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Spinal manipulation falls out of favor
The treatment is no better than other therapies, study finds.
By LEE BOWMAN
Scripps Howard News Service
Spinal manipulation by chiropractors and others to treat back pain is no better, but no worse, than other common treatments for sore backs, according to a new analysis.
Although some earlier studies in recent years have suggested that spinal manipulation might provide better relief to some patients than other therapies, Tuesday's report in the Annals of Internal Medicine levels the field for medical interventions that include exercise, physical therapy and medications.
Back pain is second only to the common cold as a reason for people to seek medical care, with an estimated 80 percent of the population suffering at least one episode during a lifetime.
Spinal manipulation involves adjusting individual vertebrae that have abnormal movement patterns or are in the wrong alignment, using the hands and body movement. The procedure is performed primarily by chiropractors, but also by physical therapists, osteopathic physicians and allopathic physicians.
While spinal manipulation is a recommended treatment in national guidelines on back pain, scientific studies on its effectiveness remain mixed.
"There is no evidence that spinal manipulation is better than other things that your physician can now recommend to you," said Dr. Paul Shekelle, a researcher for the Rand Health think tank in Santa Monica and the Greater Los Angeles Veterans Affairs Healthcare System and co-author of the new study.
A 1992 Rand study had given a slight edge to spinal manipulation. Shekelle said the new conclusion is different because new information is available.
"What we have learned since our last study is that some of the methods to treat back pain, such as bed rest, are worse than doing nothing," Shekelle said. "Spinal manipulation hasn't changed. But the medical therapy has improved because we're getting rid of those therapies that cause harm."
The new analysis looked at dozens of recent experiments comparing spinal manipulation with other therapies. The researchers found evidence that manipulation was superior only to sