As our understanding of stress, subluxation, and the effect of chiropractic on the brain grows, it’s a curious thing that research has yet to definitively prove the effect of chiropractic care on mental health (including depression and anxiety). So far, we have seen two clinical trials on the matter, one examining blood pressure and anxiety and the other looking at an individual’s perception of wellbeing. The studies offered up conflicting results. Yet in the broader research world, the link between chronic pain (especially back pain), depression and anxiety is very well documented. A new case study published in the Journal of Contemporary Chiropractic has taken a look at one individuals reduction in anxiety whilst undergoing chiropractic care for vertebral subluxation assessment and correction.
The study is the latest from New Zealand chiropractors David Russell and Tanja Glucina. It covered the case of a 38-year-old female with a “2-year history of low back discomfort, 6-month history of neck pain and a 3-month history of anxiety and panic attacks.” Interestingly, the patient reported that her pain was generally constant but increased in intensity during periods of higher stress.
Using the PHQ-4 instrument, which is regularly used to screen patients for depression and anxiety based on how they have been feeling for the past two weeks, she returned a positive screening for anxiety (which was consistent with her diagnosis from a general physician).
The chiropractor assessed her using a battery of tests including:
- The Health, Wellness and Quality of Life Instrument
- A postural examination
- Spinal Range of Motion
- Surface EMG
- Paraspinal thermography, and
- A multidimensional battery of direct indicators to assess for vertebral subluxation
Her course of chiropractic care set about correcting the vertebral subluxations found (see original report for further details. Link below ). After 12 visits in 7 weeks, during which she received care utilizing the Torque Release Technique, she reported experienced a reduction in pain and discomfort in her neck and back, but interestingly, she also experienced a reduction in depression and anxiety scores. While previously her depression score was 2/6 and her anxiety score was 3/6, the researchers reported that at the end of care:
“Improvements were recorded in both depression and anxiety (individual and combined) using the PHQ-4 screening instrument. Depression was rated as 0 out of 6 and anxiety 0.5 out of 6 at this follow-up screening.”
She had also been assessed using the Health, Wellness and Quality of Life instrument, and the researchers reported:
“Improvements were recorded in all domains of the self- reported HWQL assessment, except QoL. The greatest improvements were reported in her ability to manage stress, which improved from 48% to 78%, and in her physical functioning and mental and emotional evaluations, which increased from 48% to 73% and 50% to 75% respectively .”
The Broader Picture:
While the reality with case reports is that they don’t offer us the power to generalize based on the findings, this one does offer up some interesting points for pondering. First cab off the rank is the fact that it lines up with conventional thinking that neck and low back pain (and especially chronic pain) is linked with depression and anxiety. Here, a reduction in pain was also associated with a reduction in depression and anxiety symptoms.
From this course of care, we can’t tell the mechanism behind this. Nor can we do much but hypothesize how the vertebral subluxations root of “trauma, toxins and stress” may explain why the patients back pain was reported to increase during periods of higher stress. Still, it is an interesting inclusion in the case report.
Dr David Russell, who co-authored the paper, remarked that: “Mental health has become a major issue in society, while chiropractic care is not a treatment for these concerns cases like these do support the idea that a salutogenic model of care can have far reaching benefits to humanity. In this case the chiropractor took the time to use outcome measures to screen the patient that gave a very real result following chiropractic care. Ultimately, in this case, this individual has had a considerable change in their health well beyond the management of back and neck pain”
So far, we know that chiropractic care has an influence on the brain, physical functioning and quality of life. As time marches on, we are gaining more insight into exactly how this occurs. Until we finally reach a verdict on whether or not chiropractic care can indeed be used as part of a management plan for anxiety and depression, this case report offers at least a little evidence that the possibility exists.
You can read the full report, including specific details of the subluxation findings, here.
- Yates G, Lamping D, Abram N, Wright C, (1988), “Effects of chiropractic treatment on blood pressure and anxiety: A randomized controlled trial,” Journal Manipulative and Physiological Therapeutics, 1988;11(6):484-488
- Brockman S (20017), “The role of chiropractic manipulation in promoting an individuals perception of psychological wellbeing,” Journal of Clinical Chiropractic, 2007;10:8-23
- Russell D and Glucina T (2019), “Reduced Anxiety Symptoms in a Patient Screened with the PHQ4 Receiving Chiropractic Care: A Case Report and Review of the Literature,” Journal Contemporary Chiropractic, https://journal.parker.edu/index.php/jcc/article/view/53 retrieved 8 April 2019
- Staff Writer (2019), “Understand the facts: Chronic Pain,” Anxiety and Depression Association of America, https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain, retrieved 8 April 2019