Effectiveness of Chiropractic

In recent years, numerous independent researchers and various government agencies have conducted studies which focus on the efficacy, appropriateness and cost-effectiveness of chiropractic treatment. A summary of some of these studies are listed below:

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. “For patients with low-back in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison to hospital outpatient management.” The positive effects of chiropractic care in this 1990 study were even more evident during the follow-up study in 1995. Funding was provided by the Medical Research Council, the National Back Pain Association, the European Chiropractors Union, and the Kind Edward’s Hospital Fund for London. (#1)

The Florida Workers’ Compensation Study:
A 1988 study of 10,652 Florida workers’ compensation cases was conducted by Steve Wolk, Ph.D., and reported by the Foundation for Chiropractic Education and Research. The report supported 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 “a claimant with a back-related injury, when initially treated by a chiropractor versus a medical doctor, is less likely to become temporarily disabled, or if disabled, remains disabled for a shorter period of time; and claimants treated by medical doctors were hospitalized at a much higher rate than claimants treated by chiropractors.”(#3)

The RAND Study:
A four-phase study conducted in the early 1990s by RAND, one of America’s most prestigious centres for research in public policy, science and technology, explored many indications of low-back pain. In the RAND studies, an expert panel of researchers, including medical doctors and doctors of chiropractic, found that:

– Chiropractors deliver a substantial amount of health care to the U.S. population.
– Spinal manipulations are of benefit to some patients with acute low-back pain.

The RAND study marked the first time that representatives of the medical community went on record stating that spinal manipulation is an appropriate treatment for certain low-back pain conditions. (#2)

The Utah Study:
In another study of workers’ compensation claims, this 1991 study that was published in the Journal of Occupational Medicine found that patients of chiropractic care returned to work sooner after an injury, reporting an average of two lost work days to 20 under standard medical care. Furthermore, the study revealed that chiropractic care was 10 times less expensive than 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 manipulative therapy (chiropractic) and physiotherapy (physical therapy) 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 by the Dutch Ministry of Welfare, Health and Cultural Affairs, and by the Dutch Health Insurance Council.

The Manga Report:
This study funded by the Ontario Ministry of Health researched ways to reduce the incidence of work-related injuries, and to address cost-effective ways to rehabilitate disabled and injured workers. The report overwhelmingly supported the efficacy, safety, scientific validity, and cost-effectiveness of chiropractic for low-back pain. Additionally, it found out that higher patient satisfaction levels were associated with chiropractic care than with medical treatment alternatives. (#4)

The Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders:

This multi-disciplinary research group found spinal manipulation to be one of only a handful of treatment options of benefit for neck pain. The study which was published in the journal Spine concluded that spinal manipulation is a low risk, cost-effective choice. (#4)

#1 – Meade, T.W., Dyer, S., Browne, W., Townsend, J., Faran, A.O. (1990 & 1995) Randomised Comparison of Chiropractic and Hospital Outpatient Management for Low Back pain, British Medical Journal

#2 – Shekelle, P.G., Adams, A.H., Chaissin, M.R., Hurwitz, E.I., Phillips, R.B., Brook, R.H. (1991) “The Appropriateness of Spinal Manipulation for Low Back Pain. Project Overview and Literature Review”, Rand, Santa Monica, California

#3 – Jarvis, K.B., Phillips, R.B., Morris, E.K. (1991) “Cost per Case Comparison of Back Injury Claims versus Medical Management with Identical Diagnostice Codes”. Journal of Occupational medicine, Vol 33 (8), pp. 847-852

#4 – The Manga Report