Evidence based chiropractic

A brief review of the available data

Is chiropractic evidence based?
The term ‘evidence based practice’ (EBP) is a concept developed in traditional medicine in the early 90’s. It requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions “should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources”.

Chiropractic care is a form of alternative medicine that focuses on the diagnosis and treatment of musculoskeletal disorders, primarily those affecting the spine. Chiropractors utilize manual adjustments and various techniques to promote the body’s natural healing process and improve overall health. Over the years, chiropractic care has garnered both support and skepticism, prompting numerous studies to explore its effectiveness and safety. Is chiropractic evidence based? Let’s take a look to the latest research.

Chiropractic care and low back pain

Low back pain is one of the most common reasons people seek chiropractic care. Research has demonstrated that chiropractic spinal manipulative therapy (SMT) can be an effective treatment for acute and chronic low back pain. Several studies have shown that SMT, when performed by trained and licensed chiropractors, can lead to significant improvements in pain and function compared to placebo or no treatment.

References:

• Leininger B, Bronfort G, Evans R, Reiter T. Spinal Manipulation or Mobilization for Chronic Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 2019;44(15):E914-E923.
• Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451-1460.

Chiropractic care for neck pain

Neck pain is another common condition for which individuals seek chiropractic care. Studies have shown that spinal manipulative therapy provided by chiropractors can offer significant relief for patients with acute and chronic neck pain. Additionally, research has indicated that chiropractic care may be equally or more effective than other treatments, such as medication or exercise, in managing neck pain.

References:

• Bronfort G, Evans R, Anderson AV, et al. Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain: A Randomized Trial. Ann Intern Med. 2012;156(1 Pt 1):1-10.
• Dunning JR, Cleland JA, Waldrop MA, et al. Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther. 2012;42(1):5-18.

Chiropractic care and headaches

Chronic tension headaches and migraines are debilitating conditions that affect millions of people worldwide. Some studies suggest that chiropractic care, particularly spinal manipulative therapy, may help reduce the frequency and intensity of headaches.

References:

• Biondi DM. Physical Treatments for Headache: A Structured Review. Headache. 2005;45(6):738-746.
• Chaibi A, Tuchin PJ, Russell MB. Manual Therapies for Migraine: A Systematic Review. J Headache Pain. 2011;12(2):127-133.

Chiropractic care and sciatica

Sciatica is a painful condition caused by the compression of the sciatic nerve. Chiropractic care has been studied as a potential treatment option for sciatica, and some research suggests that it may provide relief for some patients. However, more high-quality studies are needed to establish its efficacy definitively.

References:

• McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study. J Manipulative Physiol Ther. 2010;33(8):576-584.
• Lewis RA, Williams NH, Sutton AJ, Burton K, Din NU, Matar HE, et al. Comparative Clinical Effectiveness of Management Strategies for Sciatica: Systematic Review and Network Meta-analyses. Spine J. 2015;15(6):1461-1477.

Chiropracticcare for pregnancy-related pain:

Pregnancy can be associated with various musculoskeletal issues, such as low back pain and pelvic pain. Chiropractic care during pregnancy has been studied, and some evidence suggests that it may help alleviate pregnancy-related pain and improve overall well-being.

References:

• George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A Randomized Controlled Trial Comparing a Multimodal Intervention and Standard Obstetrics Care for Low Back and Pelvic Pain in Pregnancy. Am J Obstet Gynecol. 2013;208(4):295.e1-7.
• Peterson CK, Mühlemann D, Humphreys BK. Outcomes of Pregnant Patients with Low Back Pain Undergoing Chiropractic Treatment: A Prospective Cohort Study with Short Term, Medium Term and 1 Year Follow-up. Chiropr Man Therap. 2014;22(1):15.

Safety and risks of chiropractic care:

Like any medical intervention, chiropractic care is not without potential risks. Adverse events associated with chiropractic adjustments are generally rare but can include mild soreness, stiffness, and more severe complications in isolated cases. However, serious complications are extremely rare, and chiropractic care is considered safe when performed by qualified professionals.

References:

• Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW. Spinal Manipulative Therapy for Acute Low Back Pain: An Update of the Cochrane Review. Spine (Phila Pa 1976). 2013;38(3):E158-E177.
• Branson R, DeBerard MS. Chiropractic and Stroke: A Public Health Problem Ignored. J Clin Chiropr Pediatr. 2016;15(2):1248-1256.

Chiropractic care is a widely used form of alternative medicine, and there is scientific evidence supporting its effectiveness in treating certain musculoskeletal conditions, particularly low back pain and neck pain. While additional research is still needed to establish its efficacy for other conditions, chiropractic care appears to be generally safe when performed by licensed professionals.

It’s important for patients to work with qualified chiropractors and other healthcare providers to determine the most appropriate treatment plan for their specific conditions. Always consult with a healthcare professional before beginning any new treatment.