aumento da concentração da PCR, e a diminuição da dor, o que sugere efeitos benéficos da manipulação articular vertebral sobre eventos inflamatórios e nociceptivos. (AU)

Introduction: Neck pain is the second most prevalent chief complaint reported by patients who seek chiropractic care, and affects 55% of the population (KNOPLICH, 2003; LEAVER et al., 2007). The spinal manipulation, in theory, change the entry of sensory signals from paraspinal tissues in order to improve the function physiological 3. The role of C-reactive protein (CRP) in vivo is not well defined and the results of experimental animal studies have produced contradictory results. Methods: A quasiexperimental study, the serum C-reactive protein after chiropractic treatment was determined in 12 patients, 6 with symptomatic and 6 asymptomatic neck. Blood were collected. From the samples was measured plasma concentration of C-reactive protein. Results: The results suggest that chiropractic manipulation stimulates the production of interleukins that in turn, increases the production of CRP to fight inflammation. Thus, the improvement of the inflammatory process caused by the chiropractic procedure can reduce the discharge of nociceptive afferents and thereby reduce the sensation of pain. Conclusion: There is a tendency to increased concentration of CRP and reduction of pain, suggesting beneficial effects of joint manipulation on spinal nociceptive and inflammatory events. (AU)