The Efficiency, Effectiveness and Safety 0f Chiropractic Care
United States Department of Health and Human Services – Agency for Healthcare Policy and Research, Rockville, MD. 1994 – Healthcare researchers found that some of the widely used treatments for low back pain were worthless or dangerous, and so the U.S. government had 200 healthcare experts research tens of thousands of the finest scientifically-based literature articles worldwide and report back their findings to a panel of 23 interdisciplinary experts, in which a approximately one half were MD’s. Their conclusion was that what chiropractors do – adjusting the spine – was therapeutically superior and safer to other medical/surgical treatments for low back pain. The study criticized excessive disk surgery in the past and discourage the use of disk surgery in most cases, except when serious spinal or nerve root dysfunction is found. Despite the US government findings chiropractic is not utilized in most hospitals, while you’ll not find a better and more comprehensive scientifically based clinical outcomes study for LBP anywhere in the world! Conservative alternative health care like chiropractic adjustments may reduce unnecessary disk surgery and their complications and death. Since chiropractors perform 94% of all spinal adjustments in the United States, the study places chiropractic at the forefront as the favored treatment approach for low back pain.
The British Medical Research Council, T. F. Meade, FRCP, 1990 – A British Government study of 741 patients and 11 hospitals and chiropractic clinics throughout Britain, conducted over a 10 year period, use randomized controlled trials and a scientifically accepted Oswestry Scale for pain measurement to compare chiropractic results with physiotherapy. Results were evaluated by a Ph.D.’s who acted as independent referees. The study concluded that chiropractic care was more effective than medical care by as much as a 2:1 margin. The highly regarded results made national headlines in England. A follow up study of the 741 patients three years later showed that the outpatient care in chiropractic offices was 29% more effective than hospital medical care at providing continuous relief of pain.
University of Ottawa, Canada. 1993. Pran Manga, Ph.D., Doug Angus, M.A., Costa Papdopoulos, M.H.A., William Swam, B.A. “The Effectiveness and Cost-Effectiveness Of Chiropractic Management of Low Back Pain.” – Epidemiological and health economics literature, and statistics from workers compensation boards in Canada and other countries were reviewed. The study concluded that chiropractic was markedly superior to medical management for low back pain in terms of safety, effectiveness, cost efficiency, and patient satisfaction. It urged the Canadian government to encourage and prefer chiropractic care over medical care for low back pain and recommended that chiropractors be retained by all hospitals as “gatekeepers” to direct the care of patients with low back problems and hospitals. The study concluded that chiropractic care could save the Canadian government hundreds of millions of dollars per year.
University of Saskatchewan Medical Clinic and Research Center, 1985 – Dr. David Cassidy, a chiropractor and Dr. Kirkaldy-Willis, a world renowned medical orthopedist, studied a group of 171 chronically disabled, medically unresponsive low back sufferers for seven long years as 87% of them got their first relief ever within 2-3 weeks after getting chiropractic adjustments. The prolonged benefits of this chiropractic care were documented at the university-based medical Center as the patients remained pain-free for one year later.
Royal Commission on Inquiry on Chiropractic in New Zealand, 1979 – The government of New Zealand appointed a commission to study chiropractic, which became the most comprehensive and detailed independent examination of chiropractic ever taken by any country in the world at the time. The investigative team of this 20 months study cross examined hundreds of leading educators, doctors and researchers from Australia, Canada, the United States and the United Kingdom. The study compiled 3,638 pages of transcripts consisting of 1.6 million words received under oath and published into a book of 377 pages. The commission concluded that: 1) Chiropractic is a vital, effective, impressively safe and clinically effective form of health care. It is scientifically based and uses the existing body of medical and scientific knowledge. 2) Chiropractors have – beyond reasonable doubt – a more thorough training of spinal mechanics and spinal manipulative therapy than any other health professional. 3) The other healthcare professionals should defer spinal adjusting to chiropractors since they are the best qualified. 4) Spinal adjusting must only be done by full-time practitioners of the art. 5) There must be total cooperation between all healthcare professionals in the public’s best interest. 6) In the best interest of patients, chiropractic must be included in all hospitals.
