Blog Layout

Chiropractic contributes its unique salutogenic health care approach to the emergent COVID-19 crisis

Apr 03, 2020

Chiropractic contributes its unique salutogenic health care approach to the emergent COVID-19 crisis


Amy Haas and Dave Russell


In the face of the current global concerns, it is important to work together as a community to support all possibilities for the optimal health and wellbeing of humanity. Chiropractic care is a unique salutogenic approach to health care that has been shown to improve overall well-being and to enhance physiological function and adaptability. Chiropractic therefore offers a valuable and important contribution in supporting the well-being of our international community at this trying time.


The primary objective of chiropractic care is to optimize health and well-being through the enhancement of nervous system function by reducing nerve interference caused by vertebral subluxations. 1-4  Chiropractic care has been shown to enhance and/or restore nervous system functional integrity including sensorimotor integration, cortical processing, and physiological adaptability. 5-10


Chiropractic care is salutogenic in nature, intended to support the body’s intrinsic processes rather than to “treat” any specific symptom or pathology. To be clear, chiropractic is not a treatment for any infectious disease.


In light of that, it is of note that a small-but-promising body of evidence suggests that chiropractic care may influence and support immune system function. 11-17 Though this evidence is preliminary, these data are of interest to consider in light of the intricate connection between the immune system and the nervous system, a field of quickly emerging research. 12,18-21


The nervous system plays a crucial role in alerting and guiding immune system cells to where an infection is located in an essential and coordinated response to danger. 12,18 Steinman 18 states “There are three types of interactions between the CNS and the immune system: in the first, the CNS acts reciprocally with the immune system; in the second, the CNS drives immunity; and in the third, the immune system regulates the CNS”. The synergy and coordination between the nervous system and the immune system, and of these two systems with the endocrine system and the microbiome 22-29 , suggest that the chiropractic adjustment may have broad-reaching effects on salutogenesis and adaptability via modulation of these coordinated subsystems.


Although the exact nature of the effect(s) of chiropractic care may have on immune system function specifically has certainly not yet been fully described, the beneficial and sustained effects that chiropractic care have on the function of the autonomic nervous system (responsible for organ and gland function) is established and the utility of chiropractic care for promotion of healthy adaptability, resilience, and salutogenesis is clear. Chiropractic care can therefore provide a valuable salutogenic resource for people whose well-being is tested by these stressful times 30-37


While chiropractic care plays an important role in supporting numerous aspects of general wellbeing, 5-11,38-40 it does not, in any way, replace good hygiene and other healthy lifestyle practices or medical intervention for pathology or disease including COVID-19. Additionally, because chiropractors are portal of entry professionals, in the face of the current global pandemic all chiropractors should become very familiar with their local government and WHO guidelines for appropriate hygiene and facilities sanitation procedures as well as the management/referral of people infected with, or potentially infected with COVID-19. These public health regulations are of the highest priority and should be followed for the safety and protection of the rest of the community seen in one’s practice.


Chiropractors have played an important role in the healthcare community. They offer a unique and valuable service not only to their practice community but to other health care providers at the “front lines” as well. Throughout their 125 years of serving humanity, chiropractors stand with fellow healthcare practitioners to do their part to enhance the health and well-being of the global community as it faces this pandemic challenge.


 

References


  1. World Health Organization. WHO guidelines on basic safety and training in chiropractic. Geneva: World Health Organization; 2005.
  2. Haavik H, Holt K, Murphy B. Exploring the neuromodulatory effects of vertebral subluxation and chiropractic care. Chiropr J Australia, 2010; 40(1):37-44.
  3. Russell D. The assessment and correction of vertebral subluxation is central to chiropractic Practice: Is there a gap in the clinical evidence? J Contemporary Chiropr. 2019;2(1):4-17
  4. Glucina TT, Krägeloh CU, Farvid P, Holt K. Moving towards a contemporary chiropractic professional identity. Complementary therapies in clinical practice. 2020;, 39, 101105.
  5. Haavik-Taylor H, Murphy B. Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential study. Clin Neurophysiol, 2007; 118(2):391-402.
  6. Taylor HH, Murphy B. Altered sensorimotor integration with cervical spine manipulation. J Manipulative Physiol Ther, 2008; 31(2):115-126.
  7. Taylor HH, Murphy B. Altered central integration of dual somatosensory input after cervical spine manipulation. J Manipulative Physiol Ther, 2010; 33(3):178-188.
  8. Daligadu J, Haavik H, Yielder PC, Baarbe J, Murphy B. Alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation. J Manipulative Physiol Ther, 2013; 36(8):527-537.
  9. Niazi IK, Turker KS, Flavel S, Kinget M, Duehr J, Haavik H. Changes in H-reflex and V-waves following spinal manipulation. Exp Brain Res, 2015; 233(4):1165-1173.
  10. Lelic D, Niazi IK, Holt K, Jochumsen M, Dremstrup K, Yielder P, Murphy B, Drewes A and Haavik H. Manipulation of dysfunctional spinal joints affects sensorimotor integration in the pre-frontal cortex: a brain source localization study. Neural Plasticity. 2016
  11. Colombi A, Testa M. The effects induced by spinal manipulative therapy on the immune and endocrine systems. Medicina 2019; 53:448
  12. Cohn A. Chiropractic and the Neuroimmune Connection. J Vert Subluxat Res. Sept 30, 2008:1-5
  13. Teodorczyk-Injeyan JA, McGregor M, Ruegg R, Injeyan HS. Interleukin 2-regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropr Osteopat. 2010 Sep 8;18:26.
  14. Teodorczyk-Injeyan JA, Injeyan HS, McGregor M, Harris GM, Ruegg R. Enhancement of in vitro interleukin-2 production in normal subjects following a single spinal manipulative treatment. Chiropr Osteopat. 2008 May 28;16:5
  15. Hightower BC, Pfleger B, Selano J. The Effects of Specific Upper Cervical Adjustments on the CD4 Counts of HIV Positive Patients. Chiropractic Research Journal 1994 ;3(1):32-39
  16. Brennan PC, Kokjohn K, Kaltinger CJ, Lohr GE, Glendening C, Hondras MA, McGregor M, Triano JJ. Enhanced phagocytic cell respiratory burst induced by spinal manipulation: potential role of substance P. J Manipulative Physiol Ther. 1991 Sep;14(7):399-408
  17. Selano JL, Hightower BC, Pfleger B, Feeley-Collins K, Grostic JD. The Effects of Specific Upper Cervical Adjustments on the CD4 Counts of HIV Positive Patients. The Chiro Research Journal. 1994;3(1)
  18. Steinman L. Elaborate interactions between the immune and nervous systems. Nature Immunology. 2004;5(6):575-581
  19. Murray DR, Irwin M, Reardon CA, et al. “Sympathetic and immune interactions during dynamic exercise. Mediation via a beta 2 – adrenergic-dependent mechanism.” Circulation 1992 86(1): 203
  20. Felton DL, Felton SY, Belonged DL, et al. Noradrenergic sympathetic neural interactions with the immune system: structure and function. Immunol Rev. 1987 Dec;100:225-60
  21. Cao BB, Huang Y, Jiang YY, Qiu YH. Cerebellar fastigial nuclear glutamatergic neurons regulate immune function via hypothalamic and sympathetic pathways. J Neuroimmune Pharmacol, 2015; 10(1):162-178.
  22. Taub D. Neuroendocrine interactions in the immune system. Cell Immunol. 2008; 252(1-2): 1-6.
  23. Elenkov IJ, Wilder RL, Chrousos GP, Visi ES. The sympathetic nerve – An integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev 2000; 52(4):595-638.
  24. Pavlov VA, Tracey KJ. The vagus nerve and the inflammatory reflex—linking immunity and metabolism. Nat Rev Endocrinol, 2012; 8(12):743-754.
  25. Ganta CK, Kenney MJ. Autonomic Nervous System and Immune System Interactions. Compr Phys 2014; 4(3): 1177-1200.
  26. Bonaz B, Bazin T, Pellissier S. The vagus nerve at the interface of the microbiota-gut-brain axis. Front. Neurosci. 208; 12, 1-49.
  27. Kovanur Sampath K, Mani R, Cotter JD, Tumilty S. Measurable changes in the neuro-endocrinal mechanism following spinal manipulation. Med Hypotheses. 2015;85(6):819-824.
  28. Rome PL. Neurovertebral influence upon the autonomic nervous system: Some of the Somato-Autonomic Evidence To Date. Part I. Chiropr J Aust 2009;39(1):2-17.
  29. Rome PL. Neurovertebral influence on visceral and ANS function: Some of the Somatovisceral Evidence To Date – Part II Somatovisceral. Chiropr J Aust. 2010;40(1):9-33.
  30. Bakris G, Dickholtz M, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell, B. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Human Hypertens, 2007; 42:1206-1206.
  31. Welch A, Boone R. Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine. J Chiropr Med, 2008; 7(3):86-93.
  32. Haas A, Russell D. Sustained improvement of heart rate variability in patients undergoing a program of chiropractic care: a retrospective case series. Chiro J Austr. 2017;45(4): 338-358.
  33. Winn NN, Jorgensen AM, Chen YS, Haneline MT. Effects of upper and lower cervical spinal manipulative therapy on blood pressure and heart rate variability in volunteers and patients with neck pain: A randomized controlled, cross-over, preliminary study. J Chiropr Med. 2015;14(1):1-9.
  34. Budgell B, Polus B. The effects of thoracic manipulation on heart rate variability: a controlled crossover trial. J Manipulative Physiol Ther, 2006; 29(8):603-610.
  35. Driscoll MD, Hall MJ. Effects of spinal manipulative therapy on autonomic activity and the cardiovascular system: a case study using the electrocardiogram and arterial tonometry. J Manipulative Physiol Ther. 2000;23(8):545-550.
  36. Roy RA, Boucher JP, Comtosis AS. Heart rate variability modulation after manipulation in pain-free patients vs patients in pain. J Manipulative Physiol Ther. 2009;32(4):277-286.
  37. Pickar JG. Neurophysiological effects of spinal manipulation. Spine J. 2002;2(5):357-371.
  38. Holt K, Haavik H, Chi Lun Lee A, Murphy B, Elley R. Effectiveness of chiropractic care to improve sensorimotor function associated with falls risk in older people: A randomized controlled trial. J Manipulative Physiol Ther 2016; 39(4): p. 267-278.
  39. Blanks R, Schuster T, Dobson M. A retrospective assessment of network care using a survey of self-rated health, wellness and quality of life. J Vertebral Subluxation Res 1997; 1:15–27
  40. Marino M, Langrell P. Longitudinal assessment of chiropractic care using a survey of self-rated health, wellness and quality of life: a preliminary study. J Vertebral Subluxation Res 1999; 3:1–9
Share by: