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Are Chiro's Good or Bad?

by Robb Beams

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In this 4 min video, Coach Robb (coachrobb.com) discusses how to incorporate chiropractors into your performance program for optimum results.

Related Article: Chiropractic for Maximum Output

That's it for now, until next time, good luck with your training and remember, if you have a question, log on to the Virtual Trainer Expert Forum and have your question answered by a panel of experts. In addition, be sure and check out the Racer X Virtual Trainer archive section. Your complete one-stop information zone for motocross fitness. VT Signature

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Discussion

  1. Gravatar
    Scott McCorvey August 16, 2012 at 8:15 am

    I'd like to see the peer-reviewed medical literature that supports the notion that spinal manipulations and "adjustments" increase the performance of athletes and decrease the healing time after a workout. Chiropractic medicines, will continue to be a controversial field of practice, as long as there is very little evidence that their work is efficacious.

    On a side note, I'm sure that most chiropractic offices would love to have a reliable form of income, through a steady stream of weekly visits where they can bill patients/athletes that have to pay cash for their services, all while providing a service that has no medical evidence that it works.

    "Very strong, incredible endurance, and incredible power output" all through a few spinal manipulations weekly...

  2. Gravatar
    Dr. Cory Ellerbroek August 16, 2012 at 8:47 am

    I will agree that there haven't been enough specific studies done to prove the effects of chiropractic on athletes but what about all the professional athletes that talk publicly about how much chiropractic helps their performance? I have seen quotes from Olympic athletes, NFL players, crossfitters, CHAD REED (http://www.youtube.com/watch?feature=player_embedded&v=hHOuE8bURnY) and many others that include chiropractic as part of the reason for their success. I can tell you from personal experience that many of my patients experience improved strength and balance after an adjustment. Whether or not it is measurable doesn't really matter because that person is going to be mentally stronger.

    Going to a chiropractor, by itself, is not going to make you a professional athlete, but it is just another piece of the puzzle that can help you get there.

  3. Gravatar
    2oldstroke August 16, 2012 at 2:09 pm

    Scott,
    Just a quick story--I've been having what appeared to be pain across my lower abdomen for some time now. It seemed to coincide with pain I felt about a year ago while riding my KTM on an MX track while I was sitting and hit a bump. It was kind of a zing around my lower back and like I said my abdomen. Months later it seemed to get a little worse, etc. I was worried thought it was my colon and so on. Turns out I went to the Chiro and he knew exactly what it was because he had the same thing before he went into Chiro medicine. They had put him through many tests etc. for months and he went to a Chiro and it cleared up in ONE WEEK! Anyway it was something to do with my sacrum--I think and I'm fine now. Point is Chiro isn't good for everything of course and if you are not strengthening your muscles you will become addicted to the manipulation of Chiro and it can't be corrected without muscle strength. But I know too many people that it helps and we're not talking about psychosymatic stuff.

  4. Gravatar
    Racer X Virtual Trainer August 16, 2012 at 2:55 pm

    Here is something else to think about. I train Cooper Webb (google him or start paying attention to moto more :) if you don't know who he is) and I preach to him and all my athletes about the importance of mobility and flexibility. When I started working with Cooper he was one of the most inflexible people I had ever met. He could not even straighten his arms....yep, could not fully straighten his arms! Laying on his back with his arms overhead he could not touch his arms to the floor. Imagine that. A 16 year old with that much restricted motion. Cooper understands the danger of this and the benefits if he improves his mobility. Every day I schedule stretching and sometimes it happens sometimes it does not. He is 16, very busy and stretching is boring. So it usually gets skipped or half-assed. I should also note that I do not train in person with Cooper. How did I fix this???? chiropractic! Why did it work? Because he had appointments that he had to keep and the Chiro worked with him. Could I have achieved the same result if I worked with him in person? Maybe.....but he had some major issues due to some past injuries. Is everything perfect now? No....but we are closer than we were before starting with the Chiro and he takes his stretching sessions way more serious now that he has started to see such great improvement.

