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Scientific Research on Chiropractic
Many people, including other doctors, mistakenly believe that chiropractic has not been shown to be scientifically sound and clinically effective. The type of chiropractic we utilize at our office is highly-researched, tested over the course of decades, and is safe and effective as a treatment for low back pain, neck pain, and headaches.
>> Chiropractic for Work-Related Low Back Pain - Less costly, more effective, more proven
>> Chiropractic vs Hospital Treatment for Chronic or Severe Low Back Pain - Long story short: go to hospital when necessary, not otherwise
>> Chiropractic vs. Medicine for Acute LBP: No Contest - More effective, no side effects
>> Chiropractic vs Prescription Headache Medicine
>> Headache From Neck Misalignment - Anatomical connection between neck issue and headache
>> How Many Adjustments Should I Get To Resolve My Headaches?
Chronic Spinal Pain: A Randomized Clinical Trial Comparing Medication and Spinal Manipulation
To summarize the chart illustrating this study's findings: the chiropractic patients had pain for a longer period of time than the other group of patients, were more likely to be pain-free at the 9-week mark, had no negative side-effects, and had more improved general health when the study concluded.
Additionally, the chiropractic group showed significantly greater improvement in subjective complaints, functional abilities, and in objective range of spinal motion. For those scientifically-inclined, see the abstract here.
In a follow-up study which gathered data about the participants in the original research, allowing the researchers to measure the benefits of the treatments on a longer-term than the original study.
Below you will see the results of the research as well as the conclusions the researchers reached regarding the study:
The full text of this study also compares chiropractic to acupuncture. If you're interested, follow the link and see how chiropractic did.
There is a large amount of very high-quality research studies on chiropractic adjustments as a treatment for lower back pain. It is widely known among professional health care providers that chiropractic is an effective method of treating low back pain. In fact, more than 100 RCT's (randomized controlled trials) have showed that chiropractic treatment for low back pain provides significant benefit. In most of these research papers, chiropractic outperformed whatever other therapy it was compared to.
Here are a few of the more authoratative research articles about chiropractic care for low back pain:
Spinal manipulation found, in properly-controlled research, to be superior to NSAID and/or placebo.
Before more information, here are the Key Findings as summarized by Peter W. Crownfield @ DC:
Key FindingsTo summarize this research: a well-designed study was performed that compared three treatment groups, and the best results obtained were from the subjects who had their low backs adjusted. The other groups were placebo (sham medicine & sham adjustment) or a NSAID (diclofenac). These groups were blinded. The differences between groups were clinically significant.
Read through to the article by Crownfield or the PubMed abstract for more details.
New research, in scientific journal and conducted by medical doctors, shows that chiropractic care is more effective in getting patients back to work with less likelihood of ongoing disability.
In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.
The authors state that "by visiting only or mostly a chiropractor or becoming a chiropractic loyalist, the patients do not receive other traditional medical approaches." While this is obvious, it is no less significant because those who do receive traditional medical care experienced a greater likelihood of recurrent disability.
The study, carried out by an insurance company that handles worker's compensation claims, found that patients that utilize chiropractic tend to have less ongoing disability, at less cost and with less impact on days worked. This is very important, and this effect may stem from the doctor-patient relationship being stronger with DC's as opposed to the other providers, as well as an emphasis on treatments that do not rely on drugs or surgery. Sometimes, the benefit of chiropractic care may come from not utilizing the alternatives. The authors of the study could not say what precisely accounts for the improved results among chiropractic patients. The fact that an insurance company is paying for this type of research to be done strongly suggests that this the insurance company wants to minimize the costs of medical care because all that money represents diminished profit. The insurance company is biased towards allocating health expenses cost-effectively, which means that any biases against chiropractic or allopathic schools of thought will be less likely to distort the findings in this study.
With the publication of the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study in The Spine Journal, one of the most frequently cited spine research journals in the world, the health care community at large may finally appreciate what the chiropractic profession has known for more than a century: Patients with [sic] low back pain enjoy significant improvement with chiropractic care...
To summarize the chart, the group of patients who simply went to their usual doctor were more often prescribed pain medication and did not get better. So, they took drugs but they didn't get any lasting relief. The chiropractic patients were much less likely to end up on pain medication for pain relief, and were much, much more likely to have stronger backs and less pain.
