Can Chiropractic Care Improve Scoliosis? New Research Says Yes! | Podcast Ep. 274

Foreign hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode, we are diving into the research and we're talking chiropractic care and scoliosis. This is a really cool study that I recently found as I started digging into pediatric research with the smart chiropractor. We are coming out with a pediatric marketing module and it's going to include research briefs. I've been diving into research, I found this study. I wanted to highlight it on the podcast because I think there's a lot of clinically relevant and relationship relevant information that you can utilize for your practice. As I said at the top, today's episode we're focusing on scoliosis and this study. I'm gonna link in the show notes. Its title is Scoliosis Treatment using a Combination of Manipulative and Rehabilitative Therapy. A retrospective case study series about just try about 20 cases that they looked at. And this was published in BMC Musculoskeletal Disorders in 2004. So let's build the foundation. We'll touch on some high points, we'll go from there. Scoliosis is a condition that affects millions of children and eventually adults around the world, probably tens of millions of people. And reducing scoliotic curves, even in the absence of symptoms, should be a primary objective each time a significant curve is discovered. Because this research showcases there's long term health implications associated with the continued deterioration. So there's problems that start in children and adolescents with small curves that become big deals over time. We know scoliosis is associated with things like a lower quality of life, lower scores on the SF36 health questionnaire. And it makes patients more prone to developing chronic pain than the general population. These are all real things that happen. So addressing scoliotic curves and excessive curves early on is really, really important because it can affect the long term quality of life of individuals in your community. So in this study that we're highlighting today, the researchers found improvement in literally every single one of the patients that was studied. Patients received a combination of care commonly deployed by chiropractors, things like spinal manipulation, as you can imagine, and home exercise. And the progress and the results, everything was measured using Cobb angles with standard radiographic X rays imaging. So the goal of care really with scoliosis, I think needs to be beyond just pain relief because many times, as we said, patients could be asymptomatic. And there can be benefits to addressing curves early on. Now, I'm not saying that you Want to be quote, unquote, depends on your type of practice. I get all this. But not every practice is a curve correcting chiropractic practice, and that's a. Okay. However, when you have a combination of. We talk about all the time in this podcast, strength and flexibility. The spine is designed to move. It's meant to have a balance of strength and flexibility. And as a chiropractor, I always look at movement through three spheres. Whole body movement and exercise, regional motion, cervical, lumbar, thoracic spine, and segmental motion. And if segmental motion is lacking, you don't say, that's the foundation. You don't stand a chance. You're going to have altered biomechanics. You're gonna have compensations as you get to regional and whole body motion. So addressing segmental motion, getting in there and adjusting segments is an important part of it. Activating the central nervous system, influencing the central nervous system. How exactly does that work? We're still learning. We've seen the brain changes, we've the pathways that are impacted, we've seen those reflexes in the muscles. However, it's really also about if you're going to get in there, don't forget to address the strength component. So it's not only about flexibility and motion, but it's also about strength. And I think this is where chiropractors that do have really good success taking care of scoliotic cases find that success is in addition to the adjustment. I don't want to say beyond the adjustment, but it's really taking into accord the fact that it's a balance of strength and flexibility, and you're going to get flexibility and better movement regionally, whole body and segmentally, through the adjustment. But you cannot leave out the fact that you need to do some strength training. You need to get some exercises in there. You need to get some postural correction, quote, unquote, in there to the best of your ability. Because all of those little things, not one of them does the whole trick. But when all of them are performed together, now you start to see some real gains. So how does this really play out? Well, these researchers discovered many of the proposed etiologies of idiopathic scoliosis are neurological in origin, which is interesting, including brain asymmetry, neural axis deformities, and central nervous system processing errors. And that becomes really, really interesting because is this a structural issue and biomechanical issue? Is this a neurological issue? The jury's still out. That's why they're saying proposed etiology but it's probably a combination of, of both. Now, the researchers in this study also found the combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all 19 subjects. And I'm gonna guesstimate things here, but generally speaking, the average went from about 30 degrees of curve to around 12 to 13 degrees of curve, and that's substantial. Now, a couple things I want to point out here is that I'm not saying 45, 60, 80 degrees of curve. Could there be benefit through conservative care measures at those? Perhaps. But this is not about going from a 90 degree angle to perfectly straight. This is really about stepwise improvement. But you've got to think about that stepwise improvement in terms of the deterioration. If somebody's at 30 degrees and they're 13, 14 years old, it stands to reason that that could progress throughout time. So resetting that quote, unquote, or correcting that to a certain degree and getting that down, improving it by 10, 15, 20 degrees, has a substantial potential impact on people long term. Now, hey, with this podcast episode, I know that this is a somewhat controversial topic within chiropractic. Are chiropractors there to correct curves? Are they not? You know, how does that all play out? And from my standpoint of coming with this podcast is not about promoting curve correction or not promoting curve correction. I think that it really goes to quality of life issues. And when somebody's moving and they're able to move in less pain and function at a higher level, even if the curve corrected 3 to 5 degrees or the curve didn't correct at all, there's significant benefit there. So in this study, they specifically it's case reports published in bmc, a very reputable journal, they were looking specifically at the correction of the curve. However, I think it