Chiropractic treatment and Research

Chiropractic Research

Chiropractic first started in 1895 and in the beginning the treatment was based on empirical evidence that it worked, and that seemed to serve our patients very well for many years. However, it would have been foolish not to try to back up the empirical evidence with research in order to be taken seriously as a profession.

It is certainly not good enough to rely on empirical evidence if you need to convince skeptics that it works, especially in the medical profession and third party payers.

Research is expensive and in the early days there where no funds available for research into chiropractic treatment, it therefore had to be self-funded. As more training institutions became affiliated to universities, funding became more readily available.

As a result, over the last twenty years more and more research has been done into the treatment and it is now one of the most, if not the most researched complementary medicine discipline.

Over the years many good studies have provided the evidence that the treatment is safe, effective and cost effective.

As a result it has become a registered profession in England and many other countries in Europe and it is part of the health care system in many European countries, and has been included in the USA for many years.

Chiropractic research is such a vast subject that it would be impossible for us to cover everything here, but we have the intention to include as much as possible. We are initially going to cover safety, effectiveness and cost-effectiveness of the main conditions that we treat, and we are, where appropriate, also going to compare it with other forms of treatment that are commonly used in mainstream medicine. If you don’t find information on a particular subject that is close to your heart, please let us know.

We understand that research articles can be very difficult to read, unless you are used to it, so we have tried to put a summary in lay-mans terms, which should be easy to understand, followed by a link to the original research where possible.

We would be grateful if you could give us feedback on these pages.

Safety of chiropractic treatment

The first subject that we would like to cover is safety. It is a subject that is of outmost importance to you, our patients, for obvious reasons, and therefore to us as chiropractors. We have all sworn the Hippocratic oath and our foremost aim is ‘to do no harm’.

It is also important because the safety issue has been used as a vehicle to drive a wedge between chiropractic and its patients (and potential patients), and it has been used as a tool to stop the treatment being made available to the wider population.

As with any therapeutic procedure there are possible side effects and risks involved. However, complications from the treatment are very rare.

At the ISIS Chiropractic Centres we always explain the risks involved before any treatment starts and to date we are happy to say that we have not had any patient with serious side effects since we started in 1986.

Did you know that taking normal painkillers is probably more harmful than receiving chiropractic treatment!

The risk has, in the past, and is currently being exaggerated by some people to further their agendas in a way that we feel is irresponsible. We feel it is important for you to know that the research that has been quoted on some web-sites and in some newspaper articles, has sometimes been of poor quality and also not been involving chiropractors. Some websites appear to conveniently be ignoring current research and have not upgraded their information. Some might say that there appear to be people, some very prominent in their field, who try to put people off using chiropractic.

One of the biggest antagonists of chiropractic treatment in the UK appears to be Professor Edzard Ernst of the Peninsula Medical School at Exeter. He has managed to get much press coverage over the last few years. If you want to read some comments from some of the most prominent researchers, commenting on Professor Ernst’s research, go to this page on the British Medical Journal’s (BMJ) website. We wholeheartedly recommend it.

Of course, any responsible practitioner would want and need to know if there is a risk involved in what they do. That is why the the profession is actively promoting its members to participate in research.

We have tried to give a more balanced view and also put the risks in perspective to other forms of treatment.

Please go to this page to read more about risks and about what the research says. Safety and Chiropractic Treatment.

Effectiveness of chiropractic treatment

The following research is mainly about lower back pain. If you want to read about research supporting chiropractic treatment for headaches and migraines click here.

One of the most ground breaking pieces of research in the UK was the MRC trial in 1991 and its follow-up in 1995, which showed that our treatment was more effective in treating back pain than physiotherapy and had good long term results especially for people with severe and long-standing back pain. LINK to research.

As a result of the research the guidelines for GPs treatment of back pain (RCGP 1996), that was first produced in 1996 and revised in 2001, included chiropractic treatment as a preferred treatment.

Several other studies have shown the same thing and there are now more studies to show that our treatment is effective, even more studies than into physiotherapy!

A clinical trial funded by the Medical Research Council in 2004 and published in the British Medical Journal, showed that manipulation was effective and also cost-effective for back pain. LINK to research.

In June 2006 The British Medical Journal published a review of the diagnosis and treatment of low back pain. One of the recommendations given for acute (recent onset) low back pain was that manipulation should be considered as a treatment for pain relief. Manipulation should also be considered for chronic low back pain. LINK to research.

In the beginning, many doctors said that our treatment couldn’t be recommended because there was no evidence that it worked. But several years later after much research has been provided that it is effective, cost effective and safe, we still come across people that say that there is no evidence, or at least they are not convinced by the research.

So the bottom line is, that some people don’t change their opinions regardless of the research evidence. Interestingly, the article in The British Medical Journal in 2006 mentioned above also concluded: “… Evidence based guidelines for the management of low back pain are available in many countries, but implementation needs more effort.”

Having said that, we have seen a tremendous change in GP’s and many other health professionals’ attitudes towards chiropractic and we receive referrals more regularly now than we ever have, which we are very grateful for.

Cost effectiveness of chiropractic treatment

This is an area that could really benefit you, your employer, your GP surgery, Local Health Authority, local government and central government, and maybe others. So why is chiropractic not part of the mainstream treatments?

When we say to an employer that our treatment can help you save money they probably get suspicious. It sounds like the oldest sales pitch in the book, so it is not surprising that they get suspicious. But it is true; there is plenty of evidence to show that providing free chiropractic treatment for employees can help to save money, both in lost production and absenteeism. The good news is that many employers provide private medical insurance so there is no additional cost to them.

It would also help the health authorities save money in decreased drug costs, decreased return visits to the GP, Orthopaedic surgeons and Rheumatologists. Which has been pointed out in several research articles already mentioned under the section of effectiveness and another report that was published in 1993, the Manga Report.

A recent clinical trial, mentioned above, funded by the Medical Research Council in 2004 and published in the British Medical Journal, showed that manipulation was both effective and cost-effective for back pain. LINK to research.

Conclusion

More and more research continues to be produced. It can sometimes be difficult to take on board and understand everything that comes out, even if you are used to research.

From our experience, don’t believe everything you read in the newspapers, especially if it is negative press, and that goes for any subject, not just Chiropractic.

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