An exciting report concludes that chiropractic care is more effective than medical management for a common condition: chronic low-back pain. Although this study was published 2008, it is Dr. Greif’s believe the research still stands today, he has also outlined some of the findings of this study for the lay person to better understand this breakthrough study.
As a doctor of chiropractic Dr. Greif focuses on correcting a spinal condition called vertebral subluxation, a disorder characterized by restricted spinal movement or the misalignment of spinal bones. Dr. Greif corrects these vertebral subluxations with gentle and effective maneuvers called chiropractic adjustments. And chiropractic adjustments have been shown to be more effective than other methods for alleviating chronic low-back pain.
What is Chronic Low-Back Pain?
Chronic low-back pain (CLBP) is a condition in which low-back pain persists long-term. In this study, BLBP was defined as pain lasting more than 12 weeks. Often, medical treatment fails to eradicate CLBP. Symptoms of CLBP way wax and wane but they sadly endure.
Where was the Study Published?
The study can be viewed here at US National Library of Medicine National Institutes of Health’s website.[i] It was also published in the Journal of Alternative and Complementary Medicine. This highly respected publication is peer-reviewed, meaning that papers published in it are required to meet exacting criteria and undergo a stringent review process by an international board of experts.
Who Conducted the Study?
Adam Wilkey, D.C., a chiropractor in private practices in Oldham, United Kingdom, and Michael Gregory, M.B., Ch.B., FRCA, a researcher at the Royal Oldham Hospital. Additional co-authors include David Byfield, D.C., M.Phil, and Perter W. McCarthy, Ph.D., both of the Welsh Institute of Chiropractic, University of Glamorgan, in Wales.
Why Was This Study Called For?
Chiropractors, like Dr. Greif, support ongoing efforts to expand scientific investigation of the benefits of chiropractic.
This study’s authors chose to conduct this analysis because there is a need for additional studies comparing chiropractic care to medical care for patients with CLBP.
What Previous Research Has Been Conducted on This Topic?
A wealth of research supports the use of chiropractic for back pain; however, most of this research addresses patients with acute injury rather than CLBP. In an editorial accompanying the study, Daniel Redwood, D.C. of Cleveland Chiropractic College points out that “the first wave (1975-2005) of research on chiropractic treatment of low-back pain dealt with acute cases and focused on comparing spinal manipulation to a comparison treatment or placebo.”
“A strong majority of these studies (there are now over 40 randomized controlled trails of spinal manipulation for low-back pain) found that manual manipulation outperformed competing options; in no study did a comparison treatment or placebo outperform manipulation.”
“Moreover, not a single participant in any of the trials experienced a major negative reaction to chiropractic care. The evidence supporting spinal manipulation for acute low-back pain is broad and deep, leading government consensus panels in the United States, Canada, Great Brittan, Sweden, Denmark, Australia, and New Zealand to recommend spinal manipulation in their low-back guidelines, as did recent guidelines jointly developed by the American College of Physicians and the American Pain Society.”
Dr. Redwood goes on to emphasize that we are now entering a second wave of chiropractic research, one that analyzes the difference between acute and chronic pain. This study is part of that new wave.
Where Did the Study Take Place?
The trial was performed at the National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.
Who Took Part in the Investigation?
The study included 30 patients who had suffered low-back pain for more than 12 weeks. They were all between the ages of 18 and 65.
The researchers randomly assigned study participants to either medical treatment or chiropractic care.
Both groups began the study with the same levels of pain. However, the chiropractic group was on average a decade older and had suffered from CLBP for an average of three years longer.
What Type of Care Did the Patients Receive?
The patients received their randomly assigned type of care, and only that one type, for eight weeks.
Patients in the medical treatment group underwent standard treatment protocols established within the pain clinic. This included oral and injected medications and transcutaneous electrical stimulation (TENS).
Patients assigned to chiropractic care received standard chiropractic adjustments performed to alleviate vertebral subluxations.
What Measures Were Used to Determine Results?
Before all patients began a treatment protocol, they completed questionnaires widely accepted by the medical and chiropractic professions (as well as by other professions) for evaluation of back pain, called the Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale (NRS). Scientific studies have also proven these questionnaires valid.
The patients completed the same evaluations at intervals throughout the study, and at the end of their eight week treatment.
What Were the Findings?
Findings demonstrated that the chiropractic patients enjoyed significant improvement over the medical patients, for both reduction in disability as well as reduction in pain intensity. Considering the chiropractic patients were older and had suffered their condition longer, these findings are even more momentous.
What Will Be the Impact?
Dr. Redwood explains that “chiropractors currently confront an ingrained mindset on the part of man insurers and medical physicians who demand that courses of chiropractic care be limited in duration, recognizing little or no difference between acute and chronic cases. Doctors and insurers who would never consider limiting chronic pain patients to a 6-week course of prescription anti-inflammatory or analgesic medication in many cases do not hesitate to place such limits on chiropractic management of chronic back pain.”
Dr. Redwood urges that these new findings change these attitudes, and promote chiropractic as the most effective means of caring for patients with CLBP.
Where Can I access the Study?
The study, A Comparison Between Chiropractic Management and Pain Clinic Management for Chronic Low-Back Pain in a National Health Service Outpatient Clinic, can be viewed at the US National Library of Medicine National Institutes of Health websitei (a direct link is listed below) and it also appears in the June 2008 issue of the Journal of Complementary and Alternative Medicine, volume 14, pages 465-473. It may also be viewed on the journal’s website (www.liebertonline.com/loi/acm). You can also search the study in google as well for more information.