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 Low-Back Problems:
"There is strong evidence that manipulation is more
effective than a placebo treatment for chronic low-back
pain or than usual care by the general practitioner, bed
rest, analgesics and massage." - Spine, Van Tulder and
Bouter et al. (1997)
"...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, thus 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:
"Cervical spine manipulation was associated with
significant improvement in headache outcomes in trials
involving patients with neck pain and/or neck
dysfunction and headache." - Duke Evidence Report,
McCrory, Penzlen, Hasselblad, Gray (2001)
"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 the 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
Oakland University Study
At Michigan's Oakland University, Miron Stano, Ph.D.
compared the health care costs for medical and
chiropractic patients. By reviewing the insurance claims
paid, Dr. Stano concluded that patients who received
chiropractic care, either alone or in conjunction with
medical care, experienced health care costs that were
$1000 lower on average than those who received only
medical care. Total insurance payments for patients who
received only medical care were thirty percent higher
than those who were under the care of a chiropractor.
This lower cost was attributed to lower in-patient and
out-patient costs and showed that "the chiropractic care
substitutes for other forms of out-patient care.
The Manga Report
"The Manga Report, from the University of Ottawa,
reviewed all the international evidence on the
management and low cost of back pain care. Pran Manga,
Ph.D. concluded that significant cost savings would
occur if the management of low back pain were
transferred from physicians to chiropractors. He
determined that chiropractic is safer than medical
management of low back pain. "Many medical therapies are
of questionable validity or are dearly inadequate.
Chiropractic care is greatly superior to medical
treatment in terms of scientific validity, safety, cost
effectiveness and patient satisfaction." Dr. Manga
concluded that "chiropractic should be fully insured
(and) fully integrated into the Ontario health care
system."
The British Medical Research Council
The British Medical Research Council documented a
ten-year study which compared chiropractic and hospital
out-patient management of seventy-four (74) patients
with acute and chronic mechanical low back pain. The
results showed that chiropractic care was significantly
more effective than medical treatment for patients with
chronic and severe pain. Furthermore, these results were
long-term and remained consistent throughout the
two-year follow-up period. Chiropractic was also shown
to save the British more than 10 million pounds a year
by having hospital out-patients with low back pain under
chiropractic care.
New Zealand Study
These findings reinforced the conclusions of the New
Zealand Report (377 pages) which was one of the most
thorough and positive studies of chiropractic care on
record. The twenty-month project was conducted by a
government commission.
It concluded that spinal adjusting is a vital, very safe
and clinically effective form of health care.
Chiropractors have more thorough training in spinal
mechanics and spinal care than any other health
professional. Furthermore, chiropractic is
scientifically based and must be made an integral part
of all hospital care. Finally, the report said that
"modern chiropractic is a soundly based and valuable
branch of health care in a specialized area neglected by
the medical professional."
Washington Study
J. S. Wright, D.C., conducted a study and reported to
the Journal of Chiropractic that 74.6 percent of
patients with recurring headaches, including migraines,
were either cured or experienced reduced headache
symptoms after receiving chiropractic adjustments.
Daniel C. Cherkin, Ph.D. and Frederick A. MacCormack,
Ph.D., a survey in 1989 that concluded that patients who
were receiving care from health maintenance
organizations (HMOs) in Washington State were three
times as likely to report satisfaction with chiropractic
care as they were from other physicians. The patients
also reported they believed that their chiropractor was
concerned about their welfare.
AV MED HMO Study
AV MED, a large HMO in the southeast, wanted to see if
it could save money by having patients visit
chiropractors for back pain. They chose one-hundred
patients, eighty of whom had already been treated
medically--without results. In each case, the patient
had been seen by an average of 1.8 M.D.s. After
receiving chiropractic adjustments, not one of the 100
patients had to have surgery. Furthermore, 86 percent of
them got better and none of them got worse. Herbert
Davis, M.D., the medical director of AV MED, said that
chiropractic care saved the HMO $250,000 in surgical
costs alone!
