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Chiropractic Research

Independently Conducted Research Supports the Safety, Effectiveness and Efficacy of Chiropractic.
The following are a few studies from the extensive research archives:

The Manga Report, commissioned by the Ministry of Health in Ontario and carried out by leading independent health economists at the University of Ottawa, led by Pran Manga, Ph.D., Douglas E. Angus and William R. Swan, reviewed all of the international evidence on the management of low back pain. The research concluded:

The Manga Report:

  • "There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors;
  • "There should be a "shift in policy to encourage and prefer chiropractic services for most patients with low-back pain," and chiropractic should be "fully insured (and) fully integrated" into the Ontario health care system.
  • "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."
  • "Chiropractic management is greatly superior to medical management in terms of scientific validity, safety, cost effectiveness and patient satisfaction."
  • "The literature suggests that chiropractic management of low back pain is more effective, more cost-effective, and safer than medical management. Furthermore, there is greater patient satisfaction with chiropractic care than with medical management of low back pain."
  • "The literature suggests that chiropractic manipulation is safer than medical management of low back pain, perhaps contrary to popular impressions. There are no clinical or case-control studies that demonstrate or even imply that chiropractic spinal manipulation is unsafe in the treatment of low back pain."

U.S. Government's Agency for Health Care Policy and Research (AHCPR), 1994:

In 1994, the Agency for Health Care Policy and Research published Clinical Practice Guideline 14-Acute Low Back Problems in Adults (Bigos et at. 1994). The guideline defined acute low-back pain, evaluated various treatments, and made recommendations concerning the efficacy of those treatments. According to the Guideline, spinal manipulation is one of the most safe and effective treatments for most cases of acute low-back pain.
Regarding the guideline, the following editorial comments appeared in the Annals of internal Medicine:

"The Agency for Health Care Policy and Research (AHCPR) recently made history when it concluded that ... spinal manipulation hastens recovery from acute low back pain and recommended that this therapy be used in combination with or as an alternative to non-steroidal anti-inflammatory drugs... Perhaps most significantly, the guidelines state that... spinal manipulation offers both pain relief and functional improvement (Micozzi 1998)."

U.S. Government's Agency for Health Care Policy and Research (AHCPR), 1998:

In June 1998, a second breakthrough study was funded by the U.S. government's Agency for Health Care Policy and Research (AHCPR).
This collaboration among scholars, researchers, medical doctors and chiropractors resulted in a 100-page report highlighting the valuable role of chiropractic care.

The report states, "It has takes 100 years of self-directed, bootstrap efforts utilizing internal funds to bring chiropractic into the mainstream of health care the scope of chiropractic research now parallels that of medical research."

The Rand Corporation Study, 1991:

The goal of this study was to provide a comprehensive set of indications for performing spinal manipulation for persons with low back pain. The project conducted by the Rand Corporation, a nonprofit private corporation in Santa Monica, California which conducts research and development for the U.S. Government and the private sector.
The project was directed by two medical doctors, Robert Brook, MD, and Paul Shekelle, MD, and involved two expert panels of clinicians and researchers to assess the clinical consensus on the appropriateness of spinal manipulation for more than 1600 patients with back pain conditions.

The results of the study were:

  • Acute and sub-acute mechanical back pain patients given spinal manipulation achieve better early results than patients given common medical treatments (bed rest, medication, traction, corsets).
  • 50% of the patients treated by manipulation were free of pain after one week, compared to 27% treated with bed rest.
  • Manipulation proved better for pain relief than the use of physiotherapy and analgesics.
  • Pain was relieved by manipulation in a shorter time (3.5 treatments) than by exercise (5.8 treatments).
  • Patients with pain of 2 to 3 weeks duration achieved a 50% reduction in pain more rapidly with manipulation than with mobilization.
  • Patients treated by manipulation improved significantly faster than those treated with medicine.
  • Manipulation provides earlier relief than other treatments or no treatment.
  • Spinal manipulation is the most commonly used conservative treatment for low back pain in the U.S. and is the treatment for back pain supported by the most research evidence of effectiveness in terms of early results and long term benefits."

