Research on the clinical and cost-effectiveness of Chiropractic Care – General low-back pain

General low-back pain

– In a study reported in 1992, Anderson et al. conducted a meta-analysis of twenty-three randomized controlled clinical trials of the effectiveness of spinal manipulation in the treatment of back pain. The researchers stated, “the trend for spinal manipulation to produce better results than any form of treatment to which it was compared was consistent and strong” (193). For 86% of the outcomes, spinal manipulation was more effective than any other treatment.

– In a study conducted for the Ontario Ministry of Health, Manga et al. (1993) reported that spinal manipulation is the most effective treatment for low-back pain and that spinal manipulation is “safer than medical management of low-back pain” (11).

– Following a 1993 study, researchers Cassidy, Thiel, and Kirkaldy-Willis of the Back Pain Clinic at the Royal University Hospital in Saskatchewan concluded that “the treatment of lumbar intervertebral disk herniation by side posture manipulation is both safe and effective” (102).

– A study conducted by T.W. Meade, a medical doctor, and reported in the British Medical Journal concluded, after two years of patient monitoring, that “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” (Meade 1990, 1431). “ … Improvement in all patients at three years was about 29% more in those treated by chiropractors than those treated by the hospitals. The beneficial effect of chiropractic on pain was particulary clear.” – British Medical Journal, Meade et al. (1995).

– A 1988 study of 10,652 Florida workers’ compensation cases was conducted by Wolk and reported by the Foundation for Chiropractic Education and Research. According to Wolk, back injury patients treated by chiropractors versus medical doctors or osteopaths were less likely to develop compensable injuries (injuries resulting in time lost from work and therefore requiring compensation) and less likely to require hospitalization. The author explained that chiropractors are more effective in treating low-back injuries because “chiropractic treatment, in providing more services to the patient at the outset of injury, may produce more immediate therapeutic results and may reduce the amount of time lost from work” (56).

Anderson, Robert, William C. Meeker, Brian E. Wirick, Robert D. Mootz, Diana H. Kirk and Alan Adams. 1992. “A Meta-Analysis of Clinical Trials of Spinal Manipulation”. Journal of Manipulative and Physiological Therapeutics 15, no. 3:181-194.
Manga, Pran, Doug Angus, Costa Papadopoulos, and Wliam Swan. 1993. The Effectiveness and Cost-effectiveness of Chiropractic Management of Low-Back Pain. Ottawa; University of Ottawa.
Cassidy, J. David, Haymo W. Thiel, and William H. Kirkaldy-Willis. 1993. “Side Posture Manipulation for Lumbar Intervertebral Disk Herniation”. Journal of Manipulative and Physiological Therapeutics 16,no. 2:96-103.
Meade, T.W., S. Dyer, W. Browne, J. Townsend, and A. O. Frank. 1990. “Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and Hospital Outpatient Treatment.” British Medical Journal 300, no. 6737: 1431-1437.
Wolk, Steve. 1998. “Analysis of Worker’s Compensation Medical Claims for Back-Related Injuries.”ACA Journal of Chiropractic (July): 50-59.

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