  5. Gravatar
    Scott MCCorvey August 16, 2012 at 4:56 pm

    Cory Ellerbroek DC,

    I'm not going to sit here and say that all chiropractic medicine is ineffective and factitious, but there is a lot of "medicine" that is performed that is not supported by scientific literature and has not been proven to work. Are there legit disorders that people find relief from by using a chiropractor? Absolutely! With that said though, this video is full of claims that have no scientific evidence to back it up.

    The only reason I decided to respond to this thread is because it is extremely biased and rooted in theory and not scientific fact. The video states at the end that in order for an athlete to reach his full potential the spinous processes, muscle insertion, and muscle origins have to be in full alignment, and through this one can achieve incredible strength, endurance, and power... Come on. Is this true? All an athlete needs to do to get an edge up on the competition is get his spine in "proper alignment," something that is going to be evaluated from a series of plane films and the human touch? This is the key?

    This isn't far off from the kinesiology tape that was all over the olympic footage. Something else that has never been proven to work and has had several clinical trials to support that it does nothing more than add a placebo affect. As you yourself said above, "Whether or not it is measurable doesn't really mater because that person is going to be mentally stronger." Is this a physical problem that is being corrected by "proper alignment" or is this a placebo affect that you are achieving? If it is that later the person may be "mentally stronger," but he's going to physically be the same at the end of the manipulation.





  6. Gravatar
    Ash B August 16, 2012 at 7:10 pm

    Scott,

    Thanks for being the voice of reason. In a sport where people are willing to pay anything for a perceived advantage, there will always be the sellers of snake oil, and those willing to be exploited. Remember those holographic bracelets/wrist bands?

  7. Gravatar
    Coach Robb August 17, 2012 at 4:52 am

    Hey guys - Coach Robb here.

    I never intended to imply that chiropractic was the "magic pill" to improved strength & endurance; I apologize if that was what your take away was from the video.

    My point is this - optimized movement is the integration of all pieces of the puzzle working together. Muscles move bones; tight (over extended) muscles eventually become fatigued, fatigued muscles lack strength & endurance. Muscles originate and insert to bones - if the bones are out of line, they "pull" on the muscles causing them to become fatigued. How many people have you seen that have blown out their back reaching for something - this illustrates the point.

    Think about your chain on your bike, if it is out of line by the smallest amount, you wear your chain and sprockets out faster than if they are in line - same thing applies to your muscles. I have been fortunate to work with some of the best athletes in the world in numerous sports over the last 24 years, I have seen the direct benefits of chiropractic and massage first hand. Please don't confuse the application of physiology and think of it as "snake oil".

    If you have any questions or comments, please post back here so that we can discuss openly.
    -Coach Robb/MotoE

  8. Gravatar
    Joel Younkins August 17, 2012 at 8:53 am

    I think sometimes we often get to caught up in scientific research and evidence when someone simply wants to express their views/opinions/experiences to possibly help others. In human performance we often use simply theory to get the job done because nobody has the end all be all scientific proof...Yes as coaches/trainers that's what we are after to help our athletes/clients get to peak levels. The thing is too, the scientific research done isn't always what is meant to be in a long term picture as well. Everyone has their views and beliefs in this field. It's just a matter of how you want to play your cards in this field.

  9. Gravatar
    Glenn C. McGovern August 19, 2012 at 10:25 am

    Chiropractic medicine can be helpful to motocrossers, especially coming back from a soft tissue injury. It is one tool, like massage. It has its place. I have suffered severe groin and various ankle and back injuries that I had to recover to compete in an upcoming national or FIM Vet event. I could not have done it without chiropractic help. It is used by foreign teams without question over there. I just know from personal experience it works with certain injuries.

  10. Gravatar
    Darren August 28, 2012 at 7:56 am

    What do you mean there is no research? There is more research then any other discipline for the simple fact that it doesn't sell medication so is constantly under attack. It's similar to physical therapy. Muscles, bones and nerves... What is there to believe in. I agree with the author. Indulge in some of the information below before you judge:

