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42184199_sDizziness and imbalance are amongst the most common complaints in older people, and are a growing public health concern since they put older people at a significantly higher risk of falling. A recent study explored the role of chiropractic in the treatment of dizziness/balance disorders through analysis of data from the 2008 National Health Interview Survey (the only year that included a subset of questions about balance and dizziness).  Questions were asked about dizziness, balance and  accompanying health conditions as well as their perceived causes and effects of the dizziness or balance problem. The survey data queried whether people were helped by a variety of practitioners, including chiropractors.   Balance or dizziness problems were reported by 11% of all respondents.  The reported prevalence was 35% for those aged 65 or older.  The authors found that although a small proportion (4.2%) sought chiropractic care for balance and dizziness, those who did were very likely to report that it had helped (OR, 1.73). For those in whom the cause of their balance or dizziness problem was head or neck trauma, the odds ratio for perceiving that they had been helped by a chiropractor was 9.5, compared with OR 0.53 for medical physicians. For those respondents aged 65 years and older, and for those reporting the cause of their balance and dizziness were trauma or neurological or musculoskeletal issues, the OR was even higher (OR, 13.78).

Reference:
Ndetan H, Hawk C, Sekhon VK, Chiusano M. The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data. J Evid Based Complementary Altern Med. 2016 Apr;21(2):138-42. doi: 10.1177/2156587215604974. Epub 2015 Sep 11. PubMed PMID: 26362851.

Episode

Drs. Cindy Peterson and Kim Humphreys

Drs. Cindy Peterson and Kim Humphreys join me to talk about cervical and lumbar disc herniation comparative effectiveness studies involving spinal manipulation compared to nerve root injections. We also discuss spinal manipulation for neck pain with and without dizziness as well as for chronic low back pain.

Cynthia Peterson, RN, DC, DACBR, M.Med.Ed. has worked as a chiropractic radiologist, researcher and educator in 4 countries.  She retired from her positions as Professor and researcher, Radiology Department, Orthopaedic University hospital Balgrist and Professor, Chiropractic Medicine Programme, University of Zürich in 2017. Dr. Peterson has published numerous research studies in many journals including ‘Spine’, European Spine Journal, ‘American Journal of Roentgenology’, ‘JMPT’ and ‘Skeletal Radiology’.  She is currently a Visiting Professor for the Chiropractic Department in the Faculty of Health at the University of Johannesburg, South Africa and is the Quality Assurance Consultant for the European Council on Chiropractic Education.

Barry Kim Humphreys, BSc, DC, PhD, is Professor Emeritus, Faculty of Medicine, University of Zurich. He retired in July 2017, after 9 years as the first Professor for Chiropractic Medicine in Switzerland. During this time, Professor Humphreys was responsible for the development and accreditations of the chiropractic education program, research portfolio and teaching clinic within the university, medical faculty and teaching hospital. Professor Humphreys is a graduate of the University of British Columbia (BSc), Canadian Memorial Chiropractic College (DC), and the University of Southampton, UK (PhD). He has been Academic Dean, Anglo-European College of Chiropractic, Dean of Graduate Education and Research, CMCC and Professor, Chiropractic Medicine, University of Zurich. He has been active in research including chiropractic clinical outcome studies for back and neck pain, functional MRI studies of chronic pain patients and back pain in various gravitational environments (parabolic flight).

Please view Drs. Cindy Peterson and Kim Humphreys research at researchgate.net (Peterson) as well as at researchgate.net (Humphreys).

View all of the podcast episodes at chiropracticscience.com

Here are the articles we discuss in this episode:

1. Symptomatic, Magnetic Resonance Imaging-Confirmed Cervical Disk Herniation Patients: A Comparative-Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy.
  Peterson CK, Pfirrmann CW, Hodler J, Leemann S, Schmid C, Anklin B, Humphreys BK.
  J Manipulative Physiol Ther. 2016 Mar-Apr;39(3):210-7. doi: 10.1016/j.jmpt.2016.02.004. Epub 2016 Mar 31.
  PMID: 27040033 [PubMed – indexed for MEDLINE]
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2. Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections.
  Peterson CK, Leemann S, Lechmann M, Pfirrmann CW, Hodler J, Humphreys BK.
  J Manipulative Physiol Ther. 2013 May;36(4):218-25. doi: 10.1016/j.jmpt.2013.04.005. Epub 2013 May 22.
  PMID: 23706678 [PubMed – indexed for MEDLINE]
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3. Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up.
  Humphreys BK, Peterson C.
  Chiropr Man Therap. 2013 Jan 7;21(1):3. doi: 10.1186/2045-709X-21-3.
  PMID: 23295018 [PubMed] Free PMC Article
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4. An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment.
  Wirth B, Riner F, Peterson C, Humphreys BK, Farshad M, Becker S, Schweinhardt P.
  Chiropr Man Therap. 2019 Feb 5;27:6. doi: 10.1186/s12998-018-0225-8. eCollection 2019.
  PMID: 30766664 [PubMed – indexed for MEDLINE] Free PMC Article
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