Chiropractic More Effective Than “Usual Care” For Back Pain

A recent article in Lippincott’s Bone and Joint Newsletter published an article on the effectiveness of chiropractic for acute back pain. The article discusses the work of Dr. Paul Bishop, DC, PhD, MD, a professor of orthopedics at the University of British Columbia.

The work presented by Dr. Bishop at the International Society for the Study of the Lumbar Spine in Hong Kong states:

“This is the first randomized controlled trial demonstrating that full clinical practice guidelines care including chiropractic spinal manipulative therapy produces more favorable patient outcomes than family physician-directed care in acute low back pain patients.”

Bishop and his colleagues studied 88 patients with acute back pain. The patients were assigned to either a “guidelines-based” chiropractic group or a “usual care” group by family physicians.

“The guidelines-based care included reassurance, avoidance of passive treatments, acetaminophen for pain control, four weeks of twice-weekly spinal manipulation, and return-to-work within eight weeks.”

The outcome measure used was the Roland Morris Questionnaire, and the authors found that the chiropractic patients experienced a significantly greater improvement (2.52 points on the Roland Morris) compared to the “usual care” group (.25 on the Roland Morris).

The authors reported that “usual care” treatment offered by most primary care physicians was not based on the science of back pain (it was, in Bishop’s words, “highly guideline-discordant).

“Typically, the family physician-based care involved excessive use of passive therapies such as massage and passive physical therapy, excessive bed rest, and excessive use of narcotic analgesics, Bishop added.”