Expert: Gerald Anzalone, D.C. - 10/6/2010

Question
What are the pros and cons of being treated by a chiropractor who uses this equipment?

Answer
Eric,

Thank you for your question.

Instrument-assisted spinal manipulation is purported to offer a number of benefits over traditional dynamic thrust-type manipulation, including the use of less force and increased patient safety.

In general, low-force manipulation techniques may offer benefit to individuals who may not be candidates for traditional manipulation, such as those who are osteoporotic, those who have had spinal surgery, those who are hypersensitive to conventional manual manipulation techniques, or those who prefer a low-force approach to manipulation.

A number of pilot studies conducted under the auspices of the research department of Logan Chiropractic College have suggested that the use of the Pro-Adjuster System may offer the following benefits to patients receiving this instrument manipulation:

- increased spinal ranges of motion
- decreased myofascial trigger points
- improved postural control

Potential drawbacks to these studies, in my opinion, include the small number of individuals studied and publication of data in journals other than mainstream peer-reviewed journals to more clearly demonstrate clinical efficacy through rigorous empirical investigation.

Potential cons to the clinical use of these types of devices may include the marketing tactics employed in order to attract and retain potential patients and patient preference (that is, some patients may not want to receive care with such a device, and some marketing strategies may emphasize the use of such a device as a "miracle cure", a panacea, or an approach that is superior to treatments offered by other providers). Such claims, if made, would need to be clearly demonstrated by sound and comprehensive research studies.

I note these potential drawbacks to the use of such a device through the filter of the three main components which constitute the pillars of evidence-based or evidence-informed patient care:

1. What the best available evidence cumulatively says about the method of treatment being employed;

2. How that evidence agrees or disagrees with the sound clinical judgment of the experienced clinician;

3. The patient's preferences and response to treatment.

I hope that this helps to answer your question.