Unravelling functional neurology: does spinal manipulation have an effect on the brain? - a systematic literature review

Chiropractic & Manual Therapies, 2019 · DOI: https://doi.org/10.1186/s12998-019-0265-8 · Published: July 2, 2019

Alternative Medicine Neurology Rehabilitation

Simple Explanation

This systematic review explores the hypothesis that spinal manipulation (SM) can alter brain function and whether these changes relate to clinical improvements. The review examined studies where SM was applied to humans and compared against sham treatments or other controls, focusing on outcomes related to 'brain function'. The review found that while SM seems to induce changes in 'brain function', the inconsistency and unknown clinical relevance of these changes make it premature to consider SM as a brain function treatment.

Study Duration

Not specified

Participants

1514 articles screened, 18 included

Evidence Level

Systematic Review

Key Findings

1
Spinal manipulation appears to cause changes in brain function, but these changes are inconsistent across studies.
2
The clinical significance of these changes in brain function remains unknown.
3
Evidence suggests that SM has the potential to transiently alter somatosensory integration, cerebellar inhibition, and brain area activation related to pain processing.

Research Summary

This systematic review evaluated 18 articles to investigate the effect of spinal manipulation (SM) on 'brain function' and its association with clinical benefits. The review found that SM appears to induce changes in 'brain function', but these changes are inconsistent and their clinical relevance is unknown. The authors conclude that promoting SM as a treatment to improve 'brain function' is premature due to the lack of evidence and inconsistent results.

Practical Implications

Clinical Practice

Clinicians should be cautious about promoting spinal manipulation as a treatment for improving brain function due to limited and inconsistent evidence.

Research

Future studies should focus on symptomatic subjects, relate neurophysiological changes to clinical outcomes, and adhere to rigorous methodological standards.

Education

The chiropractic profession should consider the potential consequences of promoting unproven claims about the effect of spinal manipulation on the brain.

Study Limitations

1
Potential for missed relevant articles due to single author applying eligibility criteria to titles.
2
Statistical methods and results sections in included articles were often difficult to interpret.
3
Heterogeneity in study subjects, outcome variables, and experimental protocols limited comparisons and meta-analyses.

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