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» Chiropractic Reduces Falling Risk in the Elderly
» House Introduces Bill to Expand Chiropractic Access...Military Retirees Families
» Jump For Your Adjustment!
» Obesity Linked to Chronic Back Pain

Chiropractic Reduces Falling Risk in the Elderly


Chiropractic Care Improves Senses and Reduces Risks of

Falling in the Elderly Population



William J. Owens DC, DAAMLP


As our population ages, our most senior are being told that their heart diseases or cancers won’t be as likely to cause death as sequella from a fall. Therefore, doctors are urging that sect of population to rely more and more on canes, walkers and other devices to help offer greater support when balance issues become even slightly problematic. According to Holt et. Al (2016) “Falls account for more than 80% of injury related hospital admissions in people older than 65 years and they are the leading cause of injury related death in older adults. Approximately 30%-40% of community-dwelling older adults suffer from at least 1 fall per year.” (pg. 267)


Holt et. al. listed the following risks associated with falls

  1. Lower limb weakness
  2. Recent History of Falling
  3. Gait Deficits
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging


The National Institute of Health (NIH) expanded the list of risk factors in older adults to include:

  1. Muscle weakness
  2. Balance and gait
  3. Blood pressure drops
  4. Postural hypotension
  5. Reflexes slower
  6. Foot problems
  7. Sensory problems
  8. Vision issues
  9. Confusion
  10. Medications



Comparatively speaking, both the Holt et. Al. and the NIH are in agreement that falling can be a multifactorial issue with often no single cause or solution. However, if an older person, who has one or more of the above risk factors can minimize those risks, the likelihood of falling can be decreased and potentially extend their life. Holt et. al. continued “There is however, a growing body of basic science evidence that suggests that chiropractic care may influence sensory and motor systems that potentially have an impact on some of the neuromuscular risk factors associated with falling.” (pg. 268) In short, the evidence has suggested that chiropractic can reduce the risk of falling in older adults.


Holt et. al. found that the mechanisms where chiropractic may influence sensorimotor functions are:

  1. Neuroplastic processes in the central nervous system through altered afferent input.
  2. Pain and altered cognition as a result with respect to attention focus and physical function
  3. Muscle strength and muscle activity patters
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

Looking at those neuroplastic processes or effects of chiropractic on the central nervous system, Gay et al. (2014) reported, “…pain-free volunteers processed thermal stimuli applied to the hand before and after thoracic spinal manipulation (a form of MT).  What they found was that after thoracic manipulation, several brain regions demonstrated a reduction in peak BOLD [blood-oxygen-level–dependent] activity. Those regions included the cingulate, insular, motor, amygdala and somatosensory cortices, and the PAG [periaqueductal gray regions]” (p. 615). In other words, thoracic adjustments produced direct and measureable effects on the central nervous system across multiple regions, which in the case of the responsible for the processing of emotion (cingulate cortex, aka limbic cortex) are regarding the insular cortex which also responsible for regulating emotion as well has homeostasis. The motor cortex is involved in the planning and execution of voluntary movements, the amygdala’s primary function is memory and decision making (also part of the limbic system), the somatosensory cortex is involved in processing the sense of touch (remember the homunculus) and, finally, the periaqueductal gray is responsible for descending pain modulation (the brain regulating the processing of painful stimuli).


This is a major step in showing the global effects of the chiropractic adjustment, particularly those that have been observed clinically, but not reproduced in large studies.  “The purpose of this study was to investigate the changes in FC [functional changes] between brain regions that process and modulate the pain experience after MT [manual therapy]. The primary outcome was to measure the immediate change in FC across brain regions involved in processing and modulating the pain experience and identify if there were reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity” (Gay et al., 2014, p. 615). 


Coronado et al. (2012) reported that, “Reductions in pain sensitivity, or hypoalgesia, following SMT [spinal manipulative therapy or the chiropractic adjustment] may be indicative of a mechanism related to the modulation of afferent input or central nervous system processing of pain” (p. 752). “The authors theorized the observed effect related to modulation of pain primarily at the level of the spinal cord since (1) these changes were seen within lumbar innervated areas and not cervical innervated areas and (2) the findings were specific to a measure of pain sensitivity (temporal summation of pain), and no other measures of pain sensitivity, suggesting an effect related to attenuation of dorsal horn excitability and not a generalized change in pain sensitivity” (Coronado et al., 2012, p. 752).These findings indicate that a chiropractic spinal adjustment affects the dorsal horns at the root levels which are located in the central nervous system.  This is the beginning of the “big picture” since once we identify the mechanism by which we can positively influence the central nervous system, we can then study that process and its effects in much more depth.    


One of the main questions asked by Corando et al. (2012) “…was whether SMT (chiropractic adjustments) elicits a general response on pain sensitivity or whether the response is specific to the area where SMT is applied. For example, changes in pain sensitivity over the cervical facets following a cervical spine SMT would indicate a local and specific effect while changes in pain sensitivity in the lumbar facets following a cervical spine SMT would suggest a general effect. We observed a favorable change for increased PPT [pressure pain threshold] when measured at remote anatomical sites and a similar, but non-significant change at local anatomical sites. These findings lend support to a possible general effect of SMT beyond the effect expected at the local region of SMT application (p. 762).


