In this study, Dr. Kirkaldy-Willis presented the results of chiropractic spinal manipulation in 283 patients with chronic, constant, non-treatment responsive, disabling, severe low back and leg pain.
These patients were given a “two or three week regimen of daily spinal manipulations by an experienced
chiropractor.”
81% of the patients with referred pain syndromes and 48% of those
with compressive neuropathology achieved a good clinical outcome. Dr. Kirkaldy-Willis notes
“In most cases of chronic low back pain, there is an initial increase in symptoms after the first few manipulations [probably
as a result of breaking adhesions]. In almost all cases, however, this increase in pain is temporary and can be easily controlled by local application of ice.”
“However, the gain in mobility must be maintained during this period to prevent further adhesion formation.” Therefore,
“anything less than two weeks of daily manipulation is inadequate for chronic low back pain patients.”
“No patients were made worse by the manipulation, yet many experienced an increase in pain during the first week of treatment.
Patients undergoing manipulative treatment must therefore be
reassured that the initial discomfort is only temporary.”
Spinal adjusting apparently remodels tissues and perhaps breaks adverse articular adhesions, a process that temporarily increases symptoms;
these increased symptoms are the rule, not the exception, and a patient should be
informed about their potential appearance.
The increased motion helps the large
majority of chronic low back/leg pain patients, and as Dr. Kirkaldy-Willis found,
“no patients were made worse.”