Effectiveness of Chiropractic

Summaries of Research

The Meade Study:
A three-year British comparison of Chiropractic care and standard medical care of low-back pain patients found Chiropractic treatment more effective than hospital outpatient management for patients with chronic or severe back pain. The positive effects of Chiropractic care in this1990 study were even more evident during the follow-up period. Funding of this study was provided by the Medical Research Council, the National Back Pain Association, the
European Chiropractors Union, and the King Edward’s Hospital Fund for London.

The RAND Study:
Preliminary reports published in 1991 by one of the most prestigious centres for research in public policy confirms the appropriateness of spinal manipulation for some low-back pain patients. This study is part of a larger, multi-year project designed by the Consortium for Chiropractic Research to help establish standards of care for the Chiropractic profession. The Foundation for Chiropractic Education and Research (FCER) is assisting in the management of this study.

The Florida Study:
The highlights of this 1988 FCER-funded report support the findings of earlier studies of workers’ compensation claims that Chiropractic care is more cost-effective than standard medical care in the management of work-related back injuries. The results of this study indicated Chiropractic patients suffered shorter periods of total disability, and their cost of care was lower, compared to patients of medical doctors, who were likely to be hospitalised.

The Utah Study:
In another study of worker’s compensation claims, this 1991 study found that patients of Chiropractic care returned to work sooner after injury, reporting an average of two lost work days to twenty under standard medical care in compensation payouts. Funding of this study was provided by the Workers’ Compensation Fund of Utah, the Los Angeles College of Chiropractic, and the Greenawalt Fellowship Fund.

The Koes’ Clinical Trial:
A 1991 Dutch project compared Chiropractic and physiotherapy for the treatment of persistent back and neck complaints. After 12 months, the manipulative therapy groups showed greater improvement in the primary complaint as well as in physical function, with fewer visits. Funding for this trial was provided for the Dutch Ministry of Welfare, Health and Cultural Affairs, and by the Dutch Health Insurance Council.

The Manga Study:
This study researched both the effectiveness and cost-effectiveness of the Chiropractic management of low-back pain, and found “on the evidence, particularly the most scientifically valid clinical studies, spinal manipulations applied by Chiropractors is shown to be more effective than alternative treatment for low-back pain. Many medical therapies are of questionable validity or are clearly inadequate. The study was funded by the Ontario Ministry of Health.

Cost Effectiveness

The Manga Report commissioned by the Canadian government clearly indicates the cost effectiveness of Chiropractic treatment over standard medical treatment:

”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 manipulation is safer than medical management of low-back pain.”

“There would be highly significant cost savings if more management of low-back pain was transferred from physicians to Chiropractors... Users of Chiropractic care have substantially lower health costs, especially inpatient costs, than those who use medical care only.”

In The Australian Study, 1,996 workers’ compensation cases were evaluated in patients who experienced work-related mechanical low back pain. It was found that those individuals who received Chiropractic care for their back pain returned to work four times faster (6.26 days vs. 25.56 days) and had treatment that cost four times less ($392 vs. $1,569) than those who received treatments from medical doctors. Also, in those patients who received Chiropractic care there was a significantly lower incidence of progression to a chronic low back pain status.

(Mechanical Low-Back Pain: A Comparison of Medical and Chiropractic Management Within the Victorian Work Care Scheme. Ebrall, PS. Chiropractic Journal of Australia - 1992; 22:47-53.)



Did You Know That Chiropractic Care Is Second To None?

The Meade Study: Chiropractic Offers Long-Term Benefits: This study concluded, “For patients with low-back pain in whom manipulation is not contraindicated, Chiropractic almost certainly confers worthwhile, long-term benefit in comparison to hospital outpatient management. According to a study conducted by Ontario’s Ministry of Health ”...for the management of low-back pain.

The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada. Low Back Pain of Mechanical Origin: Randomised Comparison of Chiropractic and Hospital Outpatient Treatment. Meade, TW et al British Medical Journal - 1990; 300:1431-1437.


Chiropractic Treatment vs. Outpatient Hospital Treatment by P.T’s and M.D’s

In this study, British medical researchers found Chiropractic treatment significantly more effective than hospital outpatient treatment, especially in patients with chronic and severe back pain. Significantly fewer patients needed to return for further treatments at the end of  the first and second year in those who received Chiropractic care (17% compared with 24%). In addition, “two and three years after patients with back pain were treated by Chiropractors, they experienced far less pain than those who were treated by medical doctors.”

The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.


Chiropractic Treatment vs. Physiotherapy

Spinal manipulation provided greater improvement of symptoms in these suffering from persistent back and neck complaints compared with physical therapy. The patients receiving spinal manipulation also had greater improvements of physical functioning in fewer visits.

Randomised Clinical Trial of Manipulative Therapy and Physiotherapy for Persistent Back and Neck Complaints: Results of One Year Follow Up. Koes, B.W. et al. British Medical Journal - 1992; 304:601-605


Chiropractic Treatment vs. Mobilisation

Those receiving spinal manipulation achieved a 50% reduction in their pain levels more rapidly than those receiving mobilisation (therapy commonly used by Physical Therapists)

A Benefit of Spinal Manipulation as Adjunctive therapy for Acute Low-Back Pain: A Stratified Controlled Trial. Hadler NM et al. Spine - 1987; 12:703-706


Chiropractic Treatment vs. Bed Rest

50% of the individuals in the spinal manipulation group were pain free in one week compared with only 27% of those receiving bed rest.

Low-Back Pain Treated by Manipulation. Coyer AB and Curwin I. British Medical Journal - 1955; 1:705-707


Chiropractic Treatment vs. Codeine

Spinal manipulation provided significant improvement in the subjects overall pain score compared with the commonly prescribed medication, codeine.

Lumbar Spine Manipulation on Trial: Part 1 - Clinical Assessment. Evans DP et al. Rheumatology and Rehabilitation - 1978; 17:46-53


Chiropractic Treatment vs. Deep Heat Applications

Patients receiving spinal manipulation experienced a significantly shorter time to pain relief than those receiving deep heat applications.

Distinct benefit for spinal manipulation vs diathermy (deep heat application used by P.T’s) in return to light work at one month.

Another study found spinal manipulation provided better pain relief for those with less than one week of pain and in patients with their first attack of back pain.

A Benefit of Spinal Manipulation as Adjunctive therapy for Acute Low-Back Pain: A Stratified Controlled Trial. Hadler NM et al. Spine - 1987; 12:703-706