Cramer G, et al. Basic Science Research Related to Chiropractic Spinal Adjusting: The State of the Art and Recommendations Revisited. Journal of Manipulative & Physiological Therapeutics November/December 2006; 29(9):726-761.
ABSTRACT: Objective: The objectives of this white paper are to review and summarize the basic science literature relevant to spinal fixation (subluxation) and spinal adjusting procedures and to make specific recommendations for future research. Methods: PubMed, CINAHL, ICL, OSTMED, and MANTIS databases were searched by a multidisciplinary team for reports of basic science research (since 1995) related to spinal fixation (subluxation) and spinal adjusting (spinal manipulation). In addition, hand searches of the reference sections of studies judged to be important by the authors were also obtained. Each author used key words they determined to be most important to their field in designing their individual search strategy. Both animal and human studies were included in the literature searches, summaries, and recommendations for future research produced in this project.
Discussion: The following topic areas were identified: anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system. A relevant summary of each topic area and specific recommendations for future research in each area were the primary objectives of this project. Conclusions: The summaries of the literature for the 6 topic sections (anatomy, biomechanics, somatic nervous system, animal models, immune system, and human studies related to the autonomic nervous system) indicated that a significant body of basic science research evaluating chiropractic spinal adjusting has been completed and published since the 1997 basic science white paper. Much more basic science research in these fields needs to be accomplished, and the recommendations at the end of each topic section should help researchers, funding agencies, and other decision makers develop specific research priorities.
COMMENTS: This article discusses the research that has occurred since a 1997 report. Suggested areas where more anatomical research is needed include gapping of and breaking up of adhesions in the zygapophyeal joints, especially in back pain populations; degeneration of hypomobile z joints, role of afferent nerves in spinal ligaments related to adjusting; the biology of the disc and disc degeneration, disc protrusion mechanics; innervation of the disc, and the unique characteristics of the cervical discs. The forces applied, the vector angles used, and the actual contact area are important areas of study of adjustments. For example, it has been found that in a thoracic transverse process contact, the actual contact over the transverse process amounted to a fraction of the entire contact, most of which was on the soft tissue. An important area of study is effects of adjustments on immune function. The article ends with action steps for further chiropractic research. Many chiropractors minimize the need for chiropractic research. Some of these same doctors sometimes contact me for research articles and are disappointed when it doesn’t exist. This hypocrisy must end as you can‘t have it both ways. We have to fund it as society demands it.