Research
2013 Research reinforced a) The effectiveness of manipulation (which is what chiropractors mainly do and b) The effectiveness of manipulation in a statistically meaningful way. This old evidence contradicts what some say with regards to manipulation eg that placebo is as effective as manipulation intervention into conditions such as Low Back Pain, Neck Pain and Headaches. Additionally, manipulation (when carried out by people who are practised and properly skilled) will be the most effective intervention in many cases of spinal and extremity pain. (see link below). Manipulation takes practice and not every practitioner (chiro/Osteo/Physio/Medic) will be good at it. Manipulation is a skill, akin to sporting skills and not everyone is an exponent. These people will find other ways to help patients, hopefully.
Evidence-Based Practice and Chiropractic Care
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/
Other links to evidence include:
Meade et al (1995) Randomised comparison of
chiropractic and hospital outpatient treatment for
low back pain: results from extended follow up. BMJ
311; 349-351
Funded by the MRC, confirmed the findings of the earlier report.
RCGP (1999) Clinical Guidelines for the Management
of Acute Low Back Pain
Funded by the Royal College of General Practitioners proved
that the risks of manipulation are very low in skilled hands and
it can provide short-term improvement in pain and activity
levels and higher patient satisfaction.
UK BEAM Trial Team (2004) United Kingdom back
pain exercise and manipulation (UK BEAM)
randomised trial: effectiveness of physical
treatments for back pain in primary care. BMJ
329:1377
Funded by the MRC, showed that exercise was better than “best
care” in general practice at three months. Adding manipulation
there was further improvement at three months and at 12
months.
UK BEAM Trial Team (2004) United Kingdom back
pain exercise and manipulation (UK BEAM)
randomised trial: cost effectiveness of physical
treatments for back pain in primary care. BMJ
329:1381
Spinal manipulation is a cost effective addition to “best care”
for back pain in general practice. Manipulation alone probably
gives better value for money than manipulation followed by
exercise.
NICE (2006) IPG 183 – Non-rigid stabilisation
techniques for the treatment of low back pain -
guidance
Results showed that chiropractic intervention and posture
training can limit episodes of acute pain. Spinal rehabilitation
can also be beneficial.
Department of Health (2006) Musculoskeletal
Services Framework
Showed that chiropractors provide evidence-based, timely and
effective assessment, diagnosis and management of certain
musculoskeletal disorders.
Low back pain: early management of persistent non-
specific low back pain
NICE guidelines May 2009
The evidence-based recommendations include the following:
Provide people with advice and information to promote self-
management of their low back pain.
Consider offering a course of manual therapy including spinal
manipulation of up to 9 sessions over up to 12 weeks
Consider offering a course of acupuncture needling comprising
up to 10 sessions over a period of up to 12 weeks
Consider offering a structured exercise programme tailored to
the individual.
European Commission Research Directorate General
(2004) European Guidelines for the management of
chronic non-specific low back pain in primary care
(2004)
Recommendation: Consider a short course of spinal
manipulation/mobilisation as a treatment option for chronic
low back pain.
European Commission Research Directorate General
(2004) European Guidelines for the management of
acute non-specific low back pain in primary care
Findings were not to prescribe bed rest but advise patients to
continue normal activities and take pain relief and muscle
relaxants, as required. Also to consider referral for spinal
manipulation.
Manga Report ….chiropractic care can bring about improved health outcomes at a lower cost.
Tendonopathy & Neo-vascularisation
Dr Otto Chan, Orthopaedic surgeon and Radiologist, injects a high volume Homeopathic/Cortisone solution intratendonously.
Clinical Trial Shows Chiropractic Helps Headaches
UK BEAM Report states…manipulation treatment of back pain by practitioners including chiropractors, more effective than hospital outpatient treatment.
