Reference And Research

Chiropractic references and research

Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective. Below is a selection of research papers of relevance and interest with links to the detailed documents and articles where available.

The Effectiveness of Manual Therapies:

UK evidence report by Gert Bronfort et al: 25th February 2010. A systematic review of the effectiveness of manual therapy commissioned by the GCC, using the research of the highest standards. According to the parameters of the review, the levels of evidence for using manual therapies to treat a range of conditions are categorised as High and Moderate quality POSITIVE evidence; INCONCLUSIVE, but favourable evidence; INCONCLUSIVE, but non-favourable evidence; and High and Moderate quality NEGATIVE evidence. For ease of reference, a summary table can be found here. It is expected that as new research is carried out and past research is identified and reviewed, the report will be updated. In October 2010, for instance, following a review of publications in the BMJ and studies brought to his attention (Santilli et al, Lawrence et al), Professor Bronfort considered that the level of evidence for manipulation for sciatica/radiating leg pain should be changed from INCONCLUSIVE but favourable, to a moderate level of POSITIVE evidence.

UK BREEN Trial Team. Back pain, exercise and manipulation (UK BREEN) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal Nov 2004; 329; 1377 (doi: 10.1136 /bmj. 38282. 669225.AE)

UK BREEN Trial Team (2004) United Kingdom back pain exercise and manipulation (UK BREEN) randomised trial: cost effectiveness of physical treatments for back pain in primary care. BMJ 329:1381

Medical Research Council.

'Low Back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment'; Meade et al.

Medical Research Council. (Follow-up-study) Trial 'Randomised comparison of Chiropractic and hospital outpatient management for low back pain; results from extended follow up'; Meade et al.

RCGP. Clinical Guidelines for the Management of Acute Low Back Pain (1996, 1999, 2001)

National Institute for Health and Clinical Excellence (NICE). Non-rigid stabilisation procedures for the treatment of low back pain - guidance (June 2006). States that chiropractic intervention can be used in the treatment of acute low back pain.

National Institute for Health and Clinical Excellence (NICE).

Low back pain: early management of persistent non-specific low back pain. European Commission Research Directorate General (2004). European guidelines for the management of acute nonspecific low back pain in primary care. Recommends the consideration of spinal manipulation for patients failing to return to normal activities.

European Commission Research Directorate General (2004). European guidelines for the management of chronic nonspecific low back pain in primary care.

Musculoskeletal Services Framework.

Department of Health. July 2006 The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychosocial approach: a) Guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.

Clinical Standards Advisory Group. Back Pain Report 1994.

Acute Back Pain. Primary Care Project; The Wiltshire and Bath Health Commission.

Carter JT, Birrell LN (Editors) 2000.

Occupational health guidelines for the management of low back pain at work - principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work - leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000. Occupational health guidelines for the management of low back pain at work - evidence review. Faculty of Occupational Medicine. London.

Chiropractic Treatment in Workers with Musculoskeletal Complaints. Mark P Blokland DC et al; Journal of the Neuromusculoskeletal System vol 8 No 1, Spring 2000