A 45-year-old runner walks into a chiropractic office with pain in her hip. She’s been diagnosed with bursitis and tendinitis and wants to manage her pain. She recently began running longer distances, and due to changes at work, she spends more time sitting. The two factors have exacerbated injuries to the tissues in her hip.

This is a textbook example of inflammation – the body’s natural way of protecting itself. Chiropractors manage inflammation the same way they manage pain – by looking for the cause and identifying ways to manage symptoms. “My concern in this case is that the patient’s inflammation is a result of poor biomechanics or poor ergonomics,” says Dr. Ken Budgell, a chiropractor in St. John’s, Newfoundland. “When this happens, I work to understand the likely cause and remove or minimize it.” Chiropractic treatment for inflammation can include increasing flexibility and strength, adjusting form, and increasing the body’s resilience to workday stressors. For example, in the case of the 45-year-old runner, Dr. Budgell’s recommendation was to reduce the distance she was running every day, as well as her sitting time at work. He manually treated the injured muscles in her hip and introduced hip strengthening exercises. After four weeks, her pain had decreased, and she was back on track to her fitness goals.

“This type of inflammation has a mechanical source,” explains Dr. Budgell. “You can use ice, creams and medications, but that doesn’t change the mechanical load on the body. You can’t easily change a mechanical problem with a chemical solution. Increasing her hip strength to smoothly absorb each step meant safer loading on those tendons, less damage and less inflammation.”

Manual chiropractic treatments for inflammation Chiropractors start by looking for swelling, redness, heat, pain, and sometimes loss of function (such as difficulty walking) in these cases. Treatment options they could recommend could include one or more of the following:

• Low intensity ultrasound, which can have a powerful anti-inflammatory effect on joints.

• TENS (transcuatenous electrical nerve stimulation), which involves applying a low strength electrical current to a particular area to relieve acute and chronic pain such as osteoarthritis.

• Spinal manipulation, which can reduce inflammation in the joints of the spine that may cause back pain. If the inflammation comes from an underlying condition such as rheumatoid arthritis or psoriasis, a chiropractor will write a referral to a family doctor, a rheumatologist or other specialist. While chiropractors are trained to recognize the signs and symptoms of these conditions, it is outside their scope of practice to diagnose them. However, once diagnosed, a chiropractor can help manage pain or disability that may result from such inflammatory conditions.

References:

1. Chung, J.-I., et al. “Anti-Inflammatory Effect of Low Intensity Ultrasound (LIUS) on Complete Freund’s Adjuvant-Induced Arthritis Synovium.” Osteoarthritis and Cartilage, W.B. Saunders, 24 Jan. 2012,

2. Vance, C. G. T., et al. “Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pain Sensitivity, and Function in People with Knee Osteoarthritis: A Randomized Controlled Trial.” Physical Therapy, vol. 92, no. 7, 2012, pp. 898–910., doi:10.2522/ptj.20110183.

3. Teodorczyk-Injeyan JA, Injeyan HS, Ruegg R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulative Physiol Ther. 2006 Jan;29(1):14-21.

4. Beavers, K. M., Brinkley, T. E., & Nicklas, B. J. (2010). Effect of exercise training on chronic inflammation. Clinica chimica acta; international journal of clinical chemistry, 411(11-12), 785–793. doi:10.1016/j.cca.2010.02.06

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