Low Back Pain
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The vast majority of studies which have fairly included a Doctor of Chiropractic providing the Manipulation, have shown that Chiropractic was vastly superior to any other means of treating low back pain. Significant 1990 and then 1995 studies published in the British Medical Journal, involving respectively 741 patients, and then in a follow-up "Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain." [11] [12]
As if it could not be predicted, most MEDICAL studies, involving manipulation, are performed without involving a Doctor of Chiropractic, and those reviews and guidelines have found that spinal manipulation (SM) therapy for low back pain of unknown cause is of no benefit beyond standard conservative management.[13][14] A 2007 U.S. guideline weakly recommended SM as one alternative therapy for spinal low back pain in nonpregnant adults when ordinary treatments fail,[15] well the Swedish guideline for low back pain in 2002 does not recommend considering SM therapy for acute low back pain in patients needing additional help, possibly because the guideline's recommendations were based on a higher evidence level.[13] A 2008 review found that SM is similar to other forms of conventional care.[16] A 2007 literature synthesis found good evidence supporting SM and mobilization for low back pain and exercise for chronic low back pain.[17] Of four systematic reviews published between 2000 and May 2005, only one recommended SM, and a 2004 Cochrane review[18] stated that SM or mobilization is no more or less effective than other standard interventions for back pain.[19] A 2008 systematic review found insufficient evidence to make any recommendations concerning medicine-assisted manipulation for chronic low back pain.[20]
A 2007 U.S. guideline weakly recommending MEDICAL SM as one alternative therapy for spinal low back pain in nonpregnant adults, was only a weak endorsement, and predictably only when drugs and PT (ordinary) treatments fail,[21] well the Swedish guideline for low back pain in 2002 does not recommend considering SM therapy for acute low back pain in patients needing additional help, possibly because the guideline's recommendations were based on a higher evidence level.[13] A 2008 review found that SM is similar to other forms of conventional care.[16] A 2007 literature synthesis found good evidence supporting SM and mobilization for low back pain and exercise for chronic low back pain.[17] Of four systematic reviews published between 2000 and May 2005, only one recommended SM, and a 2004 Cochrane review[22] stated that SM or mobilization is no more or less effective than other standard interventions for back pain.[23] A 2008 systematic review found insufficient evidence to make any recommendations concerning medicine-assisted manipulation for chronic low back pain.[24]