Chiropractic and Low Back Conditions
Research and Results

Here are the facts about the chiropractic option for dealing with debilitating low back conditions:

The Manga Report

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., reviewed all of the international evidence on the management of low back pain. The conclusion are as follows:

• There would be 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.”Pran Manga, Ph.D.Douglas E. Angus, M.A.William R. Swan, B. Comm.

“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.”Pran Manga, Ph.D.Douglas E. Angus, M.A.William R. Swan, B. Comm.

The Rand Study

The goal of this study was to look at those individuals who might receive relief of their low back pain through chiropractic. The project was conducted by the RAND Corporation, a nonprofit private corporation in Santa Monica, California which conducts research and development for the US Government and the private sector is highly respected.

The project was directed by two medical doctors, Robert Brook, MD, and Paul Shekelle, MD, and involved two expert panels of clinicians and researchers who determined the appropriateness of spinal manipulation for more than 1600 patients with back pain.

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.
• Patients with pain of 2 to 3 weeks duration achieved a 50% reduction in pain more rapidly with chiropractic adjustments than with mobilization/exercise.
• Patients treated by manipulation improved significantly faster than those treated with medicine.
• Manipulation provides earlier relief than other treatments or no treatment.

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 the 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 year (that’s over 18 million dollars in the US currency) in Britain by having hospital outpatients with back pain treated by chiropractors.

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.

Conclusion of the 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 over medical care in dealing with these types of ailments.

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.