by Casey Chan, DC, QME
Today my patient asked me whether it becomes harmful or dangerous to use chiropractic as she gets older. She was particularly concerned about the arthritis she had in her spine. Like all forms of healthcare, there are benefits, risks and contraindications to chiropractic manipulation with patients with arthritis. If necessary there are treatment options that I can use to help her with the pain and stiffness she feels from daily stresses.
Benefits
You may have heard the saying that exercise is important for arthritis. This is because movement is important for the health and nutrition of joints. Chiropractic manipulation does the same for the health and nutrition of joints. A chiropractic manipulation is a low-amplitude high-velocity thrust into a specific, restricted, misaligned or stiff joint to induce movement into the joint. Stimulation of joint and muscle receptors through chiropractic manipulation also helps to reduce pain and muscle spasm/tension.
Risks
The caveat to both exercise and chiropractic manipulation, however, is that they both pose some risks. It is possible to sprain you hip while jogging or while overstretching. An improperly performed chiropractic manipulation may also cause a strain to your back muscles.
There are other risks to chiropractic manipulation to the arthritic and elderly patient. In the case of moderate to severe arthritis, it is possible that a forceful manipulation can fracture bone spurs. Elderly with osteoporosis are also at risk of fracture with manipulation. If disc herniation is associated with the arthritis, chiropractic may be helpful or harmful depending on the severity of the herniation. Moderate and severe disc herniations often require gentler forms of treatment.
Treatment Options
Every patient must be assessed individually to properly apply appropriate treatments that will be most beneficial while reducing the risks related to that treatment.
There are alternatives to chiropractic manipulation for the care of arthritis. This includes drop-table forms of chiropractic manipulation, joint mobilization (a gentle stretching movement to the joint), therapeutic massage, electrical stimulation (to reduce muscle tension, spasm and pain), rehabilitative exercise, and the use of an Activator instrument to stimulate joint receptors.
In contrast to the manually performed chiropractic manipulation, the drop table form of manipulation uses the design of the table to minimize the force applied to the patient. The speed of the manipulation tends to increase when the table underneath the patient drops.
An Activator instrument is a triggered device that is used to tap at specific joints to stimulate joints. Joint receptors are stimulated, causing the joint to loosen up and decreased pain. Because of the low-force of the Activator, there is low risk of injury to patients with conditions such as severe arthritis or osteoporosis.
Conclusion
I have many elderly patients, several of them older than 80 years old! A few of them are female and of petite build. I have to care for them individually using different treatment techniques depending on their condition. Many patients are helped with skillfully applied chiropractic manipulation, causing no pain. For those who have contraindications to chiropractic manipulation, there are options that I use within our clinic. Activator or drop table forms of manipulation may be used as may joint mobilization, therapeutic massage, rehabilitative exercise, electrical stimulation. The ultimate goal in caring for elderly patients is to maximize benefits and minimize risks to help our patients live a long, happy and healthy life.
