In many parts of the world, chiropractic medicine is a popular complementary care option for those with autoimmune conditions like lupus.  It is especially helpful in the treatment of the muscle weakness and joint pain commonly associated with SLE, but that is only the beginning.  Read on to find out how a chiropractor can be one of the most valued members of your healthcare team!

• Introduction to Lupus and Chiropractic Care
• How does chiropractic medicine approach lupus?
• Things to Consider First about Chiropractic Care
• In Conclusion

Introduction to Lupus and Chiropractic Care

A recent study found that approximately 40% of those with lupus or other chronic rheumatic diseases like rheumatoid arthritis and fibromyalgia use complementary therapies.  Chiropractic care is one of the most popular of these and the numbers are rising.

Chiropractic medicine broadly involves a hands-on examination of the structure and function of the body’s bones and muscles.   While it is common for a chiropractor to manually adjust the spine, and alleviate discomfort in parts of the body, like the head and neck, chiropractors are trained to do much more.  They emphasize “patient-centered” care and believe in healing illness and injury in a holistic manner.  This involves taking the time to understand the patient, and in manipulating the body physically to achieve the patient’s health goals.  Chiropractors are also some of the most highly trained of the complementary healthcare practitioners.  They are required to have a deep knowledge of anatomy and physiology, taking years of advanced study and many achieve advanced degrees.

There are over 100,000 chiropractors world-wide and the right one can be a valuable addition to your healthcare team.  Yet, is chiropractic medicine right for you?  Here are some things to consider.

How does chiropractic medicine approach lupus?

According to Dr. Bill Moreau, Chief Medical Officer of the University of Western States, chiropractic medicine can provide an continuum of care that often takes place in three phases (B. Moreau, personal communication, April 28, 2021):

1.  Pre-diagnosis:  First, an initial presentation of symptoms, usually muscle or joint pain or weakness, can lead someone to consult a chiropractor.  This phase is pre-diagnosis and involves the chiropractor carefully observing the patient and the success (or not) of treatments for specific symptoms.  Often, chiropractors have more time than other healthcare practitioners to explore these conditions and relate them to aspects of lifestyle and personal histories.

According to Dr. Moreau, chiropractors do not diagnose lupus or other autoimmune diseases – that is for the rheumatologists and primary care physicians.  However, they can be the first to see a patient with symptoms that might lead to that diagnosis.  When someone comes to a chiropractic clinic with joint pain or muscle weakness, the chiropractor is trained to view these complaints from a very holistic perspective and then possibly refer the patient to other specialists for further examination.

2.  Diagnosis:  The second phase comes when more acute symptoms require the intervention of specialists, such as rheumatologists, nephrologists and others.  At this stage, laboratory tests may lead to a confirmed diagnosis of lupus.  The chiropractor may continue to help with symptoms, but the focus of the healthcare team shifts to the specific therapies and pharmaceuticals that target the autoimmune and inflammatory responses.

3.  Maintenance:  In this third phase, as the other medical interventions take effect, chiropractors can provide an important supportive role.  Chiropractic care is not curative – of course, for lupus at this time, no therapies are.  However, at this stage the focus is on quality of life, and in this respect, chiropractic medicine can be very effective.  For instance, if a patient is in the midst of a flare, chiropractic treatments are a non-pharmacological intervention that can provide relief with far fewer contraindications than many medications.

 

More about Treatment …

Chiropractors approach treating the inflammation, pain and fatigue of lupus from a functional, holistic perspective.  Dr. Moreau explains that pain is often what drives people to seek chiropractic care, but the ability to function – to physically move and emotionally manage daily life – is perhaps the more important goal of chiropractic care.

Chiropractic therapies include a wide range of options beyond the classic spinal manipulation to treat neck and back pain that many are familiar with.  Other treatments, include physical modalities (such as ice and heat therapies); dietary changes and the use of nutraceuticals to reduce inflammation, and a concerted focus on emotional wellbeing.

More research is needed on the benefits of chiropractic care for autoimmune disease, such as lupus, but a few studies have shown high satisfaction among those receiving treatment.  Some findings include:

• Pain and Weakness:  Physical discomfort, joint pain and muscular weakness are well-known and researched symptoms that can be treated by chiropractic techniques.
• Headaches and migraines:  87% of chiropractors treat headache disorders. Reducing muscle strain and improving posture through spinal alignment may decrease the occurrence and severity of headaches.  Headaches are common for those with lupus and chiropractic treatments can make significant improvements in these cases.
• Inflammation:  Inflammatory markers – cytokines and C-reactive protein, may decrease after a series of chiropractic treatments.  More research needs to be done on how manipulation, especially of the spine, can reduce inflammation.
• Emotional wellbeing:  As inflammation and the pain it causes improve, cortisol levels may decrease.  This can be important in reducing anxiety. Chronic pain has also been shown to exacerbate depression.  A decrease in pain may help with this depression and improve many other aspects of mental health.
• Chiropractic care has also been cited as being more effective when used along with acupuncture and massage.