Research in 2007 allowed non-chiropractors to treat the "spinal manipulation" patients in a similar study, and found no significant advantage to having your back adjusted as opposed to taking pain medication. That research used physiotherapists, not chiropractors. This new study actually uses chiropractors (who, unlike physiotherapists or osteopaths, are much more extensively trained at adjusting the spine) and achieved much better results for than medical doctors, pain medication, or physiotherapists doing the adjusting.
This research published in the British Medical Journal in 1990 compared outcomes between two groups of patients with low back pain.
The quoted conclusion of the study authors was:
Conclusions - For patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain.
The specific results are very positive for chiropractic. Let's see some tables from the original article [Click on these tables to see the full size and read the words]:
In this image (TABLE IV, to the left) we can see a comparison of the two treatment groups: Hospital or Chiropractic. We see some similarities in this, such as overlap among the treatment techniques used to address back pain. But there are differences. The hospital-based treatment group got mostly exercise and non-chiropractic spinal maneuvers, as well as traction. The chiropractic group mostly got chiropractic adjustments, although exercise was also utilized. The chiropractic group, though, required more treatments and a longer-term of care.
This second image (TABLE VI, to the right) shows us the
results of the study in table format. We can see a few very important
things that we have provided in bulleted list format for simplicity:
Spinal adjustments were found in this study to be effective treatment for cervicogenic headaches (the term "cervicogenic" means that the headache is coming from a neck condition), as well as being an effective treatment for both episodic and chronic migraines.
CONCLUSIONS: Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.
Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial
The researchers found that one month of chiropractic care was more effective on the long-term than was the medication. In the short-term, during the one month length of the study, the chiropractic adjustments were roughly equal to the medication in terms of short-term pain relief. The difference was that the chiropractic patients maintained pain relief even after the study ended while the medication group was back at pre-study pain levels within a few weeks.
Rectus Capitis Posterior Minor Attaches to Dura Mater of Meninges
The rectus capitis muscle, and the other suboccipital muscles, attach the upper cervical spinal bones to the base of the skull. Problems in this part of the spine will create tension and cause cervical spine dysfunction.
Chiropractic adjustments can reduce the tension in these muscles and relieve the pulling on the meninges and decreasing the symptoms of the tension headache. An upper cervical adjustment combined with some soft tissue work on the involved muscle quite often relieves the headache within a short time.
Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial
All patients do not require multiple office visits per week, but some do - and if you have headaches that respond well to adjustments by a chiropractor, this research suggests that then you will be able to recover faster and more fully if you are adjusted more than two times per week. Please refer to the link to the PubMed listing for this study. As new research concerning dose response and visit frequency comes out, we will update this page.
Chiropractic recommended prior to surgery for sciatica because it is as effective, could make surgery unnecessary
Research further confirms the benefits of chiropractic care for sciatica, specifically noting that patients should utilize chiropractic prior to considering surgery for sciatica.
Sixty percent of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention. Of 40% left unsatisfied, subsequent surgical intervention confers excellent outcome. Patients with symptomatic LDH failing medical management should consider spinal manipulation followed by surgery if warranted.
This press release from the Foundation for Chiropractic Progress details some impressive new research about sciatica and chiropractic, and the Journal of Manipulative and Physiological Therapeutics has the abstract.
The study compared sciatica patients who either underwent chiropractic care or underwent microdiskectomy (surgery). It was either 21 trips to the chiropractor or lower back surgery.
The study found that 60% of the patients who underwent chiropractic care first experienced relief to the same degree as if they had surgery. Of the 40% who didn't, they underwent surgery and had similar outcomes as the surgery-first patients. There was no detrimental effect from delaying surgery to see if chiropractic would resolve the sciatica. The authors of the study concluded that chiropractic should be considered prior to surgery, with surgery considered after chiropractic if still warranted.
Also worth mentioning is the fact that the cost of lower back surgery is much more than the cost of 21 visits to the chiropractor. The cost of the surgery is estimated at about $25,000. 21 visits to your chiropractor can generously be assumed to cost up to $100/visit for a total of $2,100. That means that about $22,900 is saved for 60% of patients. Considering how prevalent sciatica is a large amount of money could be saved in the United States if referral for a round of chiropractic first became standard operating procedure. This randomized trial found 6 out of 10 patients ended up with results just as good as surgery, and (importantly) it involved 21 office visits. Chiropractic care is not an event, it's a process, and multiple office visits according to a treatment schedule are needed to achieve these results. A study done with fewer or less regular chiropractic adjustments and ancillary modalities might not have had the same results.