Research on the Benefits of Chiropractic Care in Laguna Beach

Chiropractic Laguna Beach CA Research On Chiropractic Care

Why is Chiropractic important and what are its benefits?

  • The Spinal Cord is the organizer of disease processes (Korr, 1976)
    • an alteration in a segment or area of the spine negatively affects the nervous system function.
  • Chiropractic is Effective in the Treatment of Low Back and Neck Pain in Laguna Beach
    • “The effectiveness of spinal manipulation in the treatment of acute and chronic low back and neck pain has been well established by outcome-based research.” (Haavik- Taylor & Murphy, 2007)
  • Movement is Vital for Proper Brain Function
    • Norman Doidge, MD wrote “The Brain’s Way of Healing: Remarkable Discoveries and Rediscoveries from the Frontiers of Neuroplasticity. ” in 2015, in which he wrote:
      • “As people become immobile, they see less, hear less, and process less information, and their brains begin to atrophy from the lack of stimulation.”
      • “The neuroplastic systems require physical movement to generate new cells and nerve growth factor.”
  • Chiropractic Care Supports Improved Immunity
    • A 2011 study in the Journal of Osteopathic Association found that "Spinal adjustment increases IgA by 139% increasing immunity, decrease risk of infections." IgA is a specific immune system protein vital for immune function.
    • A 2010 study in the Chiropractic and Osteopathy Journal found that "Those who received an adjustment had significantly higher IgG and IgM levels post adjustment compared to control groups." These markers signify increased immunity. It also showed that patients who received chiropractic adjustments showed increased levels of interlaken-2 which regulates the activities of white blood cells.
    • During the Spanish Flu in 1917 and 1918 those who got adjustments and chiropractic care had a much higher survival rate than those who were under medical care. In the state of Iowa, medical doctors treated 93,590 patients with 6,116 deaths (a loss of one patient out of every 15. In the same state, excluding Davenport, 4,735 patients were treated by chiropractors with a loss of only 6 cases- (a loss of one patient out of every 789). The numbers reveal that for influenza, out of 10,000 cases treated under medical care, there were 950 deaths, and out of 10,000 cases treated under drugless methods, there were only 25 deaths. (see article)
    • Ronald Pero, Ph. D, chief of cancer prevention research at New York’s Preventative Medicine Institute and professor of medicine in Environmental Health at New York University did a study in 1986 comparing the effect of hazardous environmental chemicals on people receiving chiropractic care, versus healthy people, versus cancer patients. He measured 107 individuals who had received long-term chiropractic care. He found that the chiropractic patients had 200 percent greater immune-competence than people who had not received chiropractic, and 400 percent greater immune-competence than people with cancer or other serious diseases. (see article)
    • In 2014, researchers at The University of Madrid Medical School and the Department of Health Sciences at the University of Jaen Spain found a link between chiropractic adjustments and the immune system. The study found that the mechanical stimulus provided by spinal manipulation triggers an increase in neurotensin, oxytocin, and cortisol blood levels. All of these have a direct effect on immune modulation and regulation. (Plaza-Manzano, et. al.)

