The Agency for Health Care Policy and Research (AHCPR)

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."