General Chiropractic Research
The Clinical Standards Advisory Group recommended in 1994 that there should be earlier access to the manipulative therapies and a redistribution of resources within the NHS to make this happen. In September 1996 the Royal College of General Practitioners issued guidelines for GPs recommending manipulative treatment within the first six weeks for patients with low back pain. They also state that the risks of manipulation are very low in skilled hands. Now research is beginning to concentrate on how chiropractic affects other areas of the musculo-skeletal system, including a trial at the University of Odense in Denmark on the effect of spinal manipulation in the treatment of neck-related headache and a Canadian patient satisfaction study which shows chiropractic as an effective means of resolving or improving back and/or neck pain.
“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 percent vs. 13 percent) 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.” Journal of Manipulative and Physiological Therapeutics, Nyiendo et al (2000).
“In a Randomised controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counselling, 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.” British Medical Journal, Korthals-de Bos et al (2003).
“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.” American Journal of Public Health, Hertzman-Miller et al. (2002)
Popularity of Chiropractic
“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 in the United States, which has tripled in the past two decades.” Annals of Internal Medicine, Meeker and Haldeman (2002)
Chiropractors 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).
Chiropractic 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).
Chiropractors 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 et al. (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).
Chiropractic For The Elderly
“[Elderly] chiropractic users were less likely to have been hospitalised, 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 to use prescription drugs.” Topics in Clinical Chiropractic, Coulter et al. (1996).
For Containing Costs and Getting Workers Back On The Job
“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 therapeutics.”Journal of Manipulative and Physiological Therapeutics , Haas et al. (2005).
First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and “deserves careful consideration” by managed care executives concerned with controlling health care spending. Medical Care, Stano and Smith (1996).
“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.” The Manga Report (1993).
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