There are various sources of evidence demonstrating that chiropractic care is effective for low back pain.
Below are a selection of some of the more recent articles and the summaries of their findings;
1. European Commission Research Directorate General (2004) European Guidelines for the management of acute non-specific low back pain in primary care
The summary of recommendations for treatment of acute non-specific low back pain included consideration of referral for spinal manipulation for patients who are failing to return to normal activities.
2. Meade et al (1990) Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment. BMJ 300; 1431-1437
This large UK trial funded by the Medical Research Council (MRC) compared chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin. Outcome: chiropractic treatment was 30% more effective than hospital outpatient management, mainly for patients with chronic or severe back pain
3. Meade et al (1995) Randomised comparison of chiropractic and hospital outpatient treatment for low back pain: results from extended follow up. BMJ 311; 349-351
This follow up trial conducted in 1995 funded by the MRC, confirmed the findings of the earlier report – patients with low back pain treated by chiropractors derive more benefit and long term satisfaction than those treated by hospitals.
4. RCGP (1999) Clinical Guidelines for the Management of Acute Low Back Pain
Manipulation can provide short-term improvement in pain and activity levels and higher patient satisfaction. The risks of manipulation are very low in skilled hands
5. UK BEAM Trial Team (2004) United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ 329:1377
This recent MRC-funded study estimated the effect of; adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise in comparison to “best care” in general practice for patients consulting with back pain. The study summerised that spinal manipulation with and without exercise showed additional improvement at 3 and 6 months compared to ‘best care’. Manipulation was found to be a cost effective addition to ‘best care’ for back pain in general practise and manipulation alone is better value for money than manipulation followed by exercise.
6. NHS- National Institute of Clinical Evidence (NICE) ‘Referral Advice- A guide to appropriate referral from general to specialist services’ Encourages manipulation therapy to help restore function. December 2001.NICE Guidelines; In May 2009, The National Institute for Health and Clinical Excellence (NICE) published new guidelines to improve the early management of persistent non-specific low back pain.
The guidelines recommend what care and advice the NHS should offer to people affected by low back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and one recommendation is to offer a course of manual therapy, including spinal manipulation, spinal mobilisation and massage.