Degenerative Joint Disease and Chiropractic

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

Chiropractic Research Results for Degenerative Joint Disease

	Chiropractic And Osteoarthritis University of Maryland Medical Center Web Site Although there is no evidence that chiropractic care can reverse the joint degeneration that causes OA, some studies indicate that spinal manipulation may: increase range of motion  restore normal movement of the spine  relax the muscles  improve joint coordination  reduce pain In fact, a comprehensive review of the scientific literature suggests that chiropractic, especially when combined with glucosamine supplements and rehabilitative stretches and exercise, is an effective supplemental treatment for OA.
	Upper Cervical Manipulation Combined with Mobilization for the Treatment of Atlantoaxial Osteoarthritis: A Report of 10 Cases J Manipulative Physiol Ther. 2011 (Feb); 34 (2): 131–137 ~ FULL TEXT A retrospective case review of 10 patients who were diagnosed with either degenerative or posttraumatic atlantoaxial arthritis based on histories, clinical symptoms, physical examination, and radiographic presentations was conducted at a multidisciplinary integrated clinic that used both chiropractic and orthopedic services. All 10 patients selected for this series were treated with a combination of upper cervical manipulation and mechanical mobilization device therapy. Outcome measures were collected at baseline and at the end of the treatment period. Assessments were measured using patients' self-report of pain using a numeric pain scale (NPS), physical examination, and radiologic changes. Average premanipulative NPS was 8.6 (range, 7–10), which was improved to a mean NPS of 2.6 (range, 0–7) at posttreatment follow-up. Mean rotation of C1–C2 at the end of treatment was improved from 28° (±3.1) to 52° (±4.5). Restoration of joint space was observed in 6 patients.
	Degenerative Changes Following Spinal Fixation in a Small Animal Model J Manipulative Physiol Ther 2004 (Mar); 27 (3): 141–154 ~ FULL TEXT Fixed segments had more degenerative changes than nonfixed segments for all Z joint parameters (ANOVA, P <.0001). Osteophyte formation and ASD were directly dependent on duration of fixation. These findings indicate that fixation (hypomobility) results in time-dependent degenerative changes of the zygapophysial joints.   You may also enjoy reviewing the FCER-funded research project leading to the publication of this article.
	Does Early Joint Trauma Lead to Osteoarthritis? Annals of Internal Medicine 2000 (Sep 5); 133 (5): 321–328 This page describes the increased risk of oateoarthritis following trauma, then reveals that surgery also increases that risk, and goes on to suggest that those risks can be reduced with conservative chiropractic care.
	Electromyographic Analysis of Neck Muscle Fatigue in Patients with Osteoarthritis of the Cervical Spine Spine (Phila Pa 1976) 1994 (Mar 1); 19 (5): 502–506 This indicates a higher fatigue of the anterior and posterior neck muscles associated with arthritic changes of the cervical spine. Rehabilitation programs must consider these muscular changes to obtain optimal outcomes.
	Spinal Manipulation May Help Reduce Spinal Degenerative Joint Disease and Disability Dynamic Chiropractic 1994 (Apr 22); 12 (9) Historically the manipulable joint lesion has, from the beginning of the chiropractic profession, been described as a painful stiff joint. [1, 2] Joint stiffness, commonly called hypomobility (also known in the chiropractic profession as "fixation") has become by consensus one of the most important aspects of the manipulable joint lesion in the professions of chiropractic, osteopathy, and manual medicine. [3, 4] Nearly 100 years of clinical agreement between three separate professions supports the existence of such a lesion although research now supports its existence.
	Effectiveness of Upper Versus Lower Cervical Adjustments with Respect to the Amelioration of Passive Rotational Versus Lateral-flexion End-range Asymmetries in Otherwise Asymptomatic Subjects J Manipulative Physiol Ther 1992 (Feb); 15 (2): 99–105 Goniometric evaluation both prior to, and again within 30 min following treatments revealed that lower cervical adjustments were far more effective for the amelioration of lateral-flexion asymmetries than were upper cervical ones, whereas upper cervical adjustments were found to be more effective for the amelioration of rotational asymmetries than those delivered to the lower cervical region. These results are consistent with the view that passive movement restriction exhibited along the rotational axis is attributable to factors related primarily to the upper cervical region, whereas restrictions of passive movement along the lateral axis are more attributable to factors related to the lower cervical region.
	Immobilization Degeneration & the Fixation Hypothesis of Chiropractic Subluxation: A Review of the Literature Related to the Degeneration of Connective Tissue Following Joint Immobilization: Implications Concerning the Fixation Hypothesis of Chiropractic Subluxations Chiropractic Research Journal 1988; 1 (1): 21–46 ~ FULL TEXT The literature was reviewed concerning the effects of joint immobilization on the degeneration of articular and periarticular connective tissue. Every connective tissue component of an articulation is affected by immobilization, and each major component is discussed individually; these include the articular cartilage, synovium, articular capsule, periarticular ligaments, subchondral bone, the intervertebral disc and the meninges.
	The Accuracy of Manual Diagnosis for Cervical Zygapophysial Joint Pain Syndromes Med J Aust 1988 (Mar 7); 148 (5): 233–236 The manipulative therapist identified correctly all 15 patients with proven symptomatic zygapophysial joints, and specified correctly the segmental level of the symptomatic joint. None of the five patients with asymptomatic joints was misdiagnosed as having symptomatic zygapophysial joints. Thus, manual diagnosis by a trained manipulative therapist can be as accurate as can radiologically-controlled diagnostic blocks in the diagnosis of cervical zygapophysial syndromes.

Other Management Approaches for Degenerative Joint Disease

	The Joint Pain Page A Chiro.Org article collection This page reviews nutritional approaches for the management of arthritic pain, stiffness, and disability.
	Chronic Joint Pain Nutrition Science News (January 1999) ~ FULL TEXT Unlike aspirin and other nonsteroidal, anti-inflammatory drugs commonly recommended for arthritis, natural remedies do more than mask painful symptoms. Antioxidants, fatty acids and enzymes target arthritis where it hurts—by protecting and repairing cartilage and reducing inflammation.
	Reversal of Osteoarthritis by Nutritional Intervention ACA Journal of Chiropractic 1990 (Nov) ~ FULL TEXT Research from rheumatology and orthopedic clinics from Europe on the ability to reverse osteoarthritis has been accumulating for the last 25 years. Based on these results, this article will describe a nutritional program, that in conjunction with standard therapies used for osteoarthritis, can actually reverse the course of osteoarthritis.

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Updated 6-25-2022