Chiropractic Care for Arthritis

If you’ve had back pain or a stiff neck, whether from arthritis or an injury, you’ve likely considered seeing a chiropractor. While it’s true that chiropractors manipulate or adjust the spine to improve pain and mobility, the benefits may extend beyond the back and neck. By using varying degrees of force in an effort to adjust misaligned joints, chiropractors try to improve the relationship between the spine and nervous system, which they believe may affect the function of all the organs and systems in the body. 

“We are certainly the front-line providers for back pain, but we’re also primary-care professionals who look at and evaluate the whole body,” says Ron Boesch, a chiropractor and professor and director of clinics at Palmer College of Chiropractic in Davenport, Iowa. Chiropractic treatment continues to grow in mainstream medicine. In a 2015 Gallup poll commissioned by the college, 60% of the more than 5,400 people polled believed chiropractic care is an effective treatment for neck and back pain. But what should you expect from a chiropractor visit and is it safe for arthritis? 

What to Expect From a Chiropractor 

If you’re looking for a non-medication way to take the edge off of those painful joints, chiropractic medicine may be for you, as long as you remember to listen to your body.

Most of what chiropractors do today is gentler than cracking backs or popping necks into place. In fact, there are more than 150 techniques that chiropractors use to manually adjust the spine, joints and muscles with varying degrees of force. 

While an athlete with lower back pain may benefit from a high-velocity spinal adjustment, you would receive care specific to your needs and your type of arthritis. A chiropractor may gently manipulate your soft tissue to stop muscle spasms and relieve tenderness. Or she may use active exercises or traction to slowly stretch your joints and increase your range of motion. Your visit may feel like a more hands-on version of physical therapy. 

Chiropractors focus on the relationships between structure and function, explains Robert Hayden, PhD, a spokesperson for the American Chiropractic Association and a chiropractor of 22 years. They are different from an osteopath, who uses manual manipulations but also treats the entire body and may use medication or surgery. 

The thinking is simple, he says. If the structure of a joint is not right, then it can’t work as it was designed. “The place where chiropractic really shines is in maximizing the function of an arthritic joint,” he adds. “Our goal is to restore patients’ function so they can have the kind of life they want.” 

During your first visit, the chiropractor should take a detailed medical history and perform a physical exam of every joint to determine what approaches are right for you. The doctor may also take an X-ray of your spine. 

Is Chiropractic Care Safe for Arthritis? 

If you have back or neck pain due to osteoarthritis, chiropractic is one of the safest therapies you can use, explains Scott Haldeman, MD, a neurologist in Santa Ana, California and Chairman Emeritus of the Research Council for the World Federation of Chiropractic. But if you have an inflammatory disease, like rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis, you are going to need to be more careful.  

If you have active inflammation (due to a flare, for example), a fused spine or osteoporosis in the spine or neck, you shouldn’t be treated with chiropractic therapy. “If a patient has joints with active swelling, I would not recommend going to a chiropractor,” says Alyce Oliver, MD, PhD, assistant professor of rheumatology at the Medical College of Georgia in Augusta. “If you can’t get swelling under control, it would be dangerous to get an adjustment.” 

Dr. Hayden agrees that inflamed joints should be “off-limits,” but notes that chiropractors offer several adjunctive therapies that can help. 

• Ultrasound. Many think of ultrasound as imaging technology, but when applied to soft tissues and joints, sound waves can also produce a massaging effect that helps reduce swelling and decrease pain and stiffness. 
• Electrotherapy. These tiny electric pulses are not painful. They treat soft tissue injuries by stimulating nerves and muscles. 
• Low-level laser or “cold laser.” This technique uses a non-heat-producing laser or light that penetrates deep into the tissue, sometimes reducing inflammation. 
• Infrared sauna. Imagine having a hot compress warm up your joints from the inside. These rooms use controlled amounts of heat to relieve pain and increase circulation. 

Even if they never touch your arthritic joint, David Feschuk, a chiropractor in Stone Mountain, Georgia, says treating the surrounding tissues may significantly reduce overall pain. 

“If someone is having a flare in a knee that is causing him to walk awkwardly, it may lead to a secondary pain syndrome in the lower back. I would not treat an inflamed joint, but if I adjust the pelvis I may be able to reduce overall pain by four to five units on the 1-to-10 pain scale and make daily living activities easier.” 

What Medical Doctors Think 
In the past, chiropractic got mixed reviews from physicians. However, in early 2017, The American College of Physicians released new guidelines. It now supports the use of nonpharmacologic therapies, such as chiropractic and acupuncture, as first-line treatments for low back pain, before using medication. 

Increasingly, studies in mainstream medical journals are demonstrating the benefits of chiropractic for back and joint pain. A 2017 review in the Journal of the American Medical Association, found that spinal manipulation reduces lower back pain. And a 2013 study published in Osteoarthritis and Cartilage found that patient education combined with 12 chiropractic treatments (twice a week for six weeks) were more effective for hip OA than a daily stretching program or patient education alone. Reports from the chiropractor-led spine program at Beth Israel Deaconess Hospital in Plymouth, Massachusetts, are also positive: Most patients with bad backs experience significant pain relief in about five visits. 

But while research shows clear benefits for musculoskeletal pain, namely of the back and neck, its effects beyond pain-relief are not known. And the jury on manual therapy for hip and knee arthritis is still out.  “There is no clear evidence that chiropractic or any other treatment offers long-term change in the X-ray findings in arthritis,” says Dr. Haldeman. 

The bottom line, he says, is chiropractic is worth a try. “However, if any clinician says her treatment will permanently cure your arthritis, you should walk out,” he warns. “If you don’t see improvement within four to 10 treatments, either switch chiropractors or try a new treatment path.” 
For more information, or to find a chiropractor near you, visit: 

• The American Chiropractic Association (ACA) 
• National Institutes of Health  
• The Arthritis Foundation Arthritis Resource Finder