Chiropractic Therapeutic Effectiveness Incidence in Absence from Work and Hospitalization, Milan Italy, 1978 – A two year Italian government-sponsored survey of 17,142 patients over a two-year period showed that chiropractic care reduced hospitalization by 87.6%, and work loss by 75.5%. The study involves chiropractors and 22 medical back-pain clinics and was done in cooperation with leading universities, which provided scholars with Ph.D.’s to be used as independent referees to record the results over the course of the study.
Australian Royal Melbourne Institute of Technology, Workers Compensation, Center for Chiropractic Research 1991 – The study compared chiropractic with medicine in the treatment of work-related low back injuries without fractures. There were 998 chiropractic cases and 998 medical cases drawn at random from a group of 3,712 patients. The average cost in the chiropractic care was $392 where is the average cost under medical care was $1569, and the time loss under chiropractic care was 6.25 days compared to 25.56 days under the medical care — getting chiropractic a 4:1 superiority in both effectiveness and time lost from work.
RAND (Research and Development) Santa Monica, California, 1992 – The Rand Group is the largest and most respected “think tank” in the United States outside of a university, and is often used by the US government. This world renowned nonprofit research group, conducted an exhaustive study of the scientific literature on chiropractic using a panel of experts including neurologists, medical orthopedist and chiropractors. They concluded that spinal adjusting — as done by chiropractors — is an appropriate treatment for low back disorders. Paul G. Shelelle, M.D., MPH, a principal participant in the study said, “There are considerably more randomized controlled trials at which show the benefit of chiropractic adjustments then there are for many other things which physicians and neurologists do all the time.” Chiropractic care was found to be scientifically based.
Lutheran General Hospital Park Ridge and the Former John F. Kennedy Hospital in Chicago, 1987 – Dr. Per Freitag, M.D., Ph.D. conducted the results of patients treated in to Chicago area hospital orthopedic wards; one using chiropractic adjustments and the other not using them. The former John F. Kennedy Hospital, which use chiropractic adjustments, was releasing patients in 5-7 days compared to Lutheran General, which was releasing patients in 14 days. Dr. Freitag – a professor at Northwestern University and an orthopedic surgeon and radiologist – was on the staff at both hospitals and had a chance to gather the data and results between chiropractic and medical care. JFK Hospital – using chiropractic adjustments – showed a 2:1 superiority advantage over medical care for low back pain.
AVMED Health Maintenance Organization – AVMED, the largest HMO in the southeastern United States located in Miami, Florida, sent a local chiropractor 100 patients to evaluate his results. 86% of the persons in this group had their ailments corrected by the chiropractor. 12 of the patients within this group were previously diagnosed by a team of M.D.’s at AVMED as needing disc surgery. All 12 were corrected by chiropractic adjustments without surgery within 2-3 weeks. Dr. Herbert Davis, the medical director at AVMED and the author of the study, concluded that the chiropractic adjustments saved AVMED $250,000 in surgical costs. He said that since he was initially a skeptic, he had a “real eye-opening experience” of the effectiveness of chiropractic.
Cost of Case Comparison of Back Injury Claims of Chiropractic Versus Medical Management with Identical Diagnostic Codes. Utah Workers Compensation Records, 1991 – A study of 3,062 nonsurgical back ailments in the 1986 Utah workers compensation records showed that chiropractic outperformed medicine by a 10:1 margin in compensation costs. Patients receiving medical care averaged 21 days lost from work and $668.39 for compensation costs, while patients receiving chiropractic care averaged less than three days lost from work and $68.38 paid for compensation. This 10:1 superiority is a matter of public record from the state of Utah.
A Study of Time Loss and Back Claims, State of Oregon, Workers Compensation Board, State of Oregon, 1971 – back injury claims in 237 back ailments were studied from the Oregon workers compensation records over a period of one year. The study was conducted by its medical director, Dr. Rolland Martin. The study revealed that 82% of the workers under chiropractic care resumed their work after one week of time lost, whereas only 41% were able to reserve in after one week under medical care. This gave chiropractic atypical 2:1 therapeutic superiority over medical care of like ailments.
