ΒΗΜΑ Science: MEDICINE - Hypertension / Blood Pressure

 

CHIROPRACTIC against hypertension

With chiropractic treatment to align the Atlas, our first vertebra, a reduction in hypertension can be achieved that is similar to what medications offer. This was demonstrated by a promising study from the University of Chicago, led by Professor G. Bekris

The Role of Chance...

However, when something good happens, it should not only be acknowledged but also publicized. In this particular case, the benefit of chiropractic in reducing hypertension arose... by chance, as often happens in medical research. Mr. Bekris explains that it all began with an observation made by a colleague of his, a private practice internist. "He told me that he often sees patients who visit a chiropractor for unrelated reasons and, after their sessions, exhibit reduced blood pressure." Notably, this phenomenon appeared in dozens of patients and was always associated with manipulations of the upper part of the spine. The data regarding these patients reached Mr. Bekris, and ultimately it was decided to conduct a pilot study, since it seemed worthwhile to investigate the matter.

Thus, a two-month study was conducted involving 50 patients with mild hypertension—all sessions were performed by one chiropractor, who, as Mr. Bekris emphasizes, was specialized in manipulations of the upper part of the spine, specifically in Atlas alignment (in the U.S., where there are thousands of chiropractors, there is even further specialization in manipulations of specific areas of the spine). Half of the patients underwent "sham manipulations" while the rest received the actual treatment, with researchers being unaware of which patient received real treatment and which received the "sham" (double-blind study). None of the patients received antihypertensive drug therapy during the eight weeks of the study.

Two months later, those who underwent Atlas alignment manipulations showed a mean reduction in systolic and diastolic blood pressure of 14 and eight millimeters of mercury, respectively—a reduction which, as the study characteristically notes, "is similar to what is achieved by using a combination of two antihypertensive drugs."

The Multifaceted Atlas

But why did the entire study focus on a single vertebra, which, as it turns out, can sometimes bear the weight of blood pressure on its "shoulders"? As noted in the article by Mr. Bekris and his team, as early as the 1940s a small group of chiropractic experts abandoned the broader concept of manipulating the entire spine and focused their specialization on the precise and fine alignment of this specific vertebra. "Unlike other vertebrae, which 'lock' into each other, the Atlas relies only on soft tissue (muscles and ligaments) to remain aligned. As a result, it is extremely vulnerable to displacement. Even if the Atlas becomes displaced, pain does not necessarily occur, so the condition is neither diagnosed nor treated. The health consequences are attributed to other causes."

In their study, the scientists explain that even a small displacement of the Atlas can injure or compress the neural pathways of the brainstem. And this relationship, between hypertension and circulatory abnormalities in the Atlas region, has been known for decades, not only to chiropractors but also to neurosurgeons. As Mr. Bekris says, "Several neurosurgeons who operate at the base of the brain have observed that intervention at this point leads to a drop in blood pressure during surgery. Likewise, surgical intervention in the area appears to lead to a long-term reduction in blood pressure. Why this happens, however, no one knows—at least for now—with certainty. One hypothesis is that the vessels in the area are 'trapped' due to poor Atlas positioning and show signs of ischemia. It is possible that returning the Atlas to its proper position releases these vessels, restores circulation to the brainstem, and lowers blood pressure."

Long-Lasting Treatment

The researchers note that their findings constitute the first official evidence of blood pressure reduction through the alignment of a single vertebra. This reduction appeared to last for at least two months, although it is currently unknown whether it will have longer-term effects (in any case, since this particular treatment is not associated with side effects, it may be easy to repeat if blood pressure rises again). According to the scientists responsible for this new study, if these results are confirmed, they may lead in the future not only to an additional treatment approach for hypertension, but also to a new risk factor for developing the condition. Thus, people with a family history of high blood pressure or those who have suffered injuries to the upper part of the spine (even if they feel no pain) will be able to be checked for possible Atlas displacement, with all that this may imply not only for the state of the "pillar" of their body, but also for the reading on the blood pressure monitor.

"Today there are techniques to check whether the Atlas has been displaced. This type of screening should be the responsibility of primary care specialists and should be conducted in patients with a history of head or neck trauma, even if it is considered minor. In an era when hypertension rates are rising and controlling it is becoming increasingly difficult due to many different factors, the connection between correcting Atlas displacement and reducing blood pressure could become an important step forward in managing these patients," the researchers conclude.

Mr. Bekris and his team are now in the process of securing funding in order to expand their study and simultaneously discover the reasons that lead to blood pressure reduction through Atlas manipulations.

If the initial observation is confirmed by further studies, it is possible, as Mr. Bekris notes, that chiropractic may serve as a complementary method for lowering blood pressure in the future. "However, we must stress that not just any chiropractor can do this. The practitioner must be specialized in Atlas manipulations, as non-specialists could even prove to be dangerous."

In an accompanying commentary on the study, published in the same scientific journal, Professor of Clinical Medicine at the University of Milan Guido Grassi states regarding the new findings that they are "good news, but should be accepted with caution." "Before this therapeutic strategy is recommended in clinical practice, it seems reasonable to wait for the results of large-scale clinical trials," Grassi emphasizes. And he is right. These first encouraging results need to be confirmed, as any hasty move without solid evidence could turn the hope in these seemingly therapeutic hands into disappointment expressed by the phrase "I put my hands on it and poked my own eyes out..."

Chiropractic in Greece

It is not uncommon in our country for a tangible reality to be recognized by everyone except the official state. The same thing happens with chiropractic. There are quite a few chiropractors practicing in Greece; however, their specialty is not recognized. The result? As Dr. of Chiropractic and President of the Hellenic Chiropractors' Association, Mr. V. Golfinopoulos states, "although there are scientists who are well-trained in their field—our association has about thirty members—there are at least 200 others who claim to be chiropractors without the proper background, a fact that can even be dangerous for patients. And this happens with the state's tolerance, as while we have been fighting for years for our recognition—which would set boundaries to the unregulated situation that exists today—we have not seen any action from the authorities."

According to Mr. Golfinopoulos, there are university departments where chiropractic is taught today within the EU, in the UK, France, and Denmark (where the chiropractic profession is also recognized). However, the specialty is recognized in many more European countries: in all Scandinavian countries, in Iceland, Ireland, Portugal, Switzerland, the Netherlands, Belgium, Cyprus, and Luxembourg. Currently in the process of recognition are Spain (where a university program is starting next September at the University of Madrid), Italy, and Germany. Worldwide, major countries such as the United States and Australia have included chiropractic in their National Health Systems. Mr. Golfinopoulos emphasizes that it is extremely important for the profession to be recognized in Greece, given that more and more patients are showing interest in chiropractors and seeking them out. "However, patients should not confuse chiropractors who have studied their field for years at university with practitioners who learn some manipulations in seminars that last two weeks and then claim to be specialists without actually being so."

Regarding the specialization of chiropractors in manipulations specifically in the upper part of the spine (such a specialized chiropractor participated in the University of Chicago study), Mr. Golfinopoulos admits that in our country, with its few professionals in the field, such specialization does not really exist. "In the US, there are 15 universities with Chiropractic Departments, graduating 1,500 new chiropractors annually. The numbers are very different."

In any case, those interested in contacting a well-trained chiropractor may visit the list of members of the Hellenic Chiropractors’ Association, as well as the website of the corresponding European Association to which the Greek Association belongs: European Chiropractors’ Union.