stands to reason that beyond just the nuts and bolts of the data, beyond just the nuts and bolts of this angle to that angle, this is about instilling people with proper motion. This is about optimizing the balance of strength and flexibility. And this is also about helping people live the highest quality of life possible. And that is, to me, the most important aspect of taking care of anybody, those with scoliosis or those without scoliosis. And that's an important thing I think all of us as chiropractors need to keep in mind as we take care of individuals, is that, yes, getting those objective results are very important. It's what all the research drives to. It's what we talk about week in and week out on this Podcast. However, subjective measures of improvement in terms of people being able to do more of what they love to do with the people they love is just as important as anything else. So as you dive into research, as you look at the cases maybe you've treated, I think there's, you know, even if it wasn't a direct treatment for scoliosis, if you had a chiropractor, you've taken care of individuals that had excessive curves and had scoliotic curves. Just the way it goes. It's that common. So being able to improve the quality of life individuals by getting in there with adjustments, utilizing strength training and stretches is very, very important. Now the other aspect of this that I think is very important to touch on is it's not a one way street. And this is something that I think we all know when we look at chiropractic care for scoliosis, as they're saying in the study, hey, this normally consists of stuff like spinal manipulation, e stim, some form of isotonic, active exercises, and potentially even shoe lifts. Those are kind of the common tool set. You might do things a little bit differently based on your technique, but it takes two to tango. And you noticed a couple things in there. Spinal manipulation, yeah, that's on us getting in there and doing the adjustment estim, passive modality as far as I'm concerned. I could take it or leave it, but they're saying it's commonly performed, not that they're recommending it. And isotonic and active exercises, the exercises are what is the. It's an active component. Right. So the patient has to have some responsibility with this. So I would also encourage you if you're taking care of individuals with scoliotic curves, and especially if those curves are being monitored by another physician, you want to put your best foot forward. And certainly you don't want, you know, the patient going back and you know, saying that the chiropractor said, you know, due to this one single adjustment one time, I'm exaggerating that the curve is going to magically correct. So get in there and use this research, this evidence, meld it with the technique that you've chosen to choose the best and most appropriate care options. In my opinion, it's a combination. Again, you have to have good segmental motion. So get in there and adjust the segments as needed. But the secondary component to this is ensure that you are giving your patient the best at home care recommendations that you can give. And that goes beyond what I'm gonna call the basic recommendations. And I'm not an expert in scoliotic care, so to speak. So I can't speak to exactly what that should be, but I'm gonna enc you. If you're going to make treating and taking care of individuals with scoliosis a major part of your practice, get in there and learn about it. Discover what the best recommendations and best active care isotonic exercises are, the best stretches and also counterbalancing the postural stress that goes on each day, every single day. I read a study was shared in Smart chiropractor group the other day talking about tech neck and things like that, being on our computers and our phones for a long period of time, which pretty much everybody is at this point in time. And there was a six times more increased likelihood of having challenges if you were on a phone for a certain amount of time. That's substantial, like a 6xing, your likelihood of experiencing pain and dysfunction is absolutely crazy. So when I'm talking about this in the terms of scoliosis, some people are sitting a lot and right now in front of zoom in front of whatever they're doing for at home. If it's a child at home schooling, if it's an adult, they're probably working from home in suboptimal conditions. Right. Many people don't have these great ergonomic workstations at home. So you have to take that into accord. They could be coming in and getting adjusted a couple times a week, but if they're not doing anything to counterbalance the eight hours they're spending in a chair, then they move to the couch for two hours, et cetera, et cetera, you're not going to get any gains. And I think as chiropractors, yeah, we want to see again these objective measures. We would love to see these things improve objectively on an image. However, you also want people just to be getting the best results with their care, subjectively living a higher quality of life. So be sure that you're also asking and addressing. It's beyond the scope of this study that we're highlighting today, but make sure that you're asking and addressing those postural quote unquote deviations. Whatever the challenges that they're experiencing each and every day because of the habits and lifestyle that they have. You know, if you can address all of those things, I think that us as chiropractors can be absolutely instrumental in the in care associated and affiliated with scoliosis. I think some chiropractors dive super deep into it. Some chiropractors don't touch it with a 10 foot pole. Probably many of us fall somewhere in between. But the research is out there. There's no question that when chiropractors utilize, you know, spinal manipulation, adjusting and then they combine it with strength, there can be improvements. The research showcases it. It's been reinforced multiple times. So don't be afraid to get out there and talk about it. Continue to learn about it, dive deep into the details, and be sure to keep your patient first. Right? This is all about patient centric care. So as we come to a close, we are approaching 200 reviews for this podcast on itunes. So if you have not left a review, if you want to help me cross that threshold, I would greatly appreciate it. I appreciate you tuning in and that is cool. But if you want to do me a solid, head over to itunes or if you're listening on your phone right now, you can scroll on down and tap how many stars you think we deserve. And if you want to go the extra mile, you can leave a few words of encouragement as well. But I hope you have a fantastic week in practice and I will talk to you soon. Thank you for joining us on this episode of the Evidence Based Chiropractor. If you want to grow your practice, come back for next week's episode. If you want to grow faster, visit the evidencebasedchiropractor.com and join our MD Marketing membership today. Sam.