BENEFITS OF CHIROPRACTIC ADJUSTMENTS & CARE in Laguna Beach

  • Turns down pain
    • (Ogura, T et al., 2011) (Haavik-Taylor & Murphy, 2007) (Muller & Giles, 2005) (Vicenzine, Collins, & Wright, 1996)
  • Decreases muscle spasm
    • ( DeVocht, Pickar, & Wilder, 2005)
  • Decreases Low Back and Neck Pain
    • (Bronfort et al., 2012) (Hanelinea & Coopersteinc, 2009) (Hass, Sharma, & Stano, 2005)
  • Helps break up adhesions in the muscles
    • (Cramer et al., 2010)
  • Improves Central Nervous System Function
    • (Harrison, Cailliet, Harrison,Troyanovich, & Harrison, 1999)
  • Alters spinal cord reflex excitability (Haavik-Taylor & Murphy, 2007)
  • Alters sensory processing (Haavik-Taylor & Murphy, 2007)
  • Alters motor excitability (Haavik-Taylor & Murphy, 2007)
  • Improves Immune Function
    • (an increasing body of evidence shows the benefit of chiropractic care on immune function) (Plaza-Manzano, G., Molina-Ortega, F., Lomas-Vega, R., Martinez-Amat, A., Achalandabaso, A., & Hita-Contreras, F., 2014) (Saggio, G., Docimo, S., Pilc, J., Norton, J., & Gilliar, W. 2011) (Teodorczyk-Injeyan, J. A., McGregor, M., Ruegg, R., & Injeyan, H. S. 2010) (Brennan et at., 1991) (Brennan, Tiano, McGregor, Kokjohn, Hondras, & Brennan, 1992) (Nansel & Szlazak, 1993) (Fidelibus, 1989) (Vernon, Dhami, Howley, & Annett, 1986) (Cohn, 2008) (Allen, 1993) (Budgell, 2000) (Teodorczyk-Injeyan, Injeyan, & Ruegg, 2006) (Boone, Oswald, Holt, Beck, Singh, & Ashton, 2005) (Muller, & Giles, 2005)
  • Suppress the sympathetic nervous system (fight or flight response)
    • (Ogura, Tashiro, Masud, Watanuki, & Shibuya, 2011)
  • Improves muscle strength
    • (Unger, 1998) (Schwartzbauer et al., 1997) (Smith & Cox, 2000)
  • Improves mechanical function
    • (Taylor, 2011)
  • Decreases Inflammation in the Body
    • (Roy, Boucher, & Comtois, 2010) (Teodorczyk-Injeyan, Injeyan, & Ruegg, 2006)
  • Benefits Injury Relief (Kessinger & Boneva, 2000) (Alacantara & Kleijan, 2008)
  • Improves Brain Function/Helps with Neurological Conditions
    • (Alcantara & Anderson, 2008) (Pistolese, 2001)(Ogura, Tashiro, Masud, Watanuki & Shibuya, 2011) (Carrick, 1997) (Risley, 1995) (Goff, 1987)
  • Improves Digestion
    • (Including irritable Bowel Syndrome, Constipation, Crohn’s Disease) (Furness, Callaghan, Rivera, & Cho, 2014) (Qu, Xing, Norman, Chen, & Gao, 2012) (Alcantara & Mayer, 2008) (Takeda, Arai, Touichi, & Mieda, 2003)
  • Diminishes Acid Reflux
    • (Ferranti, Alcantara, & Reilly, 2016)
  • Benefits Heart Health: Improves Heart Rate Variability & Organ Health
    • (Zhang, Dean, Nosco, Strathopulous, & Floros, 2006)
  • Alters spinal cord reflex excitability (Haavik-Taylor & Murphy, 2007)
  • Alters sensory processing (Haavik-Taylor & Murphy, 2007)
  • Alters motor excitability (Haavik-Taylor & Murphy, 2007)

CHIROPRACTIC HELPS WITH THE FOLLOWING SYMPTOMS:

  • Sciatica
    • (Santilli, Beghi, & Finucci, 2006)
  • Headaches
    • (Moore, Adams, Leaver, Lauche, & Sibbritt, 2017) (Edwards & Alcantara, 2017) (Tuchin, 1997)
  • High Blood Pressure
    • (Klotter, 2007) (Joel Alcantara, D. C. Resolution of Hypertension in a 72-Year-Old Male Following Subluxation Based Chiropractic Care: A Case Report & Selective Review of the Literature) (*more studies need to be done for further evidence) (Bakris et al., 2007) (Edwards, S. Deuchars, & J Deuchars, 2009)
  • Insomnia
    • (Jamison, 2005)
  • Frozen shoulder
    • (Murphy, Hall, D’amico, & Jensen, 2012)
  • Elbow Pain
    • (Vicenzine, Collins, & Wright, 1996)
  • Colic, Acid Reflux and Ear Infections in Children
    • (Alcantara, Alcantara, & Alcantara, 2011)
  • Child Bed-Wetting
    • (Reed, Beavers, Reddy, & Kern, 1994)

Chiropractic has also been known to:

  • Improve blood flow
  • Improve lymphatic flow
  • Restore Posture
  • Improve Organ function
  • Stimulate the release of joint lubricants
  • Improve cerebral spinal fluid flow
  • Stimulate cartilage stem cells called chondrocytes
  • Release the body’s own anti-inflammatory mechanisms