Nevada Worker's Compensation Study
The State Industrial Insurance Systems (SIIS) in Nevada
compared the average medical and chiropractic care for
patients who suffered industrial injuries from
1988-1990. The results showed that 24.4 percent were
back injuries but they accounted for more than 50
percent of all medical costs. Over the three-year
period, the average medical cost per patient was $2,142
which was 260 percent higher than the average
chiropractic cost per patient of $892; Loss of work time
under chiropractic care is less than one-third that for
medical care. Furthermore, injured workers are able to
continue working while receiving chiropractic care which
may not be an option for medical care patients who are
advised to have bed rest and medication. The Nevada
Worker's Compensation Study emphasized that chiropractic
eliminates the concern and expense of inappropriate
hospitalization, unnecessary surgery, improper use of
medication including the high dosage of narcotic
painkillers.
University of Saskatchewan Study
In 1985, the University of Saskatchewan Study monitored
283 patients "who had not responded to previous
conservative or operative treatment" and who were
initially classified as totally disabled. The study
revealed that after daily spinal adjustments were
administered, "81 percent ...became symptom-free or
achieved a state of mild intermittent pain with no work
restrictions.
The British Medical Journal
The British Medical Journal reported in the June 2, 1990
issue that T.W. Meade, M.D. studied patients over a
two-year period. Dr. Meade found that "for patients with
low-back pain in whom spinal adjustments are not
contraindicated, chiropractic almost certainly confers
worthwhile, long-term benefit in comparison with
hospital outpatient management."
Florida Study
In 1991, Steve Wolk, Ph.D., studied 10,652 worker's
compensation cases in Florida. The results reported by
the foundation of' Chiropractic Education and Research
concluded that: "A claimant with back-related injury,
when initially cared for 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
care for by chiropractors."
The Gallup Study
The Gallup Organization conducted a demographic poll in
1991 which revealed that ninety percent of chiropractic
patients felt their care was effective. More than eighty
percent were satisfied with the care they received and
almost seventy-five percent felt most of their
expectations had been met during chiropractic visits.
Oregon Study
Also in 1991, Joanne Nyiendo, Ph.D., conducted a
worker's compensation study in Oregon. She concluded
that the median time loss in days for comparable
injuries on any case was 9.0 days for patients who
received chiropractic care as compared to 11.5 days for
those who received medical treatment.
Saskatchewan Hospital Study
Two years later, in 1993, researchers at the Royal
University Hospital in Saskatchewan concluded that "the
care of lumbar intervertebral disk herniation by side
posture adjustments is both safe and effective." The
researchers involved in the report, J. David Cassidy,
D.C.; Haymo Thieli D.C.; M.S. and W. Kirkaldy-Willis,
M.D., are all on staff at the hospital's Back Pain
Clinic.
Journal of American Health Policy
A 1992 review of data gathered from over two million
users of chiropractic care in the United States appeared
in the Journal of American Health Policy. It stated that
"chiropractic users tend to have substantially lower
total health care costs". The data also indicated that
chiropractic care reduces the need for both physician
and hospital care.
The Agency for Health Care Policy and Research (AHCPR)
issues guidelines for low back problems.
The U.S. agency for Health Care Policy and Research (AHCPR)
formed a 23-person panel to find out the best ways to
care for low back problems in adults. These health care
professionals, including experts in orthopedic surgery,
family practice, internal medicine, physical and
rehabilitative medicine, emergency medicine,
neurosurgery, rheumatology, and many other disciplines
reviewed more than 3,900 studies on the topic. These
guidelines released in December 1994 verified what
chiropractors had been saying for years: surgery and
medication should be a last resort treatment for most
cases. Moderate exercise and chiropractic adjustments
are far more effective and less risky.
Harvard Study
According to a 1991 report by the Harvard Medical
Practice Study Group in Cambridge, Massachusetts:
"80,000 persons die every year--one person every 7
minutes--and 150,000 to 300,000 more are injured
annually from medical negligence in hospitals."
--A Measure of malpractice, Harvard University Press
1993
Philip R. Lee, M.D. assistant secretary for health and
director of the Public Health Service, said, "By
encouraging people with acute low back problems to
resume normal activities, using only those treatments
that have been scientifically shown to be effective,
these guidelines could save Americans considerable
anguish time and money now spent on unneeded or unproven
medical care."
One clear message from all these studies is that
chiropractic remains a cost effective and efficient
method of healing that is, in many instances, equal or
superior to medical care. The studies, which have often
been conducted by state health or workers compensation
agencies, have shown that chiropractic is often less
expensive, significantly reduces the time away from work
and often eliminates the dangers of drugs and surgery.
