Do chiropractic adjustments to the thoracic area reduce hypertension?

From the Guidelines

Chiropractic adjustments to the thoracic area should not be relied upon as a primary treatment for hypertension, and lifestyle modifications and conventional medical treatment should be prioritized. For those interested in exploring this approach:

• Seek a licensed chiropractor experienced in thoracic adjustments
• Typically, a series of 8-12 sessions over 4-6 weeks may be recommended
• Adjustments focus on the T1-T5 vertebrae of the upper thoracic spine However, it's crucial to:
• Continue any prescribed blood pressure medications
• Maintain regular check-ups with your primary care physician
• Combine this approach with lifestyle modifications (diet, exercise, stress reduction) as recommended by the 2020 International Society of Hypertension global hypertension practice guidelines 1 The potential mechanism involves improving nerve function in the thoracic area, which may influence autonomic nervous system regulation of blood pressure. Key lifestyle modifications include:

• Weight loss of as little as 10 lbs (4.5 kg) to reduce BP and/or prevent hypertension 1
• Adoption of the Dietary Approaches to Stop Hypertension (DASH) eating plan, which is a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of dietary cholesterol as well as saturated and total fat 1
• Reduced sodium intake, with a goal of no more than 100 mmol per day (2.4 g of sodium) 1
• Regular aerobic physical activity, such as brisk walking at least 30 minutes per day most days of the week 1
• Limiting alcohol intake to no more than 1 oz (30 mL) of ethanol per day in most men and no more than 0.5 oz of ethanol per day in women and lighter weight persons 1 This approach should be considered complementary to, not a replacement for, conventional medical treatment for hypertension, as emphasized by the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline 1. Always consult with your doctor before starting any new treatment regimen for high blood pressure.

From the Research

Chiropractic Adjustments and Hypertension

• The relationship between chiropractic adjustments to the thoracic area and hypertension has been explored in several studies 2, 3, 4, 5.
• A study published in 1988 found that chiropractic adjustments of the thoracic spine (T1-T5) resulted in significant decreases in systolic and diastolic blood pressure in patients with elevated blood pressure 2.
• Another study from 1993 reported a case of a hypertensive patient who underwent chiropractic care and experienced a reduction in blood pressure, allowing for a decrease in medication 3.
• A preliminary study from 1988 found that chiropractic adjustments caused significant changes in blood pressure in normotensive subjects, with both systolic and diastolic blood pressures being lowered in the experimental group 4.
• A more recent study from 2008 investigated the autonomic nervous system responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine, and found that thoracic adjustments may result in sympathetic responses 5.
• However, not all studies are directly relevant to the question, such as a 2022 case series that focused on the reduction of high thoracic scoliosis in adults using Chiropractic BioPhysics treatment protocols 6.

Key Findings

• Chiropractic adjustments to the thoracic area may have a hypotensive effect, reducing blood pressure in patients with hypertension 2, 3.
• The mechanisms behind this effect are not fully understood, but may involve changes in the autonomic nervous system responses to chiropractic adjustments 5.
• Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure and to fully understand the relationship between chiropractic adjustments and hypertension 2, 3, 4, 5.