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Evidence for the
Effectiveness of Chiropractic
Numerous studies throughout the
world have shown that chiropractic treatment, including manipulative
therapy and spinal adjustment, is both safe and effective. The
following are excerpts from a few of the more recent studies:
For Acute Low-Back Problems:
"For patients with acute low-back symptoms without radiculopathy, the scientific
evidence suggests spinal manipulation is effective in reducing pain and perhaps speeding
recovery within the first month of symptoms."
Clinical Practice Guidelines, AHCPR (1994)
For Long-term:
"...improvement in all patients
at three years was about 29% more in those treated by chiropractors than in those treated
by the hospitals. The beneficial effect of chiropractic on pain was particularly
clear."
British Medical Journal, Meade et al. (1995)
"Manipulative therapy and
physiotherapy are better than general practitioner and placebo treatment.
Furthermore, manipulative therapy is slightly better than physiotherapy after 12
months."
British Medical Journal, Koes et al. (1992)
For Pain:
"...patients suffering from back
and/or neck complaints experience chiropractic care as an effective means of resolving or
ameliorating pain and functional impairments, this reinforcing previous results showing
the benefits of chiropractic treatment for back and neck pain."
Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)
"...for the management of
low-back pain, chiropractic care is the most effective treatment, and it should be fully
integrated into the government's health care system"
The Manga Report (1993)
For Headaches:
"The results of this study show
that spinal manipulative therapy is an effective treatment for tension headaches."
"Four weeks after cessation of treatment...the patients who received spinal
manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in
contrast to the patients that received amitriptyline therapy, who reverted to baseline
values."
Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)
For Elderly:
"[Elderly] chiropractic users
were less likely to have been hospitalized, less likely to have used a nursing home, more
likely to report a better health status, more likely to exercise vigorously, and more
likely to be mobile in the community. In addition, they were less likely to use
prescription drugs."
Topics in Clinical Chiropractic, Coulter et al. (1996)
Patient Satisfaction
Because chiropractic treatment of
low-back pain is often more successful than medical treatment, patient satisfaction with
chiropractic care is generally higher. As these successes mount, positive
word-of-mouth spreads. Today, the popularity of chiropractic is at an all-time high.
"Overall, respondents were very
satisfied with the chiropractic care they received. Global satisfaction was 6.17 (on
a 7-point scale), that is, within the range of 'very satisfied' to 'completely
satisfied.'"
Journal of the American Chiropractic Association, Goertz et al. (1977)
". . . more likely
satisfied . . ."
"Patients positively endorsed all
items on the satisfaction questionnaire, indicating a high level of satisfaction with the
care they received."
Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)
"Compared to those who sought
care from medical doctors, those who sought care from chiropractics were more likely to
feel that treatment was helpful, more likely to be satisfied with their care, and less
likely to seek care from another provider for that same episode of pain."
Spine, Carey et al. (1996)
 American's
Perceptions of Practitioners & Treatments for Back Problems
"Those who sought care from a DC were more likely to be
very satisfied (63%) with their care than those who were treated by
a PT (56%), MD (52%), or DO (50%)."
Americans' Perceptions of Practitioners & Treatments
for Back Problems (1995)
 Nearly
30% of the U.S. population, aged 18 and older, have used chiropractic.
The Gallup Organization, Alhstrand (1991) Nine
out of ten chiropractic users felt their treatment was effective.
The Gallup Organization, Alhstrand (1991)
"...a significant percentage (84%)
felt that the care they received was 'just about perfect' and 97%
either strongly agreed or agreed with the statement, 'I would recommend
this doctor to a friend or relative.'"
Journal of Manipulative and Physiological Therapeutics,
Sawyer & Kassak (1993)
 Cost
Effectiveness of Chiropractic
Chiropractic treatment
of back pain is a perfect example of how health care expenditures
can be reduced while in fact increasing the quality of care.
Not only is the chiropractic treatment significantly less costly than
treatment managed by other health care practitioners, but because
chiropractic care can get workers back on the job more quickly, it
can save businesses the expense of lost productivity.
"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."
The Manga Report (1993)
"Treatment costs in cases managed
by chiropractic physicians increased 12% between 1986 and 1989. Treatment cost in
cases managed by medical physicians increased 71% in the same time period.
Compensation (wage replacement) costs increased 21% for the chiropractic group and 114%
for the medical group."
Journal of Manipulative and Physiological Therapeutics, Jarvis et al. (1997)
". . . chiropractic
management
of low-back pain is
more cost-effective . . ."
"The cost of health care for back and neck pain
was substantially lower for chiropractic patients than for nonchiropractic patients ($539
vs $774)." "The authors conclude that properly managed chiropractic care
can yield outcomes, in terms of surgical requirements and patient satisfaction, that are
equal to those of non-chiropractic care, at a substantially lower cost per patient."
American Journal of Managed Care, Mosley et al. (1996)
"Multiple regression analysis, to control for
differences in patient, clinical, and insurance characteristics, indicates that total
insurance payments were substantially greater for episodes with a medical first-contact
provider."
Medical Care, Stano & Smith (1996)
"Of 1,996 low-back pain cases studied, patients
receiving chiropractic treatment averaged 6.26 compensation days compared to 25.56
compensation days for medical patients."
Chiropractic Journal of Australia, Ebrall (1992)
Clinical Practice Guidelines
In 1994, the Agency for Health Care Policy and Research (AHCPR), a branch of the U.S.
Department of Health and Human Services, published Acute Low Back Pain Problems in
Adults as part of its Clinical Practice Guidelines. The panel, a
multidisciplinary group of health care experts, developed recommendations on the treatment
of acute low-back pain based on scientific evidence and extensive literature searches.
The findings concluded that spinal manipulation was
"safe and effective," and recommended it as an initial form of therapy for acute
low-back pain sufferers. Spinal manipulation (also called chiropractic adjustment)
is the principal therapeutic procedure offered by doctors of chiropractic.
Topics of Ongoing
Research
Recognizing the need for clinical
research and randomized trials, the American Chiropractic Association (ACA), the
Foundation for Chiropractic Education and Research (FCER), the National Institute of
Health (NIH), the Agency for Health Care Policy and Research (AHCPR) and numerous other
agencies have funded millions of dollars in chiropractic research.
Areas of ongoing research include:
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