    For example, recent projects supported by NCCAM include: * Comparing conventional medical care for acute back pain with an "expanded benefits" package (consisting of conventional care plus a choice of chiropractic, massage, or acupuncture) * Finding out what happens (through measurement) in the lumbar portion of the spine after chiropractic positioning and adjustment * Evaluating the effects of the speed of spinal adjustment on muscles and nerves * Studying the effectiveness of chiropractic adjustment for a variety of conditions, including neck pain, chronic pelvic pain, and temporomandibular disorders (TMD) in the jaw For More Information * NCCAM Clearinghouse Toll-free in the U.S.: 1-888-644-6226 International: 301-519-3153 TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 E-mail: info@nccam.nih.gov NCCAM Web site: nccam.nih.gov Address: NCCAM Clearinghouse, P.O. Box 7923, Gaithersburg, MD 20898-7923 Fax: 1-866-464-3616 Fax-on-Demand service: 1-888-644-6226 The NCCAM Clearinghouse provides information on CAM and on NCCAM. Services include fact sheets, other publications, and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. * National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Web site: www.niams.nih.gov Toll-free in the U.S.: 1-877-22-NIAMS (or 301-495-4484) NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; training of scientists; and information based on research. Publications are available. * Agency for Healthcare Research and Quality (AHRQ) Web site: www.ahrq.gov Telephone: 301-427-1364 AHRQ is the health services research arm of the Department of Health and Human Services. Publications that may be of interest include Chiropractic in the United States: Training, Practice, and Research (1998) and AHRQ's Clinical Practice Guideline No. 14: Acute Low-Back Problems in Adults (1994; however, this document has been archived by AHRQ and is not considered current clinical guidance). * CAM on PubMed Web site: www.nlm.nih.gov/nccam/camonpubmed.html CAM on PubMed, a database on the Internet developed jointly by NCCAM and the National Library of Medicine, offers citations to (and in most cases, brief summaries of) articles on CAM in scientifically based, peer-reviewed journals. CAM on PubMed also links to many publisher Web sites, which may offer the full text of articles. * ClinicalTrials.gov Web site: www.clinicaltrials.gov ClinicalTrials.gov is a database of information on clinical trials, primarily in the United States and Canada, for a wide range of diseases and conditions. It is sponsored by the National Institutes of Health and the U.S. Food and Drug Administration. * The Cochrane Library Web site: www.cochrane.org/reviews/clibintro.htm The Cochrane Library is a collection of science-based reviews from the Cochrane Collaboration, an international nonprofit organization that seeks to provide "up-to-date, accurate information about the effects of health care." Its authors analyze the results of rigorous clinical trials on a given topic and prepare systematic reviews. Abstracts (brief summaries) of these reviews can be read online without charge. You can search by treatment name or medical condition. Subscriptions to the full text are offered at a fee and are carried by some libraries. Definitions Acupuncture: A health care practice that originated in traditional Chinese medicine. Acupuncture involves inserting needles at specific points on the body, in the belief that this will help improve the flow of the body's energy (or qi, pronounced "chee") and thereby help the body achieve and maintain health. Acute pain: Pain that has lasted a short time (e.g., less than 3 weeks) or is severe. Alternative medical system: A medical system built upon a complete system of theory and practice; these systems have often evolved apart from and earlier than the conventional medical approach used in the United States. An example from a Western culture is naturopathic medicine; from a non-Western culture, traditional Chinese medicine. Bonesetter: A health care practitioner (not necessarily a licensed physician) whose occupation is setting fractured or dislocated bones. Cauda equina syndrome: A syndrome that occurs when the nerves of the cauda equina (a bundle of spinal nerves extending beyond the end of the spinal cord) are compressed and damaged. Symptoms include leg weakness; loss of bowel, bladder, and/or sexual functions; and changes in sensation around the rectum or genitalia. Chronic pain: Pain that has lasted a long time (more than 3 months). Clinical trial: A clinical trial is a research study in which a treatment or therapy is tested in people to see whether it is safe and effective. Clinical trials are a key part of the process in finding out which treatments work, which do not, and why. Clinical trial results also contribute new knowledge about diseases and medical conditions. Complication: A secondary disease or condition that develops in the course of a primary disease or condition, or as the result of a treatment. Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. General review: An analysis in which information from various studies is summarized and evaluated; conclusions are made based on this evidence. Hippocrates: A Greek physician born in 460 B.C. who became known as the founder of Western medicine. Homeopathy: Also known as homeopathic medicine. It is an alternative medical system that was invented in Germany. In homeopathic treatment, there is a belief that "like cures like," meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms. Manipulation: Passive joint movement beyond the normal range of motion. The term adjustment is preferred in chiropractic. Massage: A therapy in which muscle and connective tissue are manipulated to enhance function of those tissues and promote relaxation and well-being. Meta-analysis: A type of research review that uses statistical techniques to analyze results from a collection of individual studies. Mobilization: A technique, used by chiropractors and other health care professionals, in which a joint is passively moved within its normal range of motion. Myofascial therapy: A type of physical therapy that uses stretches and massage. Naturopathic medicine: Also known as naturopathy. It is an alternative medical system in which practitioners work with natural healing forces within the body, with a goal of helping the body heal from disease and attain better health. Practices may include dietary modifications, massage, exercise, acupuncture, minor surgery, and various other interventions. Observational study: A type of study in which individuals are observed or certain outcomes are measured. No attempt is made to affect the outcome (for example, no treatment is given). Orthopedist: Doctor of Medicine (M.D.) who is a surgeon specializing in disorders of the musculoskeletal system. Osteopathic medicine: Also known as osteopathy. It is a form of conventional medicine that, in part, emphasizes diseases arising in the musculoskeletal system. There is an underlying belief that all of the body's systems work together, and disturbances in one system may affect function elsewhere in the body. Most osteopathic physicians practice osteopathic manipulation, a full-body system of hands-on techniques to alleviate pain, restore function, and promote health and well-being. Osteoporosis: A reduction in the amount of bone mass, which can lead to breaking a bone after a minor injury, such as a fall. Placebo: Resembles a treatment being studied in a clinical trial, except that the placebo is inactive. One example is a sugar pill. By giving one group of participants a placebo and the other group the active treatment, the researchers can compare how the two groups respond and get a truer picture of the active treatment's effects. In recent years, the definition of placebo has been expanded to include other things that could affect the results of health care, such as how a patient feels about receiving the care and what she expects to happen from it. Prospective study: A type of research study in which participants are followed over time for the effect(s) of a health care treatment. Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. Review: See general review, systematic review, or meta-analysis. Sham: A treatment or device that is a type of placebo. An example would be positioning the patient's body and placing the chiropractor's hands in a way that mimics an actual treatment, but is not a treatment. Subacute pain: Pain that has lasted somewhat longer than acute pain (for example, more than a few days or weeks) but is not yet chronic pain. Systematic review: A type of research review in which data from a set of studies on a particular question or topic are collected, analyzed, and critically reviewed. Top References 1. Meeker WC, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Annals of Internal Medicine. 2002;136(3):216-227. 2. Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Archives of Internal Medicine. 1998;158(20):2215-2224. 3. Bronfort G. Spinal manipulation: current state of research and its indications. Neurologic Clinics. 1999;17(1):91-111. 4. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. Journal of the American Medical Association. 1998;280(18):1569-1575. 5. Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine. 2003;28(3):292-297. 6. Coulter ID, Hurwitz EL, Adams AH, et al. Patients using chiropractors in North America: who are they, and why are they in chiropractic care? Spine. 2002;27(3):291-296. 7. Vickers A, Zollman C. ABC of complementary medicine. The manipulative therapies: osteopathy and chiropractic. BMJ. 1999;319(7218):1176-1179. 8. Atlas SJ, Nardin RA. Evaluation and treatment of low back pain: an evidence-based approach to clinical care. Muscle and Nerve. 2003;27(3):265-284. 9. Pengel HM, Maher CG, Refshauge KM. Systematic review of conservative interventions for subacute low back pain. Clinical Rehabilitation. 2002;16(8):811-820. 10. Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative therapy for low back pain. Annals of Internal Medicine. 2003;138(11):871-881. 11. Complementary medicine: fact and fiction about chiropractic. Harvard Health Letter. 1999;24(3):1-3. 12. The Council on Chiropractic Education. Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status January 2003. Council on Chiropractic Education Web site. Accessed at www.cce-usa.org on June 16, 2003. 13. Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of Internal Medicine. 2002;137(12):965-973. 14. Agency for Health Care Policy and Research. Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research; 1998. AHCPR publication no. 98-N002. 15. Dagenais S, Haldeman S. Chiropractic. Primary Care. 2002;29(2):419-437. 16. Shekelle PG, Adams AH, Chassin MR, et al. Spinal manipulation for low-back pain. Annals of Internal Medicine. 1992;117(7):590-598. 17. Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22(4):435-440. 18. Hufnagel A, Hammers A, Schonle PW, et al. Stroke following chiropractic manipulation of the cervical spine. Journal of Neurology. 1999;246(8):683-688. 19. Jeret JS, Bluth M. Stroke following chiropractic manipulation: report of 3 cases and review of the literature. Cerebrovascular Diseases. 2002;13(3):210-213. 