Chiropractic Research on Back Pain (Cont.)

Assendelft et al., 2003

Meta-analysis of 39 randomized clinical trials of treatments for acute or chronic low back pain in adults. The trials compared spinal manipulation (by chiropractors and other healthcare providers) with another treatment or control condition (including no treatment, conventional medical care, pain-relieving drugs, physical therapy, exercise, and back school).

Spinal manipulation was more effective than sham therapy, but no more or no less effective than other treatments. Authors found that the specific profession of the manipulators (including chiropractors) did not affect these results.

Ernst, 2003

General review of the scientific evidence for the effectiveness of chiropractic spinal manipulation for back pain (this review is not limited to low back pain studies).

Author noted there has been only one systematic review of chiropractic spinal manipulation exclusively (Assendelft et al., 1996) and that, since that study, emerging trial data "have not tended to be encouraging. The effectiveness of chiropractic spinal manipulation for back pain is thus, at best, uncertain."

Assendelft et al., 1996

Systematic review of eight RCTs of chiropractic for acute or chronic low back pain.

Authors stated that all studies analyzed had serious flaws in design, execution, and reporting. Studies could not be pooled to reach statistical conclusions because of insufficient data and data quality problems. Authors summarized the available data by narrative, concluded they "did not provide convincing evidence for the effectiveness of chiropractic for acute or chronic low back pain," and noted that better-executed trials are needed.