Industrial Back Injury, California Workers Division of Labor Statistics, State of California 1975 – 1000 patient records of workers compensation cases were studied from 1972. The study compared the time lost in cases of back injury for individuals treated by chiropractors and medical doctors. Half of these cases were treated by chiropractors on the other half by M.D.’s. The Division of Labor Statistics got 629 patients to respond to their questioning which provided the following statistics. Once again, getting chiropractic another typical 2:1 superiority over medical care: Average days lost: 15.6 under chiropractic care; 32.0 under medical care. No time lost: 47.9% under chiropractic care compared to 21% under medical care. 60 days lost: 6.7% under chiropractic care, 13.2% under medical care.
For Acute and Chronic Pain
Nyiendo et al. Journal of Manipulative and Physiological Therapeutics, 2000 – “Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56%vs. 13%) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”
Korthals-de Bos et al, British Medical Journal 2003 – In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.
In Comparison to Other Treatment Alternatives
Haas et al (2005), Journal of Manipulative and Physiological Therapeutics – “Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.”
Hoving et al (2002), Annals of Internal Medicine – “In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care.”
Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001) – “Cervical spine adjustment was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”
Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995) – “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.”
** Scientists at the University of Maryland in 1996 discovered that a tiny muscle named in the rectus capitus posterior minor (RCPM) actually attaches itself to the brain lining at the base of the skull while the other end of the muscle attaches itself to the first cervical vertebra (atlas). Consequently any tension in this muscle pulls in the brain lining(dura mater) which is very sensitive to pain and will result in the patient feeling headaches. There is now an anatomical and structural connection providing a scientific basis for the exceptional results that chiropractors have had with headache patients.
The Safety of Chiropractic
A study comparing the risk of neck adjustments over the use of nonsteroidal anti-inflammatory drugs(NSAIDS) showed cervical adjustments are 400 times less likely to have a serious complication than NSAIDs. NSAIDs such as aspirin are one of the safest medications in the market and so, it is both inappropriate and intellectually dishonest to refer to “strokes” from neck adjustments without also mentioning that aspirin holds a 400 TIMES higher risk of causing a stroke when compared to a chiropractic adjustment.
A study in Spine Magazine, conducted by Cassidy et al, in 2011, concluded that there is no clinical correlation between HVLA cervical (neck) adjustments and a risk of stroke. To read MORE about this correlation and fictitious association, click HERE.
Haas et al (2005), Journal of Manipulative and Physiological Therapeutics – “Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”
Hertzman-Miller et al (2002), American Journal of Public Health – “Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care.Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.”
Popularity of Chiropractic
Meeker, Haldeman (2002), Annals of Internal Medicine – “Chiropractic is the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.”
Jaguars Running Back Maurice Jones-Drew relies on chiropractic to put him on top of his game.
The latest, a report published by Australia’s Cochrane Collaboration, confirms what may seem obviously to chiropractors and their patients — that chiropractic can be effective in helping people overcome low-back pain.
The research, led by Bruce Walker, DC, of the Murdoch University School of Chiropractic and Sports Science in Australia, analyzed a number of different techniques provided by chiropractors. Walker and his colleagues at Murdoch studied 12 randomized controlled trials that included 2,887 participants. Each trial compared combined chiropractic interventions to some other therapeutic approach to low-back pain.
The result: in the short-term (within one month after the study began), pain improved in patients treated both with chiropractic and comparison treatments. Benefits were somewhat greater in the chiropractic group , although the difference was not considered “clinically significant,” the study’s authors wrote.
“If consumers have acute or subacute back pain they can have some confidence that if they go to the chiropractor they’ll see some improvement,” Dr. Walker reported.
References: Walker BF, et al. Combined chiropractic interventions for low-back pain (Review). Cochrane Database of Systematic Reviews. Issue 4, 2010.