Can chiropractic help with the coronavirus? I'll give you my thoughts and more in this episode.

I wanted to share my thoughts about the novel coronavirus that originated in Wuhan China. This virus - known as SARS-CoV-2 - is responsible for the disease, which has been named COVID-19. The spread has increased rapidly around the world, starting originally in Wuhan, China, and the number of cases increases exponentially in a given region.

The mortality rate is estimated to be higher than other conditions such as influenza, but not as high as conditions such as SARS, and especially Ebola which had a mortality rate greater than 50%. Most individuals who contract COVID-19 have symptoms similar to a cold: coughing, fever, running nose, but certain individuals are at a greater risk.

The risk of serious complications increases with age, with those over 55 being at the greatest risk. Risk of complications, including death, are greater in those with preexisting conditions such as respiratory disease, cardiovascular disease, type 1 and 2 diabetes, and especially those with otherwise compromised immune systems.

Fortunately, there have been no reports of children younger than 9 dying or having serious complications from this disease. However, young, healthy adults, 20 to 30 years old, have contracted this disease and had serious complications and even died. So we're not immune to this risk.

So how can a chiropractic adjustment help you?

It can't! There's no reason to assume that getting adjusted by your chiropractor will help you prevent the disease or decrease your symptoms. Chiropractors love to cite historical facts and figures that show a benefit. For instance, in the 1918 Spanish flu, those treated by chiropractors had a much lower mortality rate than those treated by medical doctors.

The problem with these data is, number one, they're incomplete and old. They're focused on very particular areas, and there may be conflicting factors - confounding factors - that play into this scenario. For example, those who are treated by chiropractors may not have had serious cases of the disease. If you have a serious case of the flu, you're more likely to go to the hospital, not to a chiropractic school to be treated.

Chiropractors also love to cite papers in the scientific literature that show benefits like increasing interleukin 2, other inflammatory and immune markers. These papers are interesting and exciting to consider. But we do not know the effect on clinical outcome. Meaning that while an adjustment may make immediate changes to the blood markers that we look for to measure immunity, these are just a few of the tens, if not hundreds of the immune markers that can be measured. And the impact on the overall immune system is unknown and there have not been any studies - other than these historical anecdotes - to show that patients being treated by a chiropractor are less likely to get sick or less likely to have symptoms when they do get a disease. And there certainly have been no studies done to measure the impact of chiropractic on the novel coronavirus.

The best thing that a chiropractor can do is to act as a knowledgeable and well-informed healthcare professional in your community, to reiterate what has been said by the CDC, the World Health Organization, as well as your local state or county health department. Chiropractors can encourage you to wash your hands regularly using soap and warm water, spending 20 seconds getting into all the nooks and crannies and under the nails.

Chiropractors should also be encouraging you to stay home if you have symptoms of the cold or flu, and chiropractors should certainly be maintaining healthy, hygienic practices for themselves and their clinic, washing the table with anti-bacterial wipes in between patients, encouraging patients to stay home and staying home themselves if they have symptoms or are concerned they've contracted this condition or other conditions such as the flu.

We should also be encouraging otherwise healthy habits: staying physically active, eating well, avoiding crowds and large gatherings where the spread of the virus is more likely to happen. If you have other suggestions, I'd love to hear them, so please a comment below, letting me know what you think chiropractors should be doing to spread awareness of the novel coronavirus, encouraging healthy habits to improve the wellness and public health in their communities. If you happen to know of scientific studies that I haven't mentioned, that I'm not aware of, please link to those below as well.

The Role of Chiropractic

All of this is not to say that patients should stop seeing their chiropractor. There are multiple musculoskeletal conditions that can be effectively managed and treated with the help of a chiropractor.

Chiropractors may be able to play a role in 'flattening the curve' of this pandemic by managing patients with aches and pains who otherwise might show up in an emergency department where they could be exposed to this virus.

The important message here is that chiropractors should not be making unsubstantiated claims of prevention or cure for coronavirus.

As stated by the World Federation of Chiropractic in an update and rapid review of the scientific literature regarding manipulation and the immune system:

There exists no credible, scientific evidence that would permit claims of effectiveness for conferring or enhancing immunity through spinal adjustment / manipulation to be made in communications by chiropractors.

References:

Teodorczyk-Injeyan, J. A., Injeyan, H. S., McGregor, M., Harris, G. M., & Ruegg, R. (2008). Enhancement of in vitro interleukin-2 production in normal subjects following a single spinal manipulative treatment. Chiropractic & Osteopathy, 16(1), 5–9. http://doi.org/10.1186/1746-1340-16-5
Teodorczyk-Injeyan, J. A., Injeyan, H. S., & Ruegg, R. (2006). Spinal Manipulative Therapy Reduces Inflammatory Cytokines but Not Substance P Production in Normal Subjects. Journal of Manipulative and Physiological Therapeutics, 29(1), 14–21. http://doi.org/10.10…/j.jmpt.2005.10.002
Andrea Colombi, M. T. (2019). The Effects Induced by Spinal Manipulative Therapy on the Immune and Endocrine Systems. Medicina, 55(8), 448. http://doi.org/10.3390/medicina55080448
Liang Zhang, C. H. Y. (2016). The Physiological Role of Tumor Necrosis Factor in Human Immunity and Its Potential Implications in Spinal Manipulative Therapy: A Narrative Literature Review. Journal of Chiropractic Medicine, 15(3), 190–196. http://doi.org/10.1016/j.jcm.2016.04.016
Teodorczyk-Injeyan, J. A., McGregor, M., Ruegg, R., & Injeyan, H. S. (2010). Interleukin 2-regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropractic & Osteopathy, 18(1), 1–8. http://doi.org/10.1186/1746-1340-18-26