Although rare, chiropractic care comes with some risks, including: discomfort to the arms and legs; dizziness and nausea.  Most of these symptoms become far less pronounced after the first treatments.  Always, consult your healthcare team before making changes to your treatment plan – especially during a lupus flare.

Things to Consider First Regarding Chiropractic Care

• Consulting your healthcare team: Talk with a primary healthcare practitioner first. They may have important reasons why chiropractic care may or may not be the best option. Remember, all therapies need to complement other treatments, not detract from them.
• Checking insurance coverage: Increasingly, more insurance carriers support some integrated approaches to healthcare. However, it is still important check out  how much chiropractic care is covered.
• Determining cost: If an insurance carrier does not cover chiropractic care, check to see if the chiropractor can charge based on affordability (sliding scale). Sometimes, chiropractic schools, where instructors monitor students, offer services at reduced fees.
• Finding a chiropractor: Word of mouth is often the best way to find experienced and reputable chiropractors. Ask friends and family for referrals, especially if they, too, have an autoimmune disease and have benefited from chiropractic care. Ask your primary care physician for recommendations.  Finally, call nearby chiropractic clinics, and ask about their experience and success with treating lupus or other rheumatic conditions.
• Preparing for a first visit to a chiropractor:  There is no special preparation required for visiting a chiropractor.  However, here are some pointers:
  • Be prepared to discuss full health histories with chiropractors. They will probably ask many questions in order to get a holistic view of your condition.
  • Always be honest about what you are feeling and how past therapies have been effective or not.
  • Be prepared for a physical examination and possible manipulation. This usually is necessary before any diagnosis or treatment is considered.  Feel free to say no to any manipulation beyond your comfort level.
  • Do not be afraid to ask questions!
  • As with all healthcare providers, be prepared to advocate for yourself!

• Practicing after-treatment self-care: Drink plenty of water, avoid injury, and rest after a chiropractic visit. A chiropractor may also recommend gentle exercise to increase treatment benefits and reduce discomfort.
• Knowing when to stop if it’s not working: Sometimes, this can be the hardest thing to do, but remaining aware during treatment and telling the chiropractor when something does not feel right will help avoid complications. Chiropractic care is not be for everyone or every symptom, and that is okay!

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In Conclusion

Chiropractic care continues to grow in popularity with both the medical community and those receiving treatment. While chiropractic care may not be for everyone with lupus, it may provide some symptom relief … and with so few negative side-effects, it can be a valuable addition to your lupus management toolkit. Hopefully, this article provided the information needed to make a more informed decision about this complementary therapy by diving in a little deeper into how it works in integration with standard care to alleviate physical and emotional discomfort.

 

References

Bernstein, C., Wayne, P., & Rist, P. (2019). Integrating chiropractic care into the treatment of migraine headaches in a tertiary care hospital: a case series. Global Advances in Health and Medicine, 8, 1-5.https://doi.org/10.1177%2F2164956119835778

Boothby, J., Coffman, S., & Turnbull, T. (2017). Successful interprofessional treatment of juvenile rheumatoid arthritis: a case report. Integrative Medicine: A Clinician’s Journal, 16(2), 55-60. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413638/

Brady, K. (10, March 2017). 8 things you need to know before visiting a chiropractor. Women’s Health. https://www.womenshealthmag.com/health/g19961332/chiropractic-care/

Chiropractic: In depth. (2019). National Institute of Health. https://www.nccih.nih.gov/health/chiropractic-in-depth

Chou, C. (2010). Alternative therapies: What role do they have in the management of lupus? Lupus, 19, 1425-1429. https://doi.org/10.1177%2F0961203310379872

Gerrits, M., Oppen, P., Leone, S., van Marwijk, H., van der Horst, H., & Penninx, B. (2015). Pain, not chronic disease, is associated with recurrence of depressive and anxiety disorders. BMC Psychiatry, 14(187).https://link.springer.com/article/10.1186/1471-244X-14-187

Greco, C.M., Nakajima, C., & Mansi, S. (2013). Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus. Current Rheumatology Reports, 15(11).  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898893/

Roy, R., Boucher, J., & Comtois, A. (2010). Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain. Journal of Chiropractic Medicine, 9, 107-114, https://dx.doi.org/10.1016%2Fj.jcm.2010.06.002

Utilizing chiropractic care for lupus relief. (2021). The Joint Chiropractic. https://www.thejoint.com/texas/spring/spring-town-center-28043/utilizing-chiropractic-care-for-lupus-relief

 

Author:  The KFL Team

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