In the previous blog Will Surgery Fix It? we discussed research that suggested surgery for back pain may not be as effective or beneficial as many of us may have been led to believe. My intention here is to highlight how critical it is for us all to gain Health Literacy or awareness about any procedure or product before we undergo surgery, therapy or care. It is important to state that chiropractic care is not always effective at immediately revealing symptoms. Fundamentally chiropractic addresses the root cause of a health problem and if that cause has been present for sometime then healing can be a gradual process. 

Below is a summary of some of the research on the effectiveness of chiropractic care for back pain or strengthening spinal health.
In the  Manga Report, which was commissioned by the Ministry of Health in Ontario and carried out by leading independent health economists at the University of Ottawa, this group reviewed all of the international evidence on the management of low back pain. (The Effectiveness and Cost-Effectiveness Of Chiropractic Management Of Low Back-Pain Pran Manga, Ph.D. Douglas E. Angus, M.A. Costa Papadopoulos, M.H.A. William R. Swan, B.Comm. Funded by the Ontario Ministry of Health August, 1993)

Here are their findings:
  • There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors
  • There should be a “shift in policy to encourage and prefer chiropractic services for most patients with low-back pain,” and chiropractic should be “fully insured (and) fully integrated” into the health care system.
  • “The overwhelming body of evidence” shows that chiropractic management of low-back pain is more cost effective than medical management, and that “many medical therapies are of questionable validity or are clearly inadequate…”Chiropractic is safer than medical management of low-back pain.”
  • “The literature suggests that chiropractic management of low back pain is more effective, more cost-effective, and safer than medical management. Furthermore, there is greater patient satisfaction with chiropractic care than with medical management of low back pain.”
  • “The literature suggests that chiropractic manipulation is safer than medical management of low back pain, perhaps contrary to popular impressions. There are no clinical or case-control studies that demonstrate or even imply that chiropractic is unsafe in the treatment of low back pain.”

The Rand Study was a project conducted by a nonprofit private corporation in Santa Monica, California which conducts research and development for the US Government and the private sector, and commands international respect. The project was directed by two medical doctors, Robert Brook, MD, and Paul Shekelle, MD, and involved two expert panels of clinicians and researchers, to assess the clinical consensus on the appropriateness of spinal manipulation ( a term that I have replaced with spinal adjustment) for more than 1600 patients with back pain conditions.(A Community-Based Study of the Use    

of Chiropractic Services Paul G. Shekelle, MD, MPH, and Robert H. Brook MD, ScD American Journal of Public Health 1991;81:439-442)

The goal of this study was to provide a comprehensive set of indications for performing spinal adjustments for persons with low back pain. The results of the study were:

  • Low back pain is the most common complaint of patients seeking chiropractic care (from 32 percent to 45 percent, depending on the study), and spinal adjustments are the most frequently provided service (from 76 percent to 92 percent of all services).
  • Acute and sub-acute mechanical back pain patients given spinal adjustments achieve better early results than patients given common medical treatments (bedrest, medication, traction, corsets).
  • 50% of the patients adjusted were free of pain after one week, compared to 27% treated with bedrest.
  • Adjustments proved better for pain relief than the use of physiotherapy and analgesics.
  • Pain was relieved by adjustments in a shorter time (3.5 treatments) than by exercise (5.8 treatments).
  • Patients with pain of 2 to 3 weeks duration achieved a 50% reduction in pain more rapidly with adjustments than with mobilization.
  • Patients adjusted improved significantly faster than those treated with medicine.
  • Adjustments provide earlier relief than other treatments or no treatment.

British Medical Research Council Study (The British Medical Research Council conducted a 10 year, multi-center trial comparing chiropractic and hospital outpatient management of 741 patients with acute and chronic mechanical low back pain. Results of this study were reported in the June 2, 1990, issue of The British Medical Journal.)

Results of this study concluded the following:

  • Chiropractic treatment for back pain is significantly more effective, particularly for patients with chronic and severe pain.
  • Results are long-term–”the benefit of chiropractic treatment became more evident throughout the follow-up period of two years.
  • The superior results for chiropractic patients were not result of trial errors or placebo.
  • “The potential economic, resource, and policy implications of our results are extensive. Consideration should be given to providing chiropractic within the National Health Service, either in hospitals, or by purchasing chiropractic treatment from existing clinics.”
  • An economic analysis, which appears conservative and uses patient numbers reported in 1979, shows savings in excess of 10 million pounds per annum in Britain by having hospital outpatients with back pain treated by chiropractors.
  • This study provides very considerable support of the New Zealand Commission’s findings.

Chiropractic is one of the most cost effective and safest form of care for back pain.
Clinincal evidence suggests that chiropractic is more effective in dealing with back pain than other more common medical treatments.For those who have never experienced chiropractic before then research about the effectiveness of chiropractic for back pain may hold great merit.
For many chiropractors though, we are more passionate about conducting research on how chiropractic is a wonderful health enabler. We are passionate about people realising that while extrememly effective, chiropractic does not cure anything. The human body creates all healing.

Chiropractic adjustments free the nervous system to communicate effectively so that the body can self-heal and self-regulate. Vertebral subluxations and nerve interference affect our life force in countless ways. In fact having nerve interfernce is like ‘driving a car with the hand-brake on’ and chiropractic adjustments help you to live or drive at your maximum genetic capacity.
Yours in Health
Jennifer
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