Chiropractic Manipulation Results in Little Risk of Chest Injury

A preliminary study shows that maximum chest compression during chiropractic manipulation of the thoracic spine is unlikely to result in injury.

Researchers at the Medical College of Wisconsin (Milwaukee, USA) conducted a study in two parts. The first part of the study involved two practicing doctors of chiropractic medicine, each with a minimum of 4 years of doctoral training and at least 7 years of healthcare experience. Using an anthropomorphic test device (i.e., a crash-test dummy"), the researchers measured the level of chest compression induced during "normal" chiropractic manipulation, as well as that induced during spinal manipulations, wherein the doctors of chiropractics exerted maximum effort. The doctors performed simulated chiropractic manipulations on the test dummy at the midback level (T7 to T8 vertebrae).

In the second part of the study, an instrumented mechanical device was used to apply and measure the forces necessary to induce chest compression in the test dummy. These forces were increased until injurious levels of force were reached. The likelihood of injury was assessed, and classified using the Abbreviated Injury Scale (AIS), which is a classification system that has been correlated to injury thresholds during biomechanical experimentation. The manipulations efforts performed by doctors of chiropractic medicine during maximum chest compressions corresponded to a minimal risk of AIS, at level 1 on the scale of injury. The study was published early online on May 15, 2011, in the Journal of Manipulative and Physiological Therapeutics.

"We performed this study to get a better understanding of the force limits of chiropractic manipulation. This information may lead to safer manipulation procedures and help to decrease the possibility of adverse patient outcomes," said lead author Brian Stemper, PhD, an associate professor at the department of neurosurgery, adding, "individual patient characteristics including age, degeneration, and gender should be taken into consideration during treatment such as chiropractic manipulation."

Chiropractic is a form of alternative medicine that emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system. It is generally categorized as complementary and alternative medicine (CAM). Chiropractic treatment technique primarily involves manual therapy, including manipulation of the spine and other joints, as well as soft tissue therapies; treatment also commonly includes exercise, and health and lifestyle counseling.

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