Research

Research

Scientific proof that Chiropractic works!

Headaches:

A controlled study was carried out by the Nordic Institute for Chiropractic to determine whether manipulation of the neck would help headaches caused by tension in the neck. 39 people who were suffering from frequent tension type headaches emanating from the neck were recruited from 400 headache sufferers. Half of the group received Chiropractic manipulation to the neck twice a week for three weeks, the other half of the group received low level laser treatment in the upper neck and deep friction massage (including trigger points) in the lower neck and upper back, also twice a week for three weeks. Results were recorded by monitoring the change in daily requirement by the patients for painkillers, the headache intensity and the number of headache hours per day (outcome measures). Results showed that both groups had a significant reduction in all of these outcome measures. This demonstrates that the types of techniques used by Chiropractors such as manipulation and soft tissue techniques, help with tension headaches.

Reference: A randomised controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache. Nillson N. Nordic Institute for Chiropractic, Forskerparken 10, 5230 Odense M. Denmark. Journal of Manipulative and Physiological Therapeutics (USA), 1997 20: 326-330.

Neck Pain and Manual Therapy

Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial.

The study was designed to evaluate the cost effectiveness of physiotherapy, manual therapy, and care by a general practitioner for patients with neck pain, using economic evaluation alongside a randomised controlled trial in primary care. 183 patients with neck pain for at least two weeks were recruited by 42 general practitioners and randomly allocated to manual therapy, physiotherapy, or general practitioner care (counselling, education, and drugs). Clinical outcomes were perceived recovery, intensity of pain, functional disability, and quality of life. Direct and indirect costs were measured by means of cost diaries that were kept by patients for one year. Differences in mean costs between groups, cost effectiveness, and cost utility ratios were evaluated by applying non-parametric bootstrapping techniques. The manual therapy group showed a faster improvement than the physiotherapy group and the general practitioner care group up to 26 weeks, but differences were negligible by follow up at 52 weeks. The total costs of manual therapy ( 447; £273; $402) were around one third of the costs of physiotherapy ( 1297) and general practitioner care ( 1379). These differences were significant. The cost effectiveness ratios and the cost utility ratios showed that manual therapy was less costly and more effective than physiotherapy or general practitioner care.

Reference: British Medical Journal 2003;326:911 Ingeborg B C Korthals-de Bos, Jan L Hoving, Maurits W van Tulder, Maureen P M H Rutten-van Mölken, Herman J Adèr, Henrica C W de Vet, Bart W Koes, Hindrik Vondeling, Lex M Bouter.

Chronic Spinal Pain:

A comparison between needle acupuncture, drug medication and spinal manipulation for the management of chronic spinal pain was carried out by a hospital in Queensland, Australia. 77 patients were recruited for the study and each received one of the three treatments- acupuncture, non-steroidal anti-inflammatory medication, or chiropractic spinal manipulation. Results revealed that spinal manipulation was the only treatment to achieve statistically significant improvement. This demonstrates that for patients with chronic spinal pain syndromes, spinal manipulation unless contraindicated resulted in the greatest improvement.

Reference: Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a non-steroidal anti-inflammatory drug, and spinal manipulation. Journal of Manipulative and Physiological Therapeutics 1999 22(6): 376-81.

Low Back Pain:

Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up.

The aim of the study was to compare the effectiveness over three years of chiropractic and hospital outpatient management for low back pain. 741 men and women aged 18-64 years with low back pain were the subjects for the study. Manipulation was not contraindicated in any case. Oswestry questionnaire scores and scores for pain and patient satisfaction were used as outcome measures. The results from this study concluded that at three years the findings from an earlier report are confirmed that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice, those treated by chiropractic care derive more benefit and long term satisfaction than those treated by hospitals.

Reference: Koes BW, Assendelft WJJ, van der Heijden and Bouter LM. Spinal manipulation for low back pain. Spine 1996; 21: 2860-2873.