In an office at the corner of Wilshire and Westwood boulevards, UCLA alumnus Brian Nishimoto sees 20 to 30 people every day to help them alleviate bodily pains by realigning and adjusting their spines.
Nishimoto is one of the nearly 60,000 practicing chiropractors in the United States who rely on physical manipulation of the bones and muscles in the back to help cure people’s bodily pains. Chiropractic treatments remain a popular option because people think it works, even though there is a lack of scientific evidence to validate these claims.
Most of the research attempting to validate the efficacy of chiropractic treatment is either conflicting or poorly done, according to a recent review of studies on the subject.
“There has always been this sort of strangeness about chiropractors because we don’t really know if (their treatment) is working or not,” said David Fish, an associate professor of orthopedic surgery at UCLA.
At Nishimoto’s clinic, Westwood Village Chiropractic, as much as a third of patients are either students or staff at UCLA. The majority of people come in with either back or neck pain, but Nishimoto also sees people who have severe headaches or other health concerns.
Different bodily pains can be improved by targeting different parts of the spine, he said. For example, back pain might be helped by lower back manipulations whereas neck pain or headaches would require upper spine adjustments.
Patients are usually given treatment for two to four weeks, which includes spinal adjustments, heat therapy, physical therapy and massages. If their symptoms do not improve during the first two to four weeks, they are referred to other health-care providers.
“If our treatment isn’t working, we’re going to refer you to a specialist,” Nishimoto said.
Though chiropractic medicine may not always work, for certain individuals it may be a better solution than any of the other available treatment options.
Chantel Bonneau, a second-year business economics student, sees Nishimoto for treatment every other week. As a UCLA cheerleader, she hurt her back doing tumbling exercises. The physical therapy and other treatments her doctors prescribed for her did not work. As a last resort, she went to see a chiropractor and found that the treatment actually worked.
“I think (chiropractic treatment) is very effective because it’s actually proactive. You can feel the difference,” Bonneau said.
It is not entirely understood how spinal adjustments may improve specific health issues. It is thought that manipulating vertebrae and the tissues surrounding them relieves pressure placed on specific nerves. In this way, specific health issues can be improved by allowing the nervous tissue to function normally again, reducing unnecessary pain.
Furthermore, reducing the amount of pain someone is in can then improve mobility and allow that person to be involved in more activities.
Nishimoto said he was inspired to get his chiropractic degree after going to see a chiropractor himself.
“The chiropractor fixed me up after I had sustained a lot of injuries playing IM sports at UCLA,” he said.
There is not enough research to conclusively say how effective chiropractic treatment is as a whole, but some medical researchers say that the treatment has been shown to be effective for some ailments.
“I think when it comes down to it there is some pretty good research that (chiropractic treatment) is effective for lower back pain … but for chronic pain and other ailments its efficacy is not well shown,” said Ian Coulter, a professor at the UCLA School of Dentistry who has also been involved in researching chiropractic treatment.
Though there is a lot of anecdotal evidence supporting the effectiveness of chiropractic treatment, it may be hard to distinguish between successful treatment and placebo effects. The placebo effect occurs when simply awareness of the fact that a person is receiving treatment, even if the treatment is fake, cures that person’s health issues.
“Is the placebo effect working? Maybe. … If you get a patient early enough, (the improvements) might also be just because of natural recovery,” Fish said.
Coulter said that there is probably more to the treatment than just a placebo effect. “Thirty percent of any treatment effect is because of placebo effects. Medical professionals might say all results (of chiropractic treatment) are due to the placebo effect because perhaps they don’t like chiropractors,” Coulter said.
One reason why it might be hard to tell if chiropractic treatment is effective is that many chiropractors provide many services beyond performing spinal manipulations.
“In reality they can be more of a wellness practitioner. They’ll probably also talk to you about your posture, stress, diet, exercise, weight gain and other lifestyle choices,” Coulter said.
All these things added up can produce positive results, so it’s hard to tell what is caused by the placebo effect and what is due to the total treatment procedure, he added.
“I have been working as a chiropractor for 13 years and have found that more and more people are looking for alternative health care so that they can actually correct their conditions instead of just taking medication,” Nishimoto said.