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For over 100 years, chiropractic has produced
significant results with a wide variety of
health complaints. Millions of patients, from
newborns and adolescents, to adults and seniors
have benefited from this safe, conservative
form of health care.
This success has attracted the attention of
more and more researchers who want to better
understand the role of chiropractic in improving
health. This information has been prepared
to help interpret some of the many research
projects from around the world, that have
positive chiropractic implications.
Because chiropractic care centers around the
role of the nervous system, in the future,
watch for research findings in the areas of
aging, genetics, and immune system response.
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The AHCPR Findings
The results published in 1994 by the
United States Agency for Health Care
Policy Research, reviewed the many treatments
for acute low back pain in adults. The
panel consisted of medical doctors,
osteopaths, nurses, physical therapists,
and others familiar with the treatment
of low back pain. The results of their
five-year study concluded that relief
"can be accomplished most safely
with nonprescription medication and/or
spinal manipulation."
What Works & What Doesn't
The panel screened over one hundred
published studies relating to spinal
manipulation. Using the criteria of
symptomatic and functional improvement,
the researchers concluded that spinal
manipulation is helpful for patients
with acute low back pain.
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After reviewing the many treatments
for low back pain, the panel recommended
spinal manipulation. |
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Perhaps more significant were treatments
found to be ineffective and of unproven
value. The panel found no evidence of
benefit from physical therapy, massage,
traction, ultra-sound, laser treatment,
transcutaneous electrical nerve stimulation,
or biofeedback techniques.
More invasive procedures were dismissed
as well. There was little evidence to
support the use of injections, muscle
relaxers, steroids, acupuncture, or
early surgical intervention. The panel
found that even prolonged bed rest (more
than 4 days), should be avoided.
Upon review of countless controlled
randomized clinical trials, the panel
concluded that restoration of spinal
biomechanics, using methods like those
used by chiropractic doctors, to be
helpful and highly recommended.
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The Manga Report
In 1993, the Ontario Ministry of Health funded
a Canadian research project to study if chiropractic
could help lower the costs of work-related
injuries or improve the rehabilitation of
disabled or injured workers.
This study specifically explored the effectiveness
of chiropractic management of low back pain.
Based on a historical review of the most significant
clinical studies, the panel of researchers
concluded that the approaches employed by
chiropractic doctors were more effective than
traditional forms of treatment. In fact, they
found the most commonly used medical treatments
have questionable value.
Very Persuasive Evidence
Besides revealing that chiropractic patients
were able to return to work more quickly than
those who received traditional treatment,
chiropractic patients reported a high level
of satisfaction with their care.
One of the most persuasive findings was the
issue of safety. The study concluded that
chiropractic care is safer than medical management
of low back pain.
Based on the evidence, the researchers recommended
that chiropractic services be fully covered
under the Ontario Health Insurance Plan. Further,
they concluded that chiropractic doctors should
be engaged at the highest levels to assess
policy and review standards and care recommendations
for workers with back injuries.
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The Virginia Assessment
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Chiropractic Care was shown to
help avoid or reduce the incidence
of other more expensive forms
of treatment. |
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This 1992 study was conducted to determine
the value of including chiropractic
in Virginia's mandated health care coverage.
The research was conducted by a professor
of economics and preventive medicine.
Because chiropractic care could help
avoid more costly types of treatment,
it was concluded that mandating chiropractic
coverage could actually reduce costs.
Chiropractic Compared Favorably
The researchers conducted a thorough
investigation between chiropractic and
traditional medical treatment. While
their primary focus was on the costs
associated with including chiropractic
coverage, they explored safety issues,
efficacy, wage loss, and treatment frequency.
Before reaching their conclusions they
reviewed 35 different comparisons.
A concern explored in their research
was whether expanding coverage to include
chiropractic would increase costs to
the state. This concern seemed to unfounded.
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The evidence they present shows that
chiropractic care provides substantial
benefits at a relatively low cost. They
concluded that adding chiropractic benefits
would have a very small impact on health
insurance expenditures and might actually
lower overall health care costs.
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The British Study
A three year British study involved 741 patients.
Roughly half received traditional medical
treatment and the other half received chiropractic
care. The 1990 report observed that patients
seen by chiropractic doctors were significantly
better within six months and remained so during
the two year follow-up period. This, and other
evidence, led researchers to conclude that
chiropractic care compares more favorably
than traditional outpatient hospital treatment.
Long Term Results
Published in the prestigious British Medical
Journal, this study is especially important
due to its size and independent nature. Besides
revealing the effectiveness of chiropractic
in the short-term, the lasting effect of treatment
two and three years later was significant.
Researchers used the Oswestry Pain Disability
Questionnaire and the results of objective
range of motion testing to confirm their findings.
The patients progress was measured by their
ability to walk, lift, sit, and conduct their
lives. Not only did the chiropractic patients
experience better results for a longer period
of time, they missed less time from work.
Based upon patients consulting chiropractic
doctors instead of receiving hospital treatment,
the researchers concluded that reduced absenteeism
could save millions in lost production each
year. Because of its effectiveness and long-term
benefits, they recommended that including
chiropractic in the British National Health
Service should be considered.
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REFERENCES ·
Bigos, S., Bowyer, O., Braen, G., et al. Acute
Low Back Problems in Adults. Clinical
Practice Guideline No. 14. AHCPR Publication
No 95-0642. Rockville, MD: Agency for Health
Care Policy and Research, Public Health Service,
U.S. Department of Health and Human Services.
December, 1994.
The Effectiveness and Cost-Effectiveness
of Chiropractic Management of Low-Back Pain,
Pran Manga, Ph.D., Douglas Angus, M.A., Costa
Papadopoulos, M. H.A., William Swan, B. A.
Funded by the Ontario Ministry of Health,
August, 1993, Page 104.
Leonard G. Schifrin, Chancellor Professor
of Economics and Preventive Medicine, The
College of William and Mary, Williamsburg,
Virginia.
Low Back Pain of Mechanical Origin: Randomized
Comparison of Chiropractic and Hospital Outpatient
Treatment , T.W. Meade, Sandra Dyer,
Wendy Browne, Joy Townsend, A.O. Frank, British
Medical Journal, Volume 300, 2 June 1990,
Pages 1431-1437.
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