CHIROPRACTIC IN COMPARISON TO OTHER THERAPIES

  • Chiropractic found to be more beneficial than other treatments for low back pain
    • Study 1: Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation (Muller & Giles, 2003)
      • The highest proportion of early (asymptomatic status) recovery was found for manipulation (27.3%), followed by acupuncture (9.4%). And medication (5%).
      • Manipulation achieved the best overall results, with improvements of 50% on the Oswestry scale.
      • Source: Murphy
    • Study 2: Follow-up of a randomized clinical trial assessing the efficacy of medication, acupuncture, and spinal manipulation for chronic mechanical spinal pain syndromes (Muller & Giles, 2005)
      • Study found that in the one-year follow-up of the patients who had received different treatments of chronic spine pain, 5 to 7 of those with specific chiropractic manipulation had a statistically significant improvement, compared with only 1 improvement outcome in both the acupuncture and drug groups. In addition, drugs did not achieve an improvement in chronic spinal pain.
      • Spinal manipulation proved to provide the highest satisfaction and improvement when compared to drugs or acupuncture.
      • Source: Murphy
    • Study 3: Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study (Nyiendo, Haas, & Goodwin, 2000)
      • “Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”

ADDITIONAL STUDIES:

  • Study 1: Mechanobiology and diseases of mechanotransduction. (Ingber, 2003)
    • “Mechanical forces are critical regulators of cellular biochemistry and gene expression as well as tissue development.”
  • Study 2: Cervical Spine manipulation alters sensorimotor integration: A somatosensory evoked potential study (Haavik-Taylor & Murphy, 2007)
    • Spinal manipulation of dysfunctional cervical joints can lead to transient cortical plastic changes.
    • Evidence Indicates that spinal manipulation does the following:
    • Alters spinal cord reflex excitability
    • Alters sensory processing
    • Alters motor excitability
    • Spinal dysfunction effects central neural processing, as follows:
    • Spinal dysfunction will alter afferent input to the central nervous system
    • Altered afferent input to the central nervous system leads to plastic changes
    • Neural plastic changes take place both following increased and decreased afferent input
    • Altered afferent input from joints leads to both inhibition and facilitation of neural input to related muscles
    • Both painful and painless joint dysfunction will inhibit surrounding muscles
    • Source: Murphy
  • Study 3: The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. (Vicenzine, Collins, & Wright, 1996)
    • “The [manipulative] treatment technique used in this study provided a non-noxious sensory input at the cervical spine which resulted in a reduction of elbow pain that outlasted the duration of its application.”
  • Study 4: Pathophysiological model for chronic low back pain integrative connective tissue and nervous system mechanisms. (Langevin & Sherman, 2007).
    • Movement is necessary in the process of rehabilitation
    • “Rest may be initially important in the face of acute low back injury (e.g. disc herniation, muscle sprain), it Is increasingly recognized that timely resumption of of physical activity is critical to successful rehabilitation.”
    • “Fibrosis can be the direct result of hypomobility of the indirect result of hypermobility via injury and inflammation.”
    • “A carefully applied direct tissue stretch may be necessary in cases of long standing hypomobility with pronounced fibrosis and stiffness.” (Adjustment may be considered to be a “carefully applied direct tissue stretch”)
    • In patients with chronic low back pain, connective tissue fibrosis can occur in the low back due to one or several of the following factors:
      • Decreased activity
      • Changes in muscle activation patterns causing muscle co-contraction, muscle spasm or tissue microtrauma\
      • Neurally-mediated inflammation
      • Pain leads to reduced motion, and movement restriction increases fibrosis, “setting the patient up for more painful episodes.”
    • Source: Murphy

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REFERENCES:

Alcantara, J., Alcantara, J. D., & Alcantara, J. (2011). The chiropractic care of infants with colic: a systematic review of the literature. Explore: The Journal of Science and Healing, 7(3), 168-174.

Alcantara, J., & Kleija, M. (2008). Chiropractic Care of a Pediatric Patient with Foot Pain & Vertebral Subluxations Following a Fall. Journal of Vertebral Subluxation Research ~ August 11, 2008, Pgs. 1-6.