20. Haldeman S, Rubinstein SM. Cauda equina syndrome in patients undergoing manipulation of the lumbar spine. Spine. 1992;17(12):1469-1473. 21. Haldeman S, Rubinstein SM. Compression fractures in patients undergoing spinal manipulative therapy. Journal of Manipulative and Physiological Therapeutics. 1992;15(7):450-454. 22. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine. 2002;27(20):2193-2204. 23. Cooper RA, Henderson T, Dietrich CL. Roles of nonphysician clinicians as autonomous providers of patient care. Journal of the American Medical Association. 1998;280(9):795-802. 24. Chiropractic regulatory boards. Federation of Chiropractic Licensing Boards Web site. Accessed at www.fclb.org/boards.htm on June 16, 2003. 25. Hsieh CY, Adams AH, Tobis J, et al. Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial. Spine. 2002;27(11):1142-1148. 26. Cherkin DC, Deyo RA, Battie M, et al. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. New England Journal of Medicine. 1998;339(15):1021-1029. 27. Bronfort G, Goldsmith CH, Nelson CF, et al. Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial. Journal of Manipulative and Physiological Therapeutics. 1996;19(9):570-582. 28. Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. New England Journal of Medicine. 1995;333(14):913-917. 29. Pope MH, Phillips RB, Haugh LD, et al. A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine. 1994;19(22):2571-2577. 30. Triano JJ, McGregor M, Hondras MA, et al. Manipulative therapy versus education programs in chronic low back pain. Spine. 1995;20(8):948-955. 31. Meade TW, Dyer S, Browne W, et al. Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up. BMJ. 1995;311(7001):349-351. 32. Assendelft WJ, Koes BW, van der Heijden GJ, et al. The effectiveness of chiropractic for treatment of low back pain: an update and attempt at statistical pooling. Journal of Manipulative and Physiological Therapeutics. 1996;19(8):499-507. 33. Ernst E. Chiropractic spinal manipulation for back pain. British Journal of Sports Medicine. 2003;37(3):195-196. 34. Ernst E. Chiropractic care: attempting a risk-benefit analysis. American Journal of Public Health. 2002;92(10):1603-1604. 35. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. American Journal of Public Health. 2002;92(10):1634-1641. 36. Sran MM. Commentary on "Chiropractic spinal manipulation for back pain." British Journal of Sports Medicine. 2003;37:196. Top Appendix I Research Studies of Chiropractic Treatment in Adults with Back Pain Published from January 1994 through June 2003 Citation Description Findings Hurwitz et al., 200222 Randomized clinical trial (RCT) of patients in a managed care organization compared chiropractic cared (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 6 months of followup, the conventional medical care and chiropractic regimens were found to be comparably effective. Hsieh et al., 200225 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 >3 weeks but <6 months in a current episode or >2 months within the preceding 8 months for recurrent LBP, and were evaluated 3 weeks and 6 months after treatment. No statistically significant differences were found between groups at 3 weeks or 6 months. Cherkin et al., 199826 RCT in an HMO setting of 321 adults aged 20-64 with low-back pain. Patients received either chiropractic manipulation, physical therapy (PT), or a booklet on self-managing back pain. They were monitored for 2 years and evaluated for bothersomeness of 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., 199627 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 3 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., 199528 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 which provider provided the care. Meade et al., 199531 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 6 weeks, 6 months, and 1, 2, and 3 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 2 and 3 years than earlier. Authors noted that further trials are needed, e.g., on specific components of chiropractic. Triano et al., 199530 RCT comparing chiropractic spinal manipulation, sham manipulation, and a back education program. Participants (170) had low-back pain (lasting 7 weeks or longer or consisting of at least 6 episodes in 12 months) and were evaluated for pain and activity tolerance at enrollment, after 2 weeks of treatment, and after 2 weeks of no treatment. Greater improvement was found in the manipulation group than in other groups. Pain relief continued to end of evaluation period. Pope et al., 199429 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 3 weeks and evaluated through various standardized instruments and examinations. Various improvements were seen in all 4 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. dHurwitz et al. define chiropractic care as "spinal manipulation or another spinal-adjusting technique." Top Appendix II Reviews on Chiropractic Treatment for Back Pain in Adults Published from October 1996 through June 2003 Citation Description Findings Assendelft et al., 200310,e 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 health care 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, 200333 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, see below), 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., 199632 Systematic review of 8 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 narratively; 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 in future. eThis study on spinal manipulation is included because the authors were able to break down the findings according to the profession of the manipulator, including chiropractors.

