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| Research / News Highlights: CHIROPRACTIC AND HEADACHES •Duke Study Based on a literature review of several headache treatment options, a panel of multidisciplinary experts concluded that spinal manipulation resulted in almost immediate improvement for cervicogenic (originating from the neck) headaches and had significantly fewer side effects and longer lasting relief of tension-type headaches than a commonly prescribed medication... a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. MANIPULATION AND LOW BACK PAIN Consumer Reports Magazine, May 2009: Consumer Reports surveyed more then 14,000 subscribers who had lower back pain in the past year but had never had back surgery. 58% of those who tried chiropractic manipulation said it helped a lot, and 59% were "completely" or "very" satisfied with their chiropractor. Patient satisfaction for chiropractic care was higher then physical therapy, acupuncture, specialist Physician, and primary care Physician. •AHCPR Guidelines In 1994, the Agency for Health Care Policy and Research (AHCPR), part of the U.S. Department of Health and Human Services, released a clinical practice guideline for the treatment of acute low back problems. The guidelines recommended the use of spinal manipulation as an effective method of symptom control. •Ontario Ministry of Health: The Manga Report A Study to Examine the Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain. This August 1993 study, conducted by Dr. Pran Manga, researched the effectiveness and cost-effectiveness of chiropractic management of low back pain. The report concluded the following: -On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for LBP. Many medical therapies are of questionable validity or are clearly inadequate. -There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low-back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic complications for LBP patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low-back pain. -There is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management. -There is good empirical evidence that patients are very satisfied with chiropractic management of LBP. MANIPULATION AND EXERCISE •A Randomized Clinical Trial of Exercise and Spinal Manipulation for Patients with Chronic neck pain. Spine. 2001 April 1;26(7)788-797 This study supports the importance of exercise in treatment for those with chronic neck pain. The purpose of this study was to compare the efficacy of rehabilitative neck exercise and spinal manipulation for the management of patients with chronic neck pain. 191 patients were randomized to a manipulation only group, an exercise only group, and a manipulation plus exercise group. The spinal manipulative therapy and exercise group showed greater gains in all measures of strength, endurance, and range of motion than the manipulation group. •Long-term Effects of Specific Stabilizing Exercises for First-episode Low Back Pain. Spine. 11: E243-E248. This study investigated the recurrence of low back pain in patients with a first episode of low back pain. Subjects were followed for three years. Conclusion: For patients with acute first episode low back pain, specific spinal stabilization exercise substantially reduces the risk of recurrence. SPINAL SURGERY FOR DISK HERNIATION Surgical vs Nonoperative Treatment for Lumbar Disk Hernation JAMA. 2006;296:2441-2450. This study looked at standard surgical procedure (open diskectomy) vs nonoperative treatment which included education/counseling, anti-inflammatory medications, pain medication, injections, and physical therapy. Conclusion: Patients in both the surgery and the nonoperative treatment groups improved substantially over a 2-year period. |
