Chiropractic Manipulation for Hip Osteoarthritis: Promising New Data
With the exception of ischemic heart disease, osteoarthritis (OA) is the leading cause of disability in the United States. While osteoarthritis can affect younger people, it usually occurs in the elderly; radiographic studies have detected the presence of osteoarthritis in an estimated 85% of people between the ages of 55 and 64.
It affects the synovial joints, particularly those of the knee, hip, hand and facet joints of the spine, and can cause severe pain and stiffness. Osteoarthritis of the hip is especially debilitating, as it can cause pain around the hip joint, groin and lateral thigh.
In this small controlled, prospective pilot study, researchers assessed the effectiveness of chiropractic manipulation in patients with hip osteoarthritis. Eight patients, all of whom either suffered from hip pain or were diagnosed with OA of the hip, were assigned to a chiropractic group or a sham treatment group. Patients in the chiropractic group were assessed for limitation in hip range of motion and joint play restriction, and received chiropractic manipulation six times over a three-week period, using a variety of manipulative techniques. Patients in the sham group did not receive any "hands-on" assessment, but were treated with an Activator device, modified to deliver a series of "thrusts" without any real force being delivered. A pain rating scale, an osteoarthritis index and range of motion (ROM) measurements were used in both groups to assess the effectiveness of treatment.
Results showed that both the sham and manipulative treatments produced positive effects. However, trends were observed that seemed favorable for manipulation in regard to pain levels, overall OA scores and hip ROM levels.
"Based on descriptive statistics and effect-size calculations, the present study suggests that manipulative therapy may have noteworthy (short-term) clinical benefit over sham treatments in patients with OA of the hip. Furthermore, the results suggest that at least six treatments over a 3-week period are required to obtain optimum clinical results. The outcomes of this study support the need for further research into manipulative therapy for OA of the hip."
Because the sample size of this study was very small, it is not appropriate to generalize the findings of descriptive data trends to the public. As the authors point out, this paper provides some evidence for the need for a larger clinical trial.
Brantingham JW, Williams AM, Parkin-Smith GF, et al. A controlled, prospective pilot study of the possible effects of chiropractic manipulation in the treatment of osteo-arthritis of the hip. European Journal of Chiropractic