Chiropractic vs. Medicine for Acute LBP: No Contest
Acute low back pain patients demonstrate significantly greater improvement with chiropractic than "usual care."
With the publication of the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study1 in The Spine Journal, one of the most frequently cited spine research journals in the world,2 the health care community at large may finally appreciate what the chiropractic profession has known for more than a century: Patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little to no improvement with the usual care they receive from a family physician.
Published in the December 2010 edition of The Spine Journal, the study found that after 16 weeks of care, patients referred to medical doctors saw almost no improvement in their disability scores, were likely to still be taking pain drugs and saw no benefit with added physical therapy - and yet were unlikely to be referred to a doctor of chiropractic.
The inclusion of NSAIDs and manipulation/mobilization performed by physical therapists were no more effective in treating patients than family doctors who offered patients advice and acetaminophen. The study found: "[T]he addition of NSAIDs and a form of spinal manipulative therapy or mobilization administered by a physiotherapist to the lumbar spine, thoracic spine, sacroiliac joint, pelvis, and hip (compared with a detuned ultrasound as placebo manipulative therapy), to family physician 'advice' and acetaminophen were shown to have no clinically worthwhile benefit when compared with advice and acetaminophen alone."
- Bishop PB, Quon JA, Fisher CG, Dvorak MFS. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine Journal, 2010;10:1055-1064. www.ncbi.nlm.nih.gov/pubmed/20889389
- Brunarski D. "Impact of the Chiropractic Literature." Dynamic Chiropractic, Dec. 2, 2010;28(25).
- Hancock MJ, Maher CG, Latimer J, McLachlan AJ, Cooper CW, Day RO, Spindler MF, McAuley JH. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial. Lancet, 2007 Nov 10;370(9599):1638-43. www.ncbi.nlm.nih.gov/pubmed/17993364