Alcantara, J. Resolution of Hypertension in a 72-Year-Old Male Following Subluxation Based Chiropractic Care: A Case Report & Selective Review of the Literature.

Alcantara, J., & Anderson, R. (2008). Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin. The Journal of the Canadian Chiropractic Association, 52(4), 248.

Alcantara, J., & Mayer, D. M. (2008). The successful chiropractic care of pediatric patients with chronic constipation: a case series and selective review of the literature. Clinical Chiropractic, 11(3), 138-147.

Allen, J. M. (1993). The effects of chiropractic on the immune system: a review of the literature. Chiropractic Journal of Australia, 23, 132-135.

Boone, W. R., Oswald, P., Holt, K., Beck, R., Singh, K., & Ashton, A. (2005). Physical, physiological, and immune status changes, coupled with self-perceptions of health and quality of life, in subjects receiving chiropractic care: a pilot study. JOURNAL OF CHIROPRACTIC EDUCATION, 19(1), 46.

Budgell, B., Congress, C., & June, D. C. (2000). The Reflex Effects of Subluxation: The Autonomic Nervous System. J Manipulative Physiol Ther, 23(2), 104-106

Brennan, P. C., Kokjohn, K., Kaltinger, C. J., Lohr, G. E., Glendening, C., Hondras, M. A., ... & Triano, J. J. (1991). Enhanced phagocytic cell respiratory burst induced by spinal manipulation: potential role of substance P. Journal of manipulative and physiological therapeutics, 14(7), 399-408.

Brennan, P. C., Triano, J. J., McGregor, M., Kokjohn, K., Hondras, M. A., & Brennan, D. C. (1992). Enhanced neutrophil respiratory burst as a biological marker for manipulation forces: duration of the effect and association with substance P and tumor necrosis factor. Journal of manipulative and physiological therapeutics, 15(2), 83-89.

Bronfort, G., Evans, R., Anderson, A.V., Svendsen, K.H., Bracha, Y., & Grimm, R.H. (2012). Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain: A Randomized Trial. Ann Intern Med, 156: 1-10. doi: 10.7326/0003-4819-156-1-201201030-00002

Carrick, F. R. (1997). Changes in brain function after manipulation of the cervical spine. Journal of manipulative and physiological therapeutics, 20(8), 529-545.

Cramer, G.D., Henderson, C.N.R., Little, J.W., Daley, c., Grieve, T.J. (2010). Zygapophyseal Joint Adhesions After Induced Hypomobility. Journal of Manipulative & Physiological Therapeutics, 33(7): 508-518.

Cohen, R. et al. (2016) Mobility and Upright Posture Are Associated with Different Aspects of Cognition in Older Adults. Frontiers in Aging Neuroscience 8(257).

Cohn, A. (2008). Chiropractic and the Neuroimmune Connection. Journal of Vertebral Subluxation Research, Pages 1-5.

DeVocht, J. W., Pickar, J. G., & Wilder, D. G. (2005). Spinal manipulation alters electromyographic activity of paraspinal muscles: A descriptive study. Journal of Manipulative and Physiologic Therapeutics, 28(7), 465-471.

Doidge, N. (2015). The Brain’s Way of Healing: Remarkable Discoveries and Rediscoveries from the Frontiers of Neuroplasticity.

Edwards, J., & Alcantara, J. (2017). THE CARE OF A PREGNANT PATIENT WITH TRIPLETS: A CHIROPRACTOR'S EXPERIENCE. Chiropractic Journal of Australia, 45(4).

Ferranti, M., Alcantara, J., & Reilly, A. (2016) Resolution of GERD in an Infant Following Chiropractic Care: A Case Report & Selective Review of the Literature. Journal of Pediatric, Maternal, & Family Health, 2, 46-49.

Fidelibus, J. C. (1989). An overview of neuroimmunomodulation and a possible correlation with musculoskeletal system function. Journal of manipulative and physiological therapeutics, 12(4), 289-292.

Furness, J. B., Callaghan, B. P., Rivera, L. R., & Cho, H. J. (2014). The enteric nervous system and gastrointestinal innervation: integrated local and central control. In Microbial endocrinology: The microbiota-gut-brain axis in health and disease (pp. 39-71). Springer, New York, NY.

