Chiropractic care consists of joint and spine adjustments that are used to treat various pains and aches around the body [1]. An open question in chiropractic care is whether it can treat all joints in the body. Evidence on this point is conflicting, especially given how chiropractic care may indirectly contribute to pain alleviation via undirected adjustments. It is important for both patients and practitioners to understand where a chiropractor’s limitations are and whether they can treat every joint.
One pathway through which chiropractic care alleviates joint pain is spinal manipulation [2]. Specifically, a core belief of the field is that manipulating spinal vertebrae and releasing pressure helps reduce joint pain [2]. Theories as to how this occurs are wide-ranging. Some practitioners believe that this practice of extension causes fibrous adhesions between joints to break; another theory is that the manipulations change how excitable and active the central nervous system is, and others hold other views [2].
Irrespective of our understanding of how chiropractic care can treat joints, pockets of research suggest that this mode of treatment can have beneficial effects on worn or painful joints. In the context of Parkinson’s disease (PD), Chu et al. detailed a case study in which a patient demonstrated improved gait and posture after eleven weeks of chiropractic manipulation [3]. According to a meta-analysis of seven trials by Cheatham and colleagues, short-term joint range of motion has also been said to improve following instrument-assisted soft tissue mobilization, which is a type of chiropractic treatment [4]. And a 2018 JAMA Network Open study reported that chiropractic care helped alleviate back pain in a cohort of active-duty military personnel [5]. While all of these studies require supplementary evidence to ensure the replicability of their results, they do seem to indicate that, at least in some instances, chiropractic care can help patients with joint problems.
Nevertheless, chiropractors can’t treat every joint in the body, as illustrated by the case of arthritis. Medical professionals generally advise against using spinal manipulation on inflamed joints because such methods could cause greater harm [6, 7]. As a result, traditional chiropractic care may not always be an appropriate treatment for arthritis-afflicted joints [6]. Alternative modes of treatment like soft tissue therapies do exist, however, and they may be able to improve the range of motion and/or pain for people who suffer from arthritis [6]. Chiropractors often can provide soft tissue therapy in addition to traditional manipulations.
Moreover, chiropractic care can be used to indirectly treat arthritis patients. For instance, a 2015 study indicated that chiropractic care helped assuage a patient’s inflammatory pain [1]. It is important to note, however, that this positive result was owing to the chiropractor’s treatment of the patient’s mechanical injuries [1]. Those injuries stemmed from the compensatory movements she engaged in as a result of her rheumatoid arthritis, rather than rheumatoid arthritis itself [1]. As such, this study does not indicate that chiropractic can treat all sources of joint pain, but rather that it can help lessen stress on already-inflamed joints.
There are other contraindications for chiropractic care as well, such as acute joint injuries and osteoporosis. Chiropractors can’t treat every joint, however, more research is needed to better understand when alternative therapies are preferred for joint-related issues.
References
[1] R. Zimlich, “Can Chiropractic Care Help Relieve Symptoms of Rheumatoid Arthritis?,” Healthline, Updated March 14, 2022. [Online]. Available: https://www.healthline.com/health/advancing-rheumatoid-arthritis/chiropractor-for-rheumatoid-arthritis.
[2] E. Ernst, “Chiropractic: A Critical Evaluation,” Journal of Pain and Symptom Management, vol. 35, no. 5, pp. 544-562, May 2008. [Online]. Available: https://doi.org/10.1016/j.jpainsymman.2007.07.004.
[3] E. C. P. Chu, A. Y. L. Wong, and L. Y. K. Lee, “Chiropractic care for low back pain, gait and posture in a patient with Parkinson’s disease: a case report and brief view,” AME Case Reports, vol. 5, no. 34, October 2021. [Online]. Available: https://doi.org/10.21037%2Facr-21-27.
[4] S. W. Cheatham et al., “The efficacy of instrument assisted soft tissue mobilization: a systematic review,” The Journal of the Canadian Chiropractic Association, vol. 60, no. 3, pp. 200-211, September 2016. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039777/.
[5] R. H. Shmerling, “Should you see a chiropractor for low back pain?,” Harvard Health Publishing, Updated August 16, 2019. [Online]. Available: https://www.health.harvard.edu/blog/should-you-see-a-chiropractor-for-low-back-pain-2019073017412.
[6] S. Langmaid, “Chiropractic Care for Joint Problems: What to Know,” WebMD, Updated September 30, 2022. [Online]. Available: https://www.webmd.com/rheumatoid-arthritis/chiropractic-care-for-joint-problems.
[7] D. M. Taibi and C. Bourguignon, “The Role of Complimentary and Alternative Therapies in Managing Rheumatoid Arthritis,” Family and Community Health, vol. 26, no. 1, pp. 41-52, January-March 2003. [Online]. Available: https://www.jstor.org/stable/44954079.