Studies on Chiropractic

In addition to the Canadian studies previously cited, many other studies have explored chiropractic treatment. These have focused on tile effectiveness of chiropractic treatment for back pain, for work-related Injuries, and for other disorders. The following is a brief summary of some of these studies:

RAND, a non-profit research organization, has completed three studies in the United States on chiropractic, with a fourth study currently underway.

The first study, a population-based estimate concerning the use of chiropractic services, reported in the American Journal of Public Health, that "chiropractors deliver a substantial amount of health care to the U.S. population, and there are significant geographic variations in the rate and intensity of use of chiropractic services" (Skekelle 1991). The second study, "Spinal Manipulation for Low-Back Pain," published in the Annals of Internal Medicine, affirmed that spinal manipulation is of benefit to some patients with acute low-back pain (Shekelle and Adams 1992). The third study created two sets of appropriateness ratings for spinal manipulation. One set of ratings was developed by a multi-disciplinary panel and the other set was prepared by an all-chiropractic panel (Shekelle et al. 1992). The fourth study, currently underway, is to determine the types of health case problems for which people seek chiropractic care and the types of care people receive from chiropractors. This study is expected to be completed in 1994.

In Australia, a 12-month study conducted by the Australian Centre for Chiropractic Research included all work-related low-back pain claimants. Individuals were identified who received care either from a chiropractor or a medical practitioner. The results indicated that:

When chiropractic management was chosen fewer claimants required compensation and fewer compensation days were taken When medical management was chosen, the average payment per claim was greater and a greater number of patients regressed to chronic status (Ebrall 1992).

A study reported in the British Medical Journal included 741 patients between the ages of 18 and 65 who sufferedfrom chronic or severe back pain and who sought care in chiropractic and hospital out-patient clinics. After two years of patient monitoring, researchers concluded that "for patients with low-back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison with hospital out-patient management" (Meade et al. 1990).

Researchers conducted a study of workers' compensation cases in Florida and concluded that "a claimant with a back-related injury, when initially treated 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 treated by chiropractors" (Wolk 1988).

From a survey of those receiving care from health maintenance organizations (HMOs) in Washington state it was concluded that "...patients of chiropractors were three times as likely as patients of family physicians to report that they were satisfied with the care they received for low-back pain... Chiropractic patients were also more likely to have been satisfied with the amount of information they were given and to believe their doctor was concerned about them" (Cherkin and MacComack 1989)

"Family Physicians, Chiropractors, and Back Pain," is the title of an article published in the Journal of Family Practice (November 1992), addressing a comparative United States study of patients of family physicians and chiropractors. The article stated that "the number of days of disability for patients seen by family physicians was significantly higher (mean 39,7) than for patients managed by chiropractors (mean 10.8)" (Curtis and Bove 1992). A related editorial published in We same issue of the Journal of Family Practice stated that family physicians should accept the fact that "...spinal manipulation is one of the few conservative treatments for low-back pain that have [sic] been found to be effective in randomized trials. The risks of complications from lumbar manipulation are also very low" (Cherkin 1992). The latter conclusion is supported by a study published by the Chiropractic Journal of Australia which reported that "a descriptive analysis of obtainable literature on complications from low-back SMT (spinal manipulation treatment) from 1911 to 1991 indicates that, on the average, less than one case per year occurs" (Terrett and Kleynhans 1992).

The Journal of Manipulative and Physiological Therapeutics, published in the United States, reported results of a study of women between the ages of 20 and 49 with a history of dysmenorrhea (painful menstruation);"

SMT may be an effective and safe non-pharmacolocical alternative for relieving the pain and distress of primary dysmenorrhea, at least for a short period of time after treatment" (Kokjohn et al. 1992).

A number of United States clinical studies cite success rates ranging from 72% to 90% for the treatment of headaches utilizing spinal manipulation therapy. For example, a study reported in the American Chiropractic Association's Journal of Chiropractic reported that 74.6% of patients with recurring headaches, including those experiencing migraines, were either cured or experienced reduced symptomatology associated with their headaches after receiving chiropractic manipulation. Most importantly, the success rate was maintained two years after treatment ended (Wight 1978).

A number of studies have documented the effectiveness of chiropractic treatment for a variety of other conditions including soft tissue injuries and viscera' disorders (Plaugher 1993; Lewit 1985; and Korr 1978).