THOUGHTS ON CHIROPRACTIC RESEARCH

The future and stature of chiropractic is dependent upon research. Yet, I am not a researcher. I am a reader of research, a teacher, and a clinician, and I know that to understand where our profession has been and where it is going requires looking at research. Research may fall into a number of categories, such as literature review, theoretical, case study, experimental, metaanalysis, epidemiology, clinical trials, etc. Ideally, research is challenged and attempts by other researchers to replicate the results are also published. Reading the 2022 book Sickening by John Abramson, MD, reinforced for me that all research data needs to be fully disclosed and available, and potential confl icts must also be disclosed. Abramson maintains that many drug clinical trials do not do this and the data used for approval is incorrect or even purposefully deceptive. At this moment, chiropractic has a handful of top-tier researchers that are second to none. They are getting awesome chiropractic research published in top impact journals, and changing the world’s view of our profession. These researchers deserve the support of our profession. I reference their work nonstop in my classes and in my clinical practice. My academic research interest includes the infl uence of the chiropractic adjustment on neuro-visceral syndromes, neuroimmunology, neuro-vascular influences, and the influence of various brain centers. My clinical research interest includes the influence of the chiropractic adjustment on the healing of injured soft tissues and on the neurophysiology of pain. Recently I have been very intrigued by the infl uence of the upper cervical subluxation (and adjustment) on the fl ow of cerebrospinal fl uid, normal-pressure hydrocephalus, Chiari malformations, heartrate variability, and the nuclei of the vagus nerve (parasympathetic/acetylcholine). The Jon Adams study, published in the journal Spine in 2017, indicates that 93% of patients who initially seek chiropractic care do so for the care of spinal pain syndromes. The study documents that chiropractic is quite good at managing spinal pain, and that in doing so, patients experience meaningful improvements in other aspects of their health and well-being. With the awarding of the 2021 Nobel Prize in Physiology or Medicine to David Julius (University of California, San Francisco) and Ardem Patapoutian (Scripps Research, La Jolla, CA) for their work on mechanoreceptors, research on the ability of the chiropractic adjustment to inhibit pain should be refreshed. This physiological relationship was fi rst proposed and shown in the journal Canadian Family Physician by William H. Kirkaldy-Willis in 1985. A review of these concepts will be my chosen presentation at the WAVE in August 2022. On the topic of chiropractic and pain management, randomized clinical trials comparing chiropractic adjusting to nonsteroidal anti-infl ammatory drugs should continue, following those done by Lynton Giles (Spine, 2003) and Reinhold Muller (Journal of Manipulative and Physiological Therapeutics, 2005). With the devastating effects of the opioid epidemic (fl awlessly and compassionately detailed in the 2021 book The Least of Us by Sam Quinones), the infl uence of chiropractic care in reducing the use of these drugs should continue to be detailed and published, as has recently been done by James Whedon (The Journal of Alternative and Complementary Medicine, 2018; Pain Medicine, 2020), and Kelsey Corcoran (Pain Medicine, 2019). Epidemiological assessments quantifying the incredible safety record of chiropractic adjusting pertaining to issues such as disc injury, cauda equina syndrome, vascular injury, etc., should continue to be done and published. And I have a wish list of research that I fi nd quite exciting. Some of these projects are already in progress or have published preliminary data. They include: • The infl uence of chiropractic adjusting on the pregnant patient, specifi cally looking at time spent in labor; • The infl uence of chiropractic adjusting on pediatric neuro-development; • The infl uence of chiropractic adjusting on sports performance; • The infl uence of chiropractic adjusting on workplace performance, injury and work absenteeism; • The infl uence of chiropractic maintenance care on the recurrence of musculoskeletal syndromes and pain; • The infl uence of chiropractic adjusting on telomere length; • The infl uence of chiropractic adjusting on the expression of various genes, including epigenetic infl uences. The excitement of our future is linked to the quality of our research.

THOUGHTS ON

CHIROPRACTIC RESEARCH

Dr. Dan Murphy

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