The above mechanisms take the effects of chiropractic care out of the realm of theory and validates the processes through which chiropractic works based upon the scientific evidence (literature).



Holt et. Al found that outcomes measured for both sensorimotor and quality of life increased with chiropractic care. The primary outcomes of improvement choice stepping reaction time (CSRT)and sound-induced flash illusion. The CSRT involves feet placement in a timed scenario and sound-induced flash illusion involves multisensory processing to ascertain reaction to perceived illusions. Both have been significantly related to older populations and falling. Although the results of this study has its limitations, as many studies do. Holt concluded” The results of this trial indicated that aspects of sensorimotor integration and multisensory integration associated with fall risk improved in a group of community-dwelling older adults receiving chiropractic care. The chiropractic group also displayed small, statistically significant improvements in health-related quality of life related to physical health when compared with a “usual care” control. These results support previous research which suggests that chiropractic care may alter somatosensory processing and sensorimotor integration.” (pg. 277)  


As with many of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.



  1. Holt K., Haavik H., Lee A., Murphy B., Elley C., (2016) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial, Journal of Manipulative and Physiological Therapeutics, 39(4) 267-278
  2. Falls and Older Adults, Causes and Risk Factors (n.d.) National Institute of Health, retrieved from:
  3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.Journal of Manipulative and Physiological Therapeutics, 37(9), 614-627.
  4. Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis, Journal of Electromyography Kinesiology, 22(5), 752-767.
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

Author: Mark Studin DC, FASBE(C), DAAPM, DAAMLP and William J. Owens DC, DAAMLP
Source: US Chiropractic Directory
Copyright: 2016 2016

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House Introduces Bill to Expand Chiropractic Access...Military Retirees Families

A bill introduced last week in the House of Representatives and supported by the American Chiropractic Association (ACA) would expand access to chiropractic services to military retirees, dependents and survivors through the Department of Defense TRICARE health program. The legislation (H.R. 4973), introduced by Rep. Mike Rogers (R-Ala.) and Rep. Dave Loebsack (D-Iowa), would not only enable those who currently receive chiropractic care to continue their treatment but would also establish, in the wake of the nationwide opioid crisis, an important non-drug option for pain management in the program. "Chiropractors have become valued members of the military health care team. Their non-drug, non-addictive and noninvasive approach to pain management has proven effective in helping members of the military to recover from injuries, manage chronic pain and enhance their readiness for duty," said ACA President David Herd, DC. "This bill would ensure that military retirees and military family members have access to the same quality care." Chiropractic services were first made available to active-duty military personnel following the enactment in 2000 of legislation to create a permanent chiropractic benefit within the Department of Defense health care system. As part of the pilot program before full implementation, retirees, dependents and survivors were also granted access to chiropractic services on a space-available basis. At the time, it was found that the benefit was valued within the TRICARE community. Today, chiropractic is available only to active-duty service members at more than 60 military treatment facilities in the United States, as well as bases in Germany and Japan. Chiropractors focus on disorders of the musculoskeletal system, most often treating complaints such as back pain, neck pain, pain in the joints of the arms or legs and headaches. Widely known for their expertise in spinal manipulation, chiropractors are also trained to recommend therapeutic and rehabilitative exercises, and to provide dietary and lifestyle counseling.

Author: American Chiropractic Association
Source: online, February 14, 2018.
Copyright: American Chiropractic Association 2018

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Jump For Your Adjustment!

Looking to increase athletic performance and possibly your vertical jump height? Give an adjustment a try! A small blinded trial was conducted recently in young female athletes who were suffering from ankle joint dysfunction to see if an adjustment to the joint could affect their vertical jump height. The ankle joint, more technically referred to as the talocrural joint, is the joint formed from the ends of the lower leg bones (tibia and fibula) and the top bone of the ankle, the talus. Half of the female athletes with ankle joint dysfunction received an adjustment to their ankle joint once a week for three weeks while the other half received a sham treatment once a week for three weeks. On average, those receiving the adjustment to their ankle joint saw an average 0.47 cm increase in their vertical jump as compared with the sham group. Its important to recognize that adjustments provided by doctors of chiropractic can be delivered to and benefit more than just the joints of the spine. If you or someone you know is suffering from pain or dysfunction, or is simply looking to enhance their physical performance and overall health, give your local chiropractor a call today!

Source: JMPT. February 2014. Vol. 37; Issue 2.
Copyright: LLC 2014

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Obesity Linked to Chronic Back Pain

In a study published in the January 2013 issue of Spine, researchers in Norway have established a positive link between obesity and chronic lower back pain. The study was backed by census data of nearly twenty thousand men and women, aged 30-69 years and collected over a decade. Participants were divided into two groups; people without chronic back pain and those already experiencing chronic back pain. For the purposes of the study, 'chronic back pain' was defined as pain persisting for at least three months continuously over a year. The results, adjusted for age, physical activity levels, and other health factors indicated that the subjects who were 30 or more pounds overweight were 28 percent more likely to experience chronic lower back pain. The researchers pointed out that while the obesity may lead to the lower back pain, it is also possible that the lower back pain may lead to an increase in the subjects' obesity, due to decreased physical activity.

Source: Spine: 15 January 2013 - Volume 38 - Issue 2 - p 133139.
Copyright: LLC 2013

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