Research

There are thousands of published trials worldwide that show that chiropractic can give fast effective relief of symptoms and is both extremely safe and very cost-effective.

We have printed out a few of the summaries for you… showing both effectiveness and safety…  but suggest you read the “clinical trials” page for more detail.

Chiropractic compared to hospital outpatient treating for low back pain

Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment: (Meade TW, Dyer S et al 1990)

Objective: Randomised controlled test to compare chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin

Conclusions: For patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain. Introducing chiropractic into NHS practice should be considered.

Further comparisons between Chiropractic and hospital outpatient care for low back pain

Randomised comparison of chiropractic and hospital outpatient management for low back pain: Results from the extended follow up: (Meade TW, Dyer S et al 1995)

Objective: Randomised controlled test To compare the effectiveness over three years of chiropractic and hospital outpatient management for low back pain

Conclusions: At three years the results confirm the findings of an earlier report that when chiropractic or hospital physiotherapists and others treat patients with low back pain as they would in day to day practice those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals. (According to total Oswestry scores improvement in all patients at three years was about 29% more in those treated by chiropractors compared with those treated by the hospitals.)

Low back pain: which is the best way forward?

(Clinical Standards Advisory Group; Backpain Report 1994.)

Objective: In 1994, a British Clinical Standards Advisory Group was asked by the UK Health Ministers to develop guidelines for patients with back pain. They were asked To find which of the treatments available locally showed the best evidence of limiting acute attacks of low back pain in a patient.

Conclusions: The group found that there is considerable evidence that manipulation can provide short-term symptomatic benefit in some patients with acute back pain and recommended that manipulation should be available as a therapeutic option for the treatment of National Health Service patients with back pain, and should be carried out by appropriately trained therapists or practitioners.

What is the best, and cheapest treatment for low back pain.

The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project.

Objective:The group performed a prospective observational study to determine whether the outcomes of and costs of care differ among primary care practitioners, chiropractors, and orthopedic surgeons.

Conclusions:Among patients with acute low back pain, the outcomes were similar whether they receive care from primary care practitioners (GPs), chiropractors, or orthopedic surgeons. The costs of treatment were highest for the patients seen by orthopedic surgeons and were lowest for the patients seen by primary care providers. Satisfaction was greatest among the patients who went to the chiropractors.

Comparing chiropractic managment and pain clinic managment for low back pain.

A comparison between chiropractic management and pain clinic management for chronic low-back pain in a NHS outpatient clinic. Wilkey A, Gregory M, Byfield D, McCarthy PW

Objective:To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic (including any specialists, occupational health, physio,etc…-ed) or by a chiropractor.

Conclusions:This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a sub-population of patients with chronic low back pain.

Comparing spinal manipulation to conservative medical care for chronic low back pain.

A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. Hondras MA, Long CR, Cao Y, Rowell RM, Meeker WC:

Conclusions: Patients who received spinal manipulation showed significant improvements in function over those who received mainstream minimal conservative medical care. (Such as physiotherapy – ed)

Comparison of different treatments for neck pain.

Treatment of neck pain: non-invasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and It’s Associated Disorders: Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

Objective:This was a research paper review looking at the different types of ‘non-invasive’ (non surgical) treatments for neck pain and whiplash.

Conclusions:They found that treatments involving manual therapy and excercise were the most effective, and specifically for whiplash they found that patient education and joint mobilisation appeared more beneficial than the usual outpatient medical care.

Comparing GPs and Chiropractors and the relative instances of asociated strokes.

Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Cassidy JD, Boyle E, Côté P, et al 2008.

Objective:To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (GP/Hospital) visits and VBA stroke.

Conclusions:There was found to be no difference between patients receiving chiropractic treatment and patients receiving GP/hospital treatment In terms of the relative risk of stroke.

Comparing the risks of Chiropractic neck treatment to other treatments.

What are the Risk of Chiropractic Neck Treatments? William J. Lauretti, DC

Objective:A research paper review to establish what the ‘actual’ risks of cervical manipulation are, and then compare them to the other forms of treatment available.

Conclusions:The author puts the risk at between 1 in 4 million to 1 in 500 thousand, and states that there is up to a 100 times greater risk of dying from an ulcer due to taking a prescription NSAID like Motrin (or aspirin, etc… ed.) than from a cervical neck manipulation. He states that chiropractors’ malpractice insurance rates remain among the lowest in the health professions, due to their being statistically amongst the safest, and that if you live 8 miles away from your chiropractic clinic you are more likley to die in a car crash on the way than from the cervical manipulation… (so drive carefully!!! .. ed)

(Please note that other types of manipulation may not be safe as they have not been subject of rigorous medical investigations or clinical audits. Chiropractic is by far the largest profession dealing with back pains and other musculo-skeletal conditions. For over 100 years chiropractors have been using expert manipulation and in modern times the tens of thousands of chiropractors worldwide are at the forefront of the manipulative field. Other professions who have weekend or other short courses and then attempt to manipulate should,(if they wish to taken seriously) prove that they can both help patients and,most importantly,cause no harm. Ed)

A comparison between chiropractic treatment and just using heat for low back pain.

Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. Beyerman KL, Palmerino MB, Zohn LE, Kane GM, Foster KA

Objective:To evaluate the efficacy of chiropractic spinal manipulation, manual flexion/distraction, and hot pack application for the treatment of low back pain from osteoarthritis compared with moist heat alone.

Conclusions:Chiropractic care combined with heat is more effective than heat alone for treating osteo arthritis-based lower back pain. Pain reduction occurs more rapidly and to a greater degree, and range of motion (mobility) increases more rapidly and to a greater degree.

For further reading…:

  1. Clinical Standards Advisory Group, 1994.The Epidemiology and Cost of Back Pain. HMSO. ISBN 0-11-321889-3.
  2. NICE, 2009. Early management of persistent non-specific low back pain.
  3. UK BEAM Trial Team 2004.The UK Back Pain Exercise and Manipulation (BEAM) Randomised Trial: Effectiveness of Physical Treatments for Back Pain in Primary Care, BMJ; 329(7479): 1377.
  4. UK BEAM Trial Team 2004,The UK Back Pain Exercise and Manipulation (BEAM) Randomised Trial: Cost effectiveness of Physical Treatments for Back Pain in Primary Care, BMJ 329(7479): 1381.
  5. General Medical Council, 2006. Good Medical Practice (para. 55).
  6. British Medical Association, May 2009. Referrals to complementary therapists regulated by statute.
  7. Department of Health, 2006. Musculoskeletal Services Framework.