A panel of 23, supported by a staff of 200 leading
back experts, was commissioned by the U.S. Office of Public
Health to study treatment methods for back pain. They reviewed
the thousands of studies that address this issue. After selecting
the best scientifically-based studies, they concluded that spinal
manipulation (94% of which is done by Chiropractors) was clearly
superior to any other treatment for low back pain.
The AHCPR published guidelines which stated that
conservative spinal manipulation should be tried first,
before any of the more traditional approaches.
Manga Report
This unbiased independent study commissioned by
the Ontaria Ministry of Health showed chiropractic treatment
to be cost effective, safe, has a high rate of patient satisfaction
and is more effective than medical treatment for low back pain.
The report also recommends that the management of
low back pain be moved from Medical Doctors to Doctors of Chiropractic
and that hospital privileges be extended to chiropractors. Remember
this study was commissioned by the Government of Ontario and
was conducted by professor Pran Manga (Adjunct Professor, University
of Ottawa) with sole funding by the government!
Some key findings as outlined in the Executive Summary:
- Evidence from numerous countries indicate a great number of
treatments administered for low back pain show little if any
effectiveness when assessed scientifically.
- Many traditional medical therapies are of questionable usefullness
and clearly inadequate.
- There is no evidence that chiropractic treatment is unsafe
for the treatment of low back pain.
- The evidence is there that spinal manipulation (adjusting)
is not as safe or effective when performed by non chiropractors
as it is by chiropractors.
- Chiropractic care is safer, and more cost effective than medical
care for low back pain.
- Workers' Compensation literature show chiropractors return
injured workers to work faster than medical physicians care
for the same diagnosis.
- Patient satisfaction is higher when treated for low back pain
by chiropractors than by the established medical community.
- The report even goes so far as to recommend chiropractors
should be fully integrated into the Ontario health care system
and should receive hospital privileges.
RAND Study
In 1991 The Rand Study was published. It set out
to study the appropriateness of spinal manipulation as applied
to low back pain. The report was so extensive it reviewed the
scientific literature from 1952 to 1991. The data was collected
from 76 different sources and included 22 controlled trials
that addressed the use of spinal manipulation for low back pain.
The report criticized the quality of a large number
of the studies they reviewed on the topic. After settling on
the body of literature they concluded worthy of consideration
they concluded, "... support is consistent for the use of
spinal manipulation as a treatment for patients with acute low
back pain and an absence of other signs or symptoms of lower
limb nerve root involvement."
Other Research
There are numerous studies conducted over the years
assessing and comparing chiropractic management of back pain.
An example of the body of literature that addresses
chiropractic care is the study that was reported in 1990 in
the prestigious British Medical Journal. The study was conducted
by the Director of the Northwick Park Hospital in Middlesex
England. The study (Low back pain of mechanical origin: randomised
comparison of chiropractic and hospital outpatient treatment)
compared chiropractic and hospital management of low back pain.
This was one of the better studies ever undertaken due to the
fact that 741 patients, between the ages of 18 to 65, were followed
for up to 2 years after receiving their respective treatment.
The researchers concluded, "Chiropractic treatment
was more effective than hospital outpatient management, mainly
for patients with chronic or severe back pain." An interesting
observation they made was, "The benefits of chiropractic
treatment became more evident throughout the follow up period.
Secondary outcome measures also showed that chiropractic was
more beneficial."
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