Chiropractic Research

Chiropractic Healthcare Research...

The word ‘chiropractic’ is derived from Greek to mean ‘Done by hand’ and it was first established in 1895 by D.D. Palmer and later developed by his son B.J. Palmer, in the USA. Chiropractic has been rapidly growing ever since and is now one of the largest primary health care profession in the western world.

There is a growing body of evidence to support the role of chiropractic within mainstream healthcare, specialising in the treatment and management of neuromusculoskeletal conditions. Below are extracts of just some of the most significant reports.

Recent evidence (The Bronfort Report, 2010) supports the benefits of chiropractic care for:
  • General aches and pains of joints, muscle spasms and cramps
  • Joint pains resulting from osteoarthritis (including hip and knee)
  • Mechanical neck pain
  • Headaches arising from the neck
  • Prevention of migraines
  • Frozen shoulder
  • Shoulder and elbow pains (including tennis elbow) when associated with other musculo-skeletal conditions of the spine
  • Tension

The National Institute for Health & Clinical Excellence (NICE) provides the NHS with specific guidelines on how to manage specific medical conditions. In 2009 they began recommending manual therapy including spinal manipulation (ie chiropractic care) for the treatment and management of persistent or recurrent non-specific mechanical low back pain. (This is defined as tension, soreness and/or stiffness in the lower back region involving one or more muscle, joint, disc or other connective tissues).

What makes chiropractic so uniquely qualified as the worlds leading health care profession in the area of spinal health is the unique focus on the relationship among spinal motion, alignment, neurology and health. What makes chiropractors so uniquely qualified as safe and effective practitioners are their years of unique training and focus on the assessment and correction of segmental spinal motion and related neurology and the importance of spinal conditioning and lifestyle.

Dr James Chestnut (B.Ed., M.SC., D.C., C.C.W.P)
Evidence Based Chiropractic Protocols
"By the end of the Inquiry we found ourselves irresistibly and with complete unanimity, drawn to the conclusion that modern chiropractic is a soundly-based and valuable branch of health care in a specialised area neglected by the medical profession."

Chiropractic in New Zealand. (1979) 
Report of New Zealand Government Commission on Chiropractic
"On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation (chiropractic adjustment) applied by chiropractors is shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain."

Professor Pran Mange Ph.D. University of Ottawa 
The Manga Report (1993) An Independent Report Commissioned by the Ontario Provincial Government in Canada
"For patients with common or mechanical back pain and neck pain/headache there is now a change from extensive diagnostic testing, rest, medication for pain control and surgical intervention based on structural pathology as in traditional medical practice, to exercise, manual treatments, early mobilisation of patients and education about the spine and lifestyle, based on functional pathology as in traditional chiropractic practice. This management approach is not only effective but highly cost-effective".

Chapman-Smith, David LL.B. The Chiropractic Report (2008)
The Chiropractic Profession: Basic Facts, Independent Evaluations, Common Questions Answered. Vol 22 (5) pp 1-8
"Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall healthcare costs. The increasing acceptance of chiropractic care as a source of comprehensive complementary care for neuromusculoskeletal problems is reflected in that the chiropractic field is the fasted growing among all doctoral-level health professions".

Legorreta et al. (2004) Comparative Analysis of Individuals with and without Chiropractic Coverage
Archives of Internal Medicine 164 (18)
"People who were mostly treated by chiropractors had, on average, less expensive medical services and shorter initial periods of disability".

Cifuentes et al. (2011) 
Health Maintenance Care in Work-Related Low Back Pain and its Association with Disability Recurrence. 
Journal of Occupational and Environmental Medicine pp 190-198
"This MRC-funded study estimated the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain. All groups improved over time. Exercise improved disability more than “best care” at three months. For manipulation there was an additional improvement at three months and at 12 months. For manipulation followed by exercise there was an additional improvement at three months and at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred.

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
"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".

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
"This review, by Bronfort et al, was published in the Journal Chiropractic & Osteopathy in 2010. Commentaries by Professor Scott Haldeman and Professor Martin Underwood accompany the report. In summary, the report demonstrates robust randomised controlled trial (RCT) evidence that the care offered by chiropractors is effective for a wide range of conditions including back pain, neck pain, pain associated with hip and knee osteoarthritis and some types of headache.

Effectiveness of Manual Therapies – The UK Evidence Report
NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health. Its guideline on the acute management of patients with chronic low back pain was published in 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

 Low back pain: early management of persistent non-specific low back pain
Further Information
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