What’s with all the Tools?
Chiropractic treatment involves a lot of hands-on care — stretching, massage, guided exercise, and joint adjustments are frequent tools used to decrease pain, improve mobility, and return patients to their activities. Using these tools has frequently allowed me to achieve great outcomes with patients — but if you know me personally, you also know I’m almost never satisfied with the status quo.
For that reason, I use a number of adjunctive (additive) modalities that support these tools, and make patient outcomes even better. Two of these tools, acupuncture and laser therapy, were recently included in a study of myofascial pain — that painful muscular irritation that many of us have. I thought this made for a good opportunity to highlight the effectiveness of using these extra tools. After all, the sooner we eliminate painful complaints, the easier it becomes to rehabilitate problematic areas and prevent them from coming back.
Laser and Acupuncture and Stretching – Oh My.
In the study, each tool was used independently, with stretching being the one constant between groups (see Figure 1). Acupuncture and laser therapies were used for the first two weeks of treatment, and then patients continued with stretching only (no laser or acupuncture) for the next four weeks. 45 patients participated in the study, and were randomized equally between the three groups. They all had trapezius pain — the muscle at the top of your shoulder, between your neck and your arm.
After the first two weeks, both the acupuncture and laser groups showed significantly decreased pain scores from the start of treatment. After the final four weeks of stretching alone, both the acupuncture and laser groups showed significantly more improvement in pain scores than the stretching alone group. Achieving statistical significance compared to the stretching alone group is important, because it highlights a real, repeatable difference between participants — it emphasizes the effectiveness of acupuncture and laser therapy for decreasing myofascial pain.
The study also looked at pain threshold (how much it hurts when you push on the area) and functional impairment of the neck. Both of these elements also improved significantly from the start of treatment for all groups, and appear to trend towards more improvement with laser and acupuncture treatments, but they do not show statistical significance — so I cannot promote those benefits with as much conviction.
Acupuncture and laser therapy are effective adjunctive modalities used to enhance patient outcomes with chiropractic care. This study highlights how they may be beneficial in patient care — particularly as it relates to decreasing pain.
One caveat: the acupuncture treatment I am referencing is actually described in the study as “intramuscular electrical stimulation”. This means that during treatment time, after the acupuncture needle is appropriately applied, the study authors stimulated it with electrical current. This is very similar to a technique sometimes applied in our clinic termed “electroacupuncture” — I use acupuncture and electroacupuncture with similar frequency, however it is true that by definition these are not identical treatments.
Dr. Jim Gilliard is a chiropractor in Burlington, ON at Endorphins Health and Wellness Centre — located in the Burlington Professional Centre at 3155 Harvester Road, Suite 406. If you have questions, comments, or wish to book an appointment, please feel free to contact him at your convenience.
Sumen A, Sarsan A, Alkan H, Yildiz N, Ardic F. Efficacy of low level laser therapy and intramuscular electrical stimulation on myofascial pain syndrome. Journal of Back and Musculoskeletal Rehabilitation, 2015; 28: 153-158. (http://goo.gl/BffnZO)