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    Darren August 28, 2012 at 8:11 am

    Remember, there is research that supports it and some that doesn't support it's effectiveness. It depends on the research. This information is not to pull all the supporting research, but to be unbiased and just have you read the good and bad so you don't think I'm being biased. Point is, there is a lot of research in several scientific journals. In fact, the RAND Corp. is doing a major study on US soldiers as we speak. Just like in any profession, there are good and bad chiropractic physicians out there. You have to find a good provider.

    For instance, what has scientific research found out about whether chiropractic works for low-back pain?

    For this report, the results of individual clinical trials and reviews of groups of clinical trials were examined. Sources were drawn from the National Library of Medicine's PubMed database; were published in English; and studied chiropractic techniques that were identified as such (e.g., "chiropractic manipulation") rather than some other forms of "manipulation" or "spinal manipulation therapy"--which, as noted above, may be delivered by certain other health care providers.c Clinical Trials A clinical trial is a research study in which a treatment or therapy is tested in people to see whether it is safe and effective. Clinical trials are a key part of the process in finding out which treatments work, which do not, and why. Clinical trial results also contribute new knowledge about diseases and medical conditions. To find out more, see NCCAM's fact sheet "About Clinical Trials and Complementary and Alternative Medicine." So far, the scientific research on chiropractic and low-back pain has focused on if, and how well, chiropractic care helps in relieving pain and other symptoms that people have with low-back pain. This research often compares chiropractic to other treatments. Research studies Appendix I gives detailed findings from seven controlled clinical trials and one prospective observational study of chiropractic treatment for low-back pain published between January 1994 and June 2003. Summary of the research findings The studies all found at least some benefit to the participants from chiropractic treatment. However, in six of the eight studies, chiropractic and conventional treatments were found to be similar in effectiveness.22,25-29 One trial found greater improvement in the chiropractic group than in groups receiving either sham manipulation or back school.30. Another trial found treatment at a chiropractic clinic to be more effective than outpatient hospital treatment.31 General reviews, systematic reviews, and meta-analyses Appendix II lists three reviews of clinical trials on chiropractic treatment for back pain, published between October 1996 and June 2003. Summary of the research findings Overall, the evidence was seen as weak and less than convincing for the effectiveness of chiropractic for back pain. Specifically, the 1996 systematic review reported that there were major quality problems in the studies analyzed; for example, statistics could not be effectively combined because of missing and poor-quality data. The review concludes that the data "did not provide convincing evidence for the effectiveness of chiropractic."32 The 2003 general review states that since the 1996 systematic review, emerging trial data "have not tended to be encouraging�. The effectiveness of chiropractic spinal manipulation for back pain is thus at best uncertain."33 The 2003 meta-analysis found spinal manipulation to be more effective than sham therapy but no more or no less effective than other treatments.10 Several other points are helpful to keep in mind about the research findings. Many clinical trials of chiropractic analyze the effects of chiropractic manipulation alone, but chiropractic practice includes more than manipulation (see Question 5).34 Results of a trial performed in one setting (such as a managed care organization or a chiropractic college) may not completely apply in other settings.29,35 And, researchers have observed that the placebo effect may be at work in chiropractic care,34 as in other forms of health care. cThis fact sheet often uses the term "adjustment" to refer to chiropractic manipulation. In Question 9 and Appendices I and II, "manipulation" is used where it is used in the source(s) on chiropractic being discussed.

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