Goff, P. J. (1987, August). Chiropractic treatment of mental illness: a review of theory and practice. In Research Forum(Vol. 4, No. 1, pp. 4-10).

Haas, M., Sharma, R., & Stano, M. (2005) Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain. Journal of Manipulative & Physioliological Therapeutics, 28(8):555-63.

Haavik-Taylor, H. & Murphy, B. (2007) Cervical spine manipulation alters sensorimotor integration: A somatosensory evoked potential study. Clinical Neurophysiology, 118(2): 391-402.
http://www.clinph-journal.com/article/S1388-2457(06)01441-6/abstract

Harrison, D. E., Cailliet, R., Harrison, D. D., Troyanovich, S. J., & Harrison, S. O. (1999). A review of biomechanics of the central nervous system—Part I: Spinal canal deformations resulting from changes in posture. Journal of Manipulative & Physiological Therapeutics, 22(4), 227-234.

Harrison, D.E., Cailliet, R., Harrison, D.D., Troyanovich, S.J., & Harrison, S.O. (1999). A Review of Biomechanics of the Central Nervous System. PART II: Strains in the Spinal Cord from Postural Loads. Journal of Manipulative & Physiological Therapeutics, 22(5), 322-332.

Harrison, D. E., Cailliet, R., Harrison, D. D., Troyanovich, S. J., & Harrison, S. O. (1999). A review of biomechanics of the central nervous system—Part III: spinal cord stresses from postural loads and their neurologic effects. Journal of Manipulative & Physiological Therapeutics, 22(6), 399-410.

Hanelinea, M.T., & Coopersteinc, R. (2009). Chiropractic care for patients with acute neck pain: results of a pragmatic pactive-based feasibility study. Journal of Chiropractic Medicine, 8(4): 143–155.

Ingber, D. (2003). Mechanobiology and diseases of mechanotransduction. Annals of medicine, 35(8), 564-577.

Jamison, J. R. (2005). Insomnia: does chiropractic help?. Journal of Manipulative & Physiological Therapeutics, 28(3), 179-186.

Kado, D. M., Huang, M. H., Karlamangla, A. S., Barrett‐Connor, E., & Greendale, G. A. (2004). Hyperkyphotic posture predicts mortality in older community‐dwelling men and women: a prospective study. Journal of the American Geriatrics Society, 52(10), 1662-1667.

Kessinger, R. C., & Boneva, D. V. (2000). Case study: acceleration/deceleration injury with angular kyphosis. Journal of Manipulative & Physiological Therapeutics, 23(4), 279-287.

Klotter, J. (2007). Chiropractic and high blood pressure. Townsend Letter: The Examiner of Alternative Medicine, (292), 39-40.

Korr, I.M. (1976). The spinal cord as organizer of disease processes: some preliminary perspectives. The Journal of the American Osteopathic Association, 76(1): 35-45.

Langevin, H.M., & Sherman, K.J. (2007). Pathophysiological model for chronic low back pain integrative connective tissue and nervous system mechanisms. Medical Hypotheses, 68(1), 74-80.

Moore, C., Adams, J., Leaver, A., Lauche, R., & Sibbritt, D.(2017). The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors. BMC Complement Altern Med,17(1):519. doi: 10.1186/s12906-017-2026-3.

Muller, R., & Giles, L. G. F. (2005). Follow-Up of a Randomized Clinical Trial Assessing the Efficacy of Medication, Acupuncture, and Spinal Manipulation for Chronic Mechanical Spinal Pain Syndromes. Journal of Manipulative and Physiological Therapeutics, 28(1).

Murphy, F. X., Hall, M. W., D'amico, L., & Jensen, A. M. (2012). Chiropractic management of frozen shoulder syndrome using a novel technique: a retrospective case series of 50 patients. Journal of chiropractic medicine, 11(4), 267-272.

Nansel, D., & Szlazak, M. (1993). Enhanced phagocytic cell respiratory burst induced by spinal manipulation potential role of substance P (and) enhanced neutrophil respiratory burst as a biological marker for manipulation forces duration of the effect and association with substance P and tumor necrosis factor. Journal of manipulative and physiological therapeutics, 16(7), 505.

