Summary
Dr. Jeff Langmaid dives into a cutting-edge study published in Chiropractic and Manual Therapies examining how different force levels of spinal adjustments affect blood biomarkers related to oxidative stress and inflammation. The study split roughly 20 healthy adults into three groups: control (preload only), moderate force (400 Newtons), and higher force (800 Newtons), measuring total oxidant status, lipid peroxidation, total antioxidant capacity, and Resolvin D1 before, immediately after, and 20 minutes after the adjustment. The results revealed a clear divergence: the moderate force group showed reduced oxidative stress and inflammation markers, while the higher force group experienced an 80% spike in oxidative stress immediately after adjustment that diminished to 75% at 20 minutes, along with a temporary decrease in antioxidant capacity. Langmaid draws a sauna/cold plunge analogy -- the benefit may come from the body's re-acclimation to homeostasis rather than the immediate response. He emphasizes this isn't about choosing lighter adjustments, but rather the beginning of understanding the neurobiological mechanisms behind different chiropractic techniques, which could eventually guide personalized care for chronic pain patients.
Key Points
- This is the first study to examine how different adjustment force levels impact oxidative stress and inflammation biomarkers
- Moderate force (400N) adjustments reduced oxidative stress and inflammation-related damage
- Higher force (800N) adjustments caused a temporary 80% spike in oxidative stress before partial recovery at 20 minutes
- Blood biomarkers measured include total oxidant status, lipid peroxidation, antioxidant capacity, and Resolvin D1
- The WHO recently recommended spinal adjustments as part of conservative care for chronic low back pain
- Spinal adjustments have systemic neurobiological effects beyond just mechanical/structural changes
- Chronic pain patients are highly sensitized and may respond differently to varying force levels
- Future research could help tailor chiropractic techniques to individual patient presentations
Key Moments
400 Newton adjustments reduced oxidative stress while 800 Newton temporarily increased it
A study found that moderate force (400 Newton) spinal adjustments reduced oxidative stress and inflammation markers, while higher force (800 Newton) adjustments temporarily increased oxidative stress by about 80% before the body recovered.
"So and there were some differences. So in the 400 newton group, there was a reduction in total oxidative stress, meaning there was less oxidative damage. There is a reduction as well in lipid peroxidation and lipid hydroperoxide, suggesting decreased inflammation related damage. There is no significant drop."
Spinal adjustments have systemic biochemical effects beyond mechanical changes
The study demonstrates that spinal adjustments have systemic effects beyond mechanics alone, influencing biomarkers in the blood and establishing chiropractic as a neurobiological treatment option, not just a structural one.
"So what does this mean for our patients? It means that spinal adjustments definitively, as if this hasn't been proven, but there's many people out there that don't know, has systematic effects beyond the mechanical components alone. It also means that moderate force adjustments may be ideal for reducing oxidative stress and inflammation immediately."
Different force levels may need to be tailored for chronic pain patients
Understanding how different force levels affect inflammation could help chiropractors tailor treatments for sensitized chronic pain patients who have very low thresholds before pain responses are triggered.
"It also highlights that adjusting force levels could optimize inflammation reduction for patients with chronic conditions, especially when you think about somebody that's sensitized, somebody in chronic pain. Those individuals have a very low threshold before it's like, I just think of it like a old fashioned carnival game where you're like swinging the hammer and the gun."
