The role of chiropractic manipulation in promoting an individual's perception of psychological well being

Abstract

Background: A paucity of chiropractic research focuses on the relationship between chiropractic treatment and psychological mood. It is, however, becoming increasingly important to evaluate psychological change resulting from chiropractic care. Such research is required both to protect the profession from criticism that its effectiveness resides in a placebo effect and also to confer validity to findings from studies that investigate the extension of chiropractic treatment to conditions known to be affected by psychological variables. Objective: This research is intended as a preliminary study aimed at investigating, firstly, whether participation in chiropractic treatment, either sham or active, is able to alter dimensions of psychological well being and, secondly, if an alteration is seen to establish whether this can be attributed to manipulation. Research method: This double-blind study was conducted on twenty asymptomatic subjects who were randomly allocated either to a group receiving active manipulation or to one receiving sham manipulation for a total of four interventions set over a 1-month period. Various markers of psychological well being were measured through the use of questionnaires (the perceived stress scale (PSS), the profile of mood states (POMS) questionnaire and the Spielberger state trait anxiety inventory (STAI)) given out before and after each intervention. Data were analysed per intervention for intra-group and inter-group changes as well as for intra-group changes over the time period of multiple interventions. Results: Few statistically significant results were seen. These were clustered around the first intervention. Results showed that active manipulation, in contrast to sham, had a stronger and broader effect on promoting emotional well being. Sham manipulation also caused significant change but on fewer markers of psychological mood. No effect was as strong as to cause significant inter-group differences. Conclusion: While active manipulation was seen to exert a stronger effect than sham manipulation on markers of psychological well being, the mechanism by which this effect is generated remains unknown. The changes seen are in part likely to be attributable to aspects relating to the clinical encounter; however, these changes are minimal and fail to exert any influence over time. This suggests that chiropractic care when effective is effective because it offers effective treatment and not an effective placebo via changes in psychological well being. © 2006 The College of Chiropractors.