Nyiendo, J., Haas, M., & Goodwin, P. (2000). Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study. Journal of Manipulative & Physiological Therapeutics, 23(4), 239-245.

Ogura, T., Tashiro, M., Masud, m. Watanuki s., & Shibuya, K. (2011). Cerebral metabolic changes in men after chiropractic spinal manipulation. Alternative Therapies Health Medicine, 17(6):12-7.)https://search.proquest.com/openview/55a361b1107e3fb891a6a2622d69a887/1?pq-origsite=gscholar&cbl=32528

Pistolese, R. A. (2001). Epilepsy and seizure disorders: a review of literature relative to chiropractic care of children. Journal of Manipulative & Physiological Therapeutics, 24(3), 199-205.

Plaza-Manzano, G., Molina-Ortega, F., Lomas-Vega, R., Martinez-Amat, A., Achalandabaso, A., & Hita-Contreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. Journal of Orthopedic and Sports Physical Therapy, 44(4), 231-239.

Qu, L., Xing, L., Norman, W., Chen, H., & Gao, S. (2012). Irritable bowel syndrome treated by traditional Chinese spinal orthopedic manipulation. Journal of Traditional Chinese Medicine, 32(4), 565-570.

Reed, W. R., Beavers, S., Reddy, S. K., & Kern, G. (1994). Chiropractic management of primary nocturnal enuresis. Journal of manipulative and physiological therapeutics, 17(9), 596-600.
Risley, W.B. (1995). Impaired Arterial Blood Flow to the Brain as a Result of a Cervical Subluxation: A Clinical Report. Journal American Chiropractic Assoc June 1995. pp. 61-63.

Roy, R. A., Boucher, J. P., & Comtois, A. S. (2010). Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain. Journal of Chiropractic Medicine, 9(3), 107-114.

Saggio, G., Docimo, S., Pilc, J., Norton, J., & Gilliar, W. (2011). Impact of osteopathic manipulative treatment on secretory immunoglobulin a levels in a stressed population. Journal of the American Osteopathic Association, 111(3), 143.

Santilli V, Beghi E, & Finucci S (2006). Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine Journal, 6(2):131-7.

Schwartzbauer J, Kolber J, et al. (1997). Athletic performance and physiological measures in baseball players following upper cervical chiropractic care: a pilot study. Journal of Vertebral Subluxation Research, 1(4): 33-39.

Takeda, Y., Arai, S., Touichi, H., & Mieda, T. (2003). Long term remission and alleviation of symptoms in allergy and Crohn's disease patients following spinal adjustment for reduction of vertebral subluxations. JVSR, 4(4).

Taylor, D.N. (2011). A theoretical basis for maintenance spinal manipulative therapy for the chiropractic profession. Journal of Chiropractic Humanities, 18(1): 74-85.

Teodorczyk-Injeyan, J. A., McGregor, M., Ruegg, R., & Injeyan, H. S. (2010). Interleukin 2-regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropractic & osteopathy, 18(1), 26.

Teodorczyk-Injeyan, J. A., Injeyan, H. S., & Ruegg, R. (2006). Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. Journal of Manipulative & Physiological Therapeutics, 29(1), 14-21.

Tuchin, P. J. (1997). A case series of migraine changes following a manipulative therapy trial. Australasian Chiropractic & Osteopathy, 6(3), 85.

Unger JF. (1998). The effects of a pelvic blocking procedure upon
muscle strength: a pilot study. Chiropractic Technique, 10(4):150-155

Vicenzino B., Collins D., & Wright, A. (1996) The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain, 68(1), 69-74.

Vernon, H. T., Dhami, M. S., Howley, T. P., & Annett, R. (1986). Spinal manipulation and beta-endorphin: a controlled study of the effect of a spinal manipulation on plasma beta-endorphin levels in normal males. Journal of manipulative and physiological therapeutics, 9(2), 115-123.

Zhang, J., Dean, D., Nosco, D., Strathopulous, D., Floros, M. (2006) Effect of chiropractic care on heart rate variability and pain in a multisite clinical study. Journal of manipulative and physiological therapeutics, 29(4): 367-274

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