Chiropractic Effectiveness

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)

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.”

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.

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

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.


Dr. Darryl Roundy

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