Chiropractic Research on Back Pain

Chiropractic research on back pain can be found in various scientific studies that have been published from January 1994 through June 2003. The descriptions and findings of these research studies are based on randomized clinical trials and primarily focused on people with low back pain. Other chiropractic research on back pain focused just on adults with the condition.

Chiropractic Research on Back Pain: A Summary

The following table describes descriptions and findings for various chiropractic research studies on back pain.
Published from January 1994 through June 2003
Hurwitz et al., 2002
Randomized clinical trial (RCT) of patients in a managed care organization compared chiropractic care (with and without any of the following added: heat or cold therapy, ultrasound, electrical muscle stimulation) with conventional medical care (with and without physical therapy added). Participants (652) had acute, subacute, or chronic low back pain with or without leg pain. Back pain intensity and back-related disability were measured.
After six months of follow-up, the conventional medical care and chiropractic regimens were found to be comparably effective.
Hsieh et al., 2002
RCT compared four treatments for subacute low back pain (LBP): "joint manipulation" by a chiropractor, back school (program of counseling and exercises), myofascial therapy, and joint manipulation plus myofascial therapy. Participants (178) had LBP for either longer than three weeks but less than six months in a current episode or more than two months within the preceding eight months for recurrent LBP, and were evaluated three weeks and six months after treatment.
No statistically significant differences were found between groups at three weeks or six months.
Cherkin et al., 1998
RCT in an HMO setting of 321 adults aged 20 to 64 with low back pain. Patients received chiropractic manipulation, physical therapy (PT), or a booklet on self-managing back pain. They were monitored for two years and evaluated for bothersome symptoms and level of dysfunction.
The outcomes for those who received manipulation or PT were better than those who received the booklet, but "only marginally better." There were no significant differences between the manipulation and PT groups. Authors note that manipulation and PT "may slightly reduce symptoms."
Bronfort et al., 1996
For chronic low back pain, prospective RCT compared: (1) chiropractic spinal manipulation therapy (SMT) plus trunk-strengthening exercises with (2) chiropractic SMT plus trunk-stretching exercises and (3) trunk-strengthening exercises combined with an NSAID (drug). Enrollees (174) were measured for low back pain, disability, and functional health status at 5 and 11 weeks.
Each of the three regimens yielded a "similar and clinically important improvement over time that was considered superior to the expected natural history of long-standing chronic low back pain."
Carey et al., 1995
Prospective observational study on the outcomes of care for acute low back pain by chiropractors, primary care practitioners, and orthopedic surgeons, including how long it took to return to functional status. Participants (1,633) had acute pain of less than 10 weeks' duration.
Time to recovery was "essentially the same," regardless of who provided the care.
Meade et al., 1995
RCT of 741 patients who came to chiropractic and hospital outpatient clinics in 11 centers for low back pain. Participants were randomized to receive either chiropractic or hospital-outpatient management. Outcomes were measured mainly with a pain disability questionnaire, at six weeks, six months, and one, two, and three years.
Chiropractic was found to be more effective, especially for those with "short current episodes, a history of back pain, and initially high [pain scale] scores." Benefit was less evident at two and three years than earlier. Authors noted that further trials are needed, for example, on specific components of chiropractic care.
Triano et al., 1995
RCT comparing chiropractic spinal manipulation, sham manipulation, and a back-education program. Participants (170) had low back pain (lasting seven weeks or longer or consisting of at least six episodes in 12 months) and were evaluated for pain and activity tolerance at enrollment, after two weeks of treatment, and after two weeks of no treatment.
Greater improvement was found in the manipulation group than in other groups. Pain relief continued to end after the evaluation period.
Pope et al., 1994
Prospective RCT compared chiropractic spinal manipulation for treatment of subacute low back pain to massage, use of a corset, and TMS (electrical muscle stimulation). Patients (164) were treated for three weeks and evaluated through various standardized instruments and examinations.
Various improvements were seen in all four groups. The manipulation group had the most improvement in flexion and pain. However, authors concluded overall that none of the changes in physical outcomes measured was significantly different between groups.
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