- The Appropriateness of Spinal Manipulation for Low Back Pain: Indications and Ratings by a Multidisciplinary Panel, Rand Corporation, Santa Monica, CA (1991)

British Medical Research Council Study:

The British Medical Research Council conducted a 10 year, multi-center trial comparing chiropractic and hospital outpatient management of 741 patients with acute and chronic mechanical low back pain. Results of the study were reported in the June 2, 1990, issue of The British Medical Journal, and concluded the following:

  • "Chiropractic treatment was significantly more effective, particularly for patients with chronic and severe pain."
  • Results were long-term--"the benefit of chiropractic treatment became more evident throughout the follow-up period of two years."
  • "The superior results for chiropractic patients were not result of trial errors or placebo."
  • "The potential economic, resource, and policy implications of our results are extensive. Consideration should be given to providing chiropractic within the National Health Service, either in hospitals, or by purchasing chiropractic treatment from existing clinics."
  • An economic analysis, which appears conservative and uses patient numbers reported in 1979, shows savings in excess of 10 million pounds per annum in Britain by having hospital outpatients with back pain treated by chiropractors.
  • The study provides very considerable support of the New Zealand Commission's findings.

State of California Industrial Back Injury Study:

In 1972 Richard Wolf, MD, questioned 1000 patients about work time loss and residual pain, and 629 patients responded, of which half were medically treated and the other half were treated by chiropractic.

Avg. days lost 60 days lost No time lost
Under Chiropractic Care 15.6 6.7% 47.9%
Under Medical Care 32.0 13.2% 21.0%

Conclusion of study:Patient time loss was cut in half under chiropractic care compared to medical care in all three categories. Chiropractic effectiveness is two to one better over medical care in these types of ailments.

Florida Workers' Compensation Study:

A 1988 study of 10,652 Florida workers� compensation cases was conducted by Wolk and reported by the Foundation for Chiropractic Education and Research. According to Wolk, back injury patients treated by chiropractors versus medical doctors or osteopaths were less likely to develop compensable injuries (injuries resulting in time lost from work and therefore requiring compensation) and less likely to require hospitalization. The author explained that chiropractors are more effective in treating low-back injuries because "chiropractic treatment, in providing more services to the patient at the outset of injury, may produce more immediate therapeutic results and may reduce the amount of time lost from work."

Nevada Workers' Compensation Study:

  • For the three year period ending in 1990, the average medical cost per patient ($2142) was 260% higher than the average chiropractic case ($892).

  • Injured workers are often able to continue working while receiving chiropractic treatments. This may not be the case with standard medical treatment protocol of bed rest and medication.

  • Chiropractic eliminated the concern of unnecessary surgery, inappropriate hospitalization, improper use of medication and the high frequency of narcotic analgesics.

Stano Study:

This study, conducted in 1993, compared health care costs of patients who received chiropractic care for neuro-musculoskeletal problems with those treated solely by medical and osteopathic physicians.

After reviewing nearly 2,000,000 chiropractic records, researcher Miron Stano, Ph.D., of Oakland University, concluded that patients that receive chiropractic care, either solely or in conjunction with medical care, experienced significantly lower health care costs.

Low Back Pain:

"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, Agency for
Healthcare Policy and Research (1994)


"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 sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitryptyline therapy, who reverted to baseline values. Chiropractic management of low back pain is more cost effective."

- Journal of Manipulative and Physiological
Therapeutics, Boline (1995)

"The cost of health care for back and neck pain was substantially lower for chiropractic patients than for non-chiropractic patients ($539 vs. $474) 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 (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, Ebral (1992)

"Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain."

- British Medical Journal (1990) British
Medical Research Council Study

Long Term Effectiveness:

"Two and three years after patients with back pain were treated by chiropractors, they experienced far less pain than those who were treated by medical doctors."

- British Medical Journal (1990), "Low back pain
of mechanical origin: Randomized comparison
of chiropractic and hospital outpatient management."

Chiropractic's Increase In Utilization:

"Chiropractic is a growing component of the healthcare sector, and it is widely used by the population."

- The College of William and Mary, Williamsburg, VA and Medical College of VA, Richmond, VA, Jan. 1992 "Mandated health insurance coverage for chiropractic treatment: An economic assessment with implications for the Commonwealth of Virginia."

"Chiropractic patients were three times more satisfied with their care than patients of family practice physicians."

- Western Journal of Medicine 1987 "Patient evaluations of Low Back Pain Care from family physicians and chiropractors."