COPD is a debilitating condition that affects millions of people across the globe. Treating COPD can prove difficult because the root cause of the condition varies between individuals. However, emerging research suggests that spinal manipulation and other natural and noninvasive treatments can be effective initiatives for relief.
What Is COPD?
COPD (chronic obstructive pulmonary disease) refers to a group of conditions that causes respiratory problems due to airflow blockage. In patients with COPD, progressive airflow is limited and lung function declines, making even simple tasks like walking upstairs difficult. Examples of COPD conditions include chronic bronchitis and emphysema.
The prevalence of COPD is widespread, affecting more than 16 million Americans each year. It is ranked sixth globally in the causes of death for both men and women. COPD is most commonly caused by the inhalation of tobacco smoke, though other factors which influence the lungs—respiratory infections, air pollution, and family history—can also contribute to the condition.
COPD is diagnosed using a breathing test called spirometry. Patients are asked to breathe into a small machine that is connected to a mouthpiece. This is used to monitor the rate and volume of the airflow that the patient breathes in and out over a period of time. Unfortunately, many COPD cases go undiagnosed, and even for those that are diagnosed there is no cure. Instead, treating COPD is a matter of managing pain and breathing patterns.
Treating COPD with Spinal Manipulation
A body of evidence exists that suggests that manual therapy has the potential to increase the flexibility of the thoracic excursion and chest wall, subsequently leading to improvements in exercise capacity and lung function. These alterations in respiratory mechanics can lead to improvements in patients with certain chronic respiratory diseases, including COPD and chronic asthma.
The term manual therapy usually accounts for a variety of techniques, including soft tissue therapy and joint mobilization or manipulation. Another powerful form is spinal manipulation, the application of high-velocity, low amplitude force to move a joint complex which is usually effective in decreasing pain and improving range of motion in the joints. Both manual therapy and spinal manipulation are non-pharmacologic interventions for treating COPD, and they have been shown to improve exercise capacity in patients with the debilitating condition.
Spinal manipulation works to increase thoracic mobility, consequently reducing the strenuous work of breathing. The importance of increasing exercise capacity, the more general result of the application of spinal manipulation, cannot be overstated, as research shows exercise capacity to be a predictor of mortality in cases of COPD.
“Use of Spinal Manipulation Therapy for Management of COPD”
The research into spinal manipulation’s efficacy in treating COPD is still relatively unexplored. However, in February of 2016, authors Wearing, et al. published their findings on the subject in The Journal of Alternative and Complementary Medicine. Their article “Use of Spinal Manipulation Therapy for Management of COPD” was a systematic review geared toward investigating the result of administering spinal manipulation therapy and other modalities to patients with COPD.
In the study, spinal manipulation was defined by application of high-velocity, low-amplitude targeted pressure. The effect of other modalities falling under the manual therapy umbrella were also explored in conjunction with spinal manipulation therapy, as was pharmacological intervention. Pooling the body of research, Wearing, et al. included in their review primary research studies with participants of legal age (18 years) with an existing diagnosis of COPD for which the effect of spinal manipulation therapy on COPD was tested.
Six articles met the inclusion criteria and so were included for review, each with statistically small sample sizes (1 to 33 participants aged 55 to 85 years). The six studies included were broken up as such: three randomized controlled trials which employed exercise therapy from a pulmonary rehabilitation program, one case series, one pre-post observational study, and one single case study.
The conclusions of the review suggest strongly that spinal manipulation therapy is an effective measure in treating COPD. Following spinal manipulation, patients in five of the six studies reported improvements in both exercise performance and lung function. Furthermore, all three of the randomized trials indicated that combining exercise therapy with spinal manipulation treatments was more effective in the treatment of COPD.
It should be noted that it was not uncommon for patients to report minor adverse effects—mainly muscle soreness—in the 24 hours after treatment. This resolved within that 24 hours without any additional intervention. This soreness did not outweigh the benefits of spinal manipulation and exercise therapy for patients with COPD. Authors Wearing, et al. call for greater research into spinal manipulation’s efficacy in treating COPD, especially when combined with exercise therapy.
