Kirkland Chiropractor, Chiropractic care, Redmond, Bellevue, Bothell, Totem Lake, Washington.
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Research
"Only 15% of all medical interventions are supported by solid scientific evidence”
The following statement was made by Dr. Shekelle of the independent research group the RAND Corporation regarding chiropractic care on ABC’s 20/20. “There are considerably more randomized controlled trials which show benefit of this (chiropractic) than there are for many, many other things which physicians and neurosurgeons do all the time.”
While a complete review of all the current literature and research that’s been done on chiropractic is not my intention, here’s some highlights of the studies that have been done on chiropractic’s effectiveness for low back pain, headaches and more recently how chiropractic works at a neurological level. Some Highlights of the Major Studies Done Effectiveness, Cost-Effectiveness and Long-Term Benefits Chiropractic Improves Your Quality of Life Chiropractic-Therapeutical Effectiveness-Social Importance, Incidence of Absence from Work and Hospitalization Survey on a Sample of 17, 142 patients, Italy, 1987, Professor F. Splendori. In 1987, a study of 17,142 patients (22 clinics) in Italy by medical physicians and chiropractors concluded: “The results of our survey presented herein, are clear and incontrovertible: our sample population of over seventeen thousand patients treated with chiropractic for at least two years showed that this treatment could lead to 55-75% reduction in the number of daily absences from work and could cut down the number of hospitalized patients by 87.60 % vis-à-vis other currently used forms of treatment (pharmacological, physiokinesiotherapeutic, surgical, etc.)……. A most meaningful indicator of the effectiveness of chiropractors is the improvement it produces in the quality of life, not only because of its curative effect but also thanks to its preventative and rehabilitative functions.” Members of the Medical Community Recognize Shekelle, P.G., Adams, A., et al. The Appropriateness of Spinal Manipulation for Lower-Back Pain. RAND Corporation, Santa Monica, California, 1992. This study conducted by the prestigious RAND Corporation, marks the first time that representatives of the medical community have gone on record stating that chiropractic is an appropriate treatment for certain low-back pain conditions. Chiropractic Offers Long-Term Benefits Meade, T.W., Dyer, S., et al. “Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and Hospital Outpatient Treatment”, British Medical Journal, 2 June 1990, Vol. 300, Number 67137, Pages 1431-1437. Research in Great Britain conducted by T.W. Meade, a medical doctor, compared chiropractic manipulation and hospital outpatient treatment for low-back pain, consistent of corset wearing and standard physical therapy. The study concluded, For patients with low-back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison to hospital outpatient management. In a Canadian Broadcasting Corporation radio interview, Dr. Meade stated, “Our trial showed that chiropractic is a very effective treatment, more effective than conventional hospital out-patient treatment for low-back pain, particularly in patients who had back pain in the past and who got severe back problems…One of the unexpected findings was that the treatment differences – the benefit of chiropractic over hospital treatment-actually persists for the whole of that three-year period….it looks as though the treatment that the chiropractors give does something that results in a very long-term benefit.” Follow-up to Meade Study Published by British Medical Journal The results of the follow-up study, published in the August 5, 1995 edition of BMJ, were even more compelling. With additional data now available, researchers learned that chiropractic patients not only reported less pain than hospital patients at six weeks, but three years later chiropractic patients reported a 29% greater improvement with chiropractic compared to hospital treatment. The most dramatic improvements were associated with pain reduction, but many of the factors that contribute to the quality of life were affected by chiropractic care. Sitting for more than a short period of time and sleeping showed the most significant improvement, but scores such as personal care, lifting, walking, standing, sex life, social life, and ability to travel also improved. Lower Compensation Costs and Jarvis, K.B., Phillips, R.B., et al. “Cost per Case Comparison of Back Injury Claims of Chiropractic versus Medical Management for Conditions with Identical Diagnostic Codes,” Journal of Occupational Medicine, August 1991, Volume 33, Number 8, Pages 847-52. This study examined cost comparisons between medical and chiropractic providers for back-related injuries with identical diagnostic codes. It concluded that compensation costs for work time lost were an astonishing $68.38 for patients who received standard non-surgical medical treatment. The number of work days lost under medical care was nearly ten times higher for those receiving medical care. Shorter Disability