Chiropractic Spinal Manipulation Proven Effective for Chronic Neck and Low Back Pain
Evidence has been around for a long time that chiropractic care is more effective for acute low back pain than medical care and physiotherapy combined. This has generally been accepted by the medical establishment.
A review of the scientific literature by Tulder et al. in 1997 (Spine 1997; 22:2128-2156) has brought about the understanding that manipulation is more effective for chronic low back pain than usual care by the general practitioner, bed rest, analgesics and massage. In addition, combining exercise with manipulation gives even better results.
More research on chronic neck pain by, Giles and Mueller (JMPT 199; 22(6):376-381), Hoving, Koes et al. (Annals Int Med 2002; 136:713-722), and Evans, Bonfort et al. (Spine 2002; 27(21):2383-2389) shows
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manipulation is safe and effective for chronic neck pain. And again, yet even better results are reached when combining manipulation with exercise.
The Giles and Mueller trial reported that chiropractic manipulation was superior to needle acupuncture (with and without electrical stimulation), and medication for both chronic neck and chronic back pain.
Spine published a further trial by Giles and Muller (Giles LGF, Muller R (2003) Chronic Spinal Pain: A Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation. Spine 28(14):1490-1502.) Chiropractic manipulation resulted in greater short-term improvement than acupuncture or medication (Cerebrex, Vioxx, Paracetamol), on both subjective and objective assessments.
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The highest proportion of patients with complete early recovery (asymptomatic status) was found for manipulation (27.3% of patients, which compared with acupuncture (9.4 %) and medication (5%). Is this a difference of almost 300% improvement over acupuncture and more than 500% improvement over medication? Why have we not heard more about this given the large prevalence of neck and back pain in our population?
1. Tulder et al. in 1997 (Spine 1997; 22:2128-2156)
2. Giles and Mueller (JMPT 1999; 22(6):376-381)
3. Hoving, Koes et al. (Annals Int Med 2002; 136:713-722)
4. Evans, Bonfort et al. (Spine 2002; 27(21):2383-2389)
Copyright 2003
Dr. Victor Jean Ouellette
All Rights Reserved
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