Synopsis of Recent Studies

A four-year 2004 study recently published in the Archives of Internal Medicine
(Vol. 164, October 11, 2004), the professional journal of the American Medical
Association, reports significantly lower costs and better outcomes among

patients who have access to chiropractic treatment for back pain

The study, believed to be the largest of its kind, compared 1 million members
of a  managed health plan who had no coverage for chiropractic care to
700,000 members of the plan with coverage for chiropractic treatment.

Back pain patients with chiropractic insurance coverage were found to have
reduced hospitalizations, fewer MRIs, a lower rate of back surgery and fewer radiographs.
The cost of treatment for patients with chiropractic coverage was 28 per cent lower
than the cost of care for back pain sufferers with no chiropractic coverage.

A 1998 study finds that low back pain sufferers are just as likely to get appropriate spinal manipulation from chiropractors as patients with other health problems are to get appropriate medical procedures from physicians. The study, considered the most thorough analysisyet of spinal manipulation, is in the current Annals of Internal Medicine.
"Everybody needs to stop treating chiropractors as if they are quacks. An appropriateness rate of roughly half is in the same ballpark as the findings for certain medical procedures when appropriateness measures were introduced a dozen years ago,'' said Dr. Paul Shekelle, an author of the study.
Annals of Internal Medicine, July 1998, 129:9-17.


A 1995 study found that chiropractors were the choice of one third of all patients who sought back care and who saw only one provider. From previous studies, it was found that approximately two thirds of all outpatient visits for back pain are made to chiropractors. Results of this study indicate that chiropractors were the primary provider for 40% of all episodes of back pain and were retained as primary providerby 92% of patients who had a second episode of back pain.

Medical Care, Vol.33, pp.842-50.

A 1995 study found that low back pain patients whose primary provider was a chiropractor were significantly more satisfied with their care than patients whose primary care provider was a medical doctor or orthopaedic surgeon. Patients of chiropractors more frequently responded that a careful examination of their back was undertaken (96.1% vs. 79.9%), the cause of their problem was clearly explained (96.1% vs. 79.9%) and that their satisfaction with the treatment of their back problem was excellent (52.1% vs 31.5%)

New England Journal of Medicine, Vol 333, pp. 913-17.

In 1993, the Ontario Ministry of Health funded a province-wide study of chiropractic effectiveness. Chiropractic therapy for back pain was compared with a variety of other treatments, including prescription drugs, surgery, spinal fusion, traction and physiotherapy.The study concluded that chiropractic management of low-back pain is the most cost-effective, and that costs to the health care system could be significantly reduced by transferring more management of low-back pain to chiropractors.

In 1990, a randomised controlled trial conducted by the British Medical Research Council compared chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin. The investigators concluded that chiropractic treatment almost certainly confers long term benefit in comparison with outpatient hospital management. They also related that consideration should be given to providing chiropractic coverage in hospitals.

BMJ, Vol. 300, pp.1431-37.

A follow up study was published in the British Medical Journal in 1995 which presents the full results and concludes that "at three years the results confirm the findings of an earlier report that when chiropractic or hospital therapists treat patients with low back pain, those treated by chiropractic derive more benefit and long-term satisfaction than those treated by

BMJ, Vol. 311, pp. 349-51.


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