and Lower Related Costs for Chiropractic Patients Wolk, S. “Chiropractic versus Medical Care: A Cost Analysis of Disability and Treatment for Back-Related Workers’ Compensation Cases.” Foundation for Chiropractic Education and Research, Arlington, Virginia, September 1988. This major study examined 10, 652 closed cases of patients with back-related injuries who were covered by Florida workers’ compensation law to compare chiropractic case management with standard medical case management. The results indicated that the duration of temporary total disability was 51.3 percent shorter for chiropractic patients; the cost of chiropractic service was 58.8 percent lower, and 52.2 percent of medical patient claimants were hospitalized compared to only 20.3 percent of chiropractic patients. Governmental Safety Studies Done On Chiropractic Care Chiropractic care is extremely safe for people of all ages. Time and time again chiropractic care has been proven to be among the safest and most effective treatments used in the health care field. Here are highlights of 3 of the largest federally funded studies done on chiropractic in Canada, the United States as well as New Zealand. The Manga Report This report which was commissioned by the Ontario Ministry of Health represents the largest analysis of scientific literature on the most effective and cost effective treatments for low back pain. After reviewing all the international evidence on the management of low back pain, lead investigator Pran Manga, Ph.D., found the treatments provided by Doctors of Chiropractic were exceptionally safe – much safe than for standard medical treatments of similar conditions.
“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 Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report) Pran Manga and Associates (1993) – University of Ottawa, Canada. The Agency on Health Care Policy and Research Study On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released Clinical Practice Guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of diagnostic and treatment methods for acute low back pain. The 23 member AHCPR panel was multidisciplinary and consisted of medical doctors, chiropractic doctors, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer representative. Their findings included:
Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S., et al. Agency for Health Care Policy and Research Publication No. 950642 (1994) –U.S. Department of Health and Human Services The New Zealand Commission Report The government of New Zealand published a 377 page report which assessed the efficacy and safety of chiropractic care. The report was a result of almost 2 years of conducted hearings form recognized health care experts. Their main findings included:
New Zealand Report. Hasselberg PD. Government Printer, Wellington – 1979. What About Headaches?
Chiropractic – Deemed An Effective Treatment for Cervicogenic Headaches In a large study conducted in 2001 by Duke University’s Evidence-Based Practice Center for Clinical Health Policy Research a goal was set to identify and summarize from controlled trials, the efficacy of behavioral and physical treatments for tension-type and cervicogenic headaches. Different studies from everything from traditional medical intervention, to acupuncture, chiropractic, massage, relaxation techniques and biofeedback were looked at. Amongst many of the conclusions, the study summarized that: “If effective and available, non-pharmacological treatments may be the first choice for most patients and may also be well suited for the significant minority of patients who: (a) have poor tolerance of pharmacological treatments; (b) have medical contraindications for pharmacological treatments; (c) experience insufficient relief from, or are unresponsive to, pharmacological treatment; (d) wish to become pregnant (or are nursing); (e) have a history of long-term, frequent, or excessive use of analgesic or abortive medications that can aggravate headache problems; or (f) simply prefer to avoid medication use”. Conclusions With Regard to Chiropractic:
McCrory DC, Penzien DB, Hasselblad V, Gray RN. Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache. Duke University Evidence-based Practice Center for Clinical Health Policy Research. – 2001 Surprise! Chiropractic Has a More Lasting Effect Compared to Drugs For the Treatment of Headaches and Without the Side Effects A study done at Northwestern Chiropractic College in 1995 of 150 headache sufferers compared the effectiveness of spinal manipulation and pharmaceutical treatment (amitriptyline) for chronic tension-type headaches. The results showed that compared to the group taking amitriptyline, the group receiving spinal manipulation showed a reduction of 32% headache intensity, 42% headache frequency, 30% in over-the-counter medication usage and an improvement of 16% in functional health status. By comparison the amitriptyline therapy group showed no improvement or a slight worsening from baseline values in the same major outcome measures and the group also reported a number of side effects from taking the medication. Conclusion: Spinal manipulative therapy is an effective treatment for tension type headaches. Amitriptyline therapy was slightly more effective in reducing pain at the end of the treatment period but was associated with more side effects. Four weeks after stopping treatment, however, the patients receiving spinal manipulative therapy experienced sustained therapeutic benefit in all major outcomes in contrast to patients that received amitriptyline therapy, who reverted to baseline values. Boline P, Kassak K, Bronfort G, et al. Spinal Manipulation vs. amitriptyline for the treatment of chronic tension type headaches – a randomized clinical trial. J Manipulative Physiol Ther; 1995 18(3): 148-54 Chiropractic Alone Is Just As Effective For Migraine Headaches Compared To A Combined Chiropractic/Medical Approach A study done at Northwestern Chiropractic College in 1998 of 218 patients with the diagnosis of migraine headache were measured via a headache index score derived from a daily headache pain diary during the last 4 weeks of treatment and during the 4 week follow-up period. The reduction in headache index scores during treatment compared with baseline was 49% for amitriptyline, 40% for spinal manipulation and 41% for the combined group. During the post-treatment follow-up period the reduction from baseline was 24% for amitriptyline, 42% for spinal manipulation and 25% for the combined group. Conclusion: There was no advantage to combining amitriptyline and spinal manipulation for the treatment of migraine headache. Spinal manipulation seemed to be as effective as a well established and efficacious (amitriptyline), treatment option for patients with frequent migraine headaches. Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headaches. J Manipulative Physiol Ther; 1998 Oct;21(8): 511-9 Spinal Manipulation Has A Significant Positive Effect in A study done at the University of Odense, Denmark of 53 cervicogenic headache sufferers as described by the International Headache Society looked at how soft tissue therapy and spinal manipulation affected analgesic use per day, headache intensity per episode and in number of headache hours per day. The use of analgesics decreased by 36% in the manipulation group, but was unchanged in the soft-tissue group. The number of headache hours per day decreased by 69% in the manipulation group, compared with 37% in the soft tissue group. Finally, headache intensity per episode decreased by 36% in the manipulation group, compared with 17% in the soft tissue group. Nilsson N, Christensen HW, Hartvigsen J. The effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiolo Ther; 1997 Jun; 20(5): 326-30. Exercise and Manipulative Therapy Have a Lasting Effect On Reducing the Symptoms of Cervicogenic Headaches A study done in Australia of 200 headache suffers concluded that both manipulative therapy and specific exercises significantly reduced headache frequency and intensity, and the neck pain and effects were maintained. The combined therapies were not significantly superior to either therapy alone, but 10% more patients gained relief with the combination. Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002 Sep 1; 7(17) : 1835 -43; discussion 1843 Chiropractic and Non-musculoskeletal Conditions Although, many have known for a long time that chiropractic is effective for muscle/joint and spine problems, what is less commonly known is that chiropractic works because it affects your nervous system. Due to the fact that your nervous system affects every function in your body, chiropractic may work at many levels to affect your health. Today, we can’t say definitively that chiropractic can treat non-musculoskeletal / visceral conditions but, every chiropractor has had an experience where a patient may say, “Doc, I don’t know what you did but, my stomach problems have gone away”. Now, while we can’t say that we alleviated that problem with chiropractic we can say that we affected your nervous system and your body did the rest! As chiropractors we see your body as a self-maintaining, self-healing organism. The most commonly studied non-musculoskeletal conditions with respect to chiropractic are asthma and infantile colic. While studies have been somewhat inconclusive at this point, current studies have shown some positive results. Most intriguing has been the effect of chiropractic on the immune system. Chiropractic For Infantile Colic The effects of spinal manipulation were looked at and compared to the effects of the drug dimethicone for 2 weeks on a group of infants. The main outcome measure used was the changes in daily hours of crying . By trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group. On days 8 to 11, crying was reduced by 1 hour for the diemethicone group, whereas crying in the manipulation group was reduced by 2.7 hours. From trial day 5 onward the manipulation group did significantly better than the dimethicone group. Conclusion: Spinal manipulation is effective in relieving infantile colic. Wiberg JM, Nordsteen J, Nilsson N. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther 1999 Oct;22(8):517-22. Stay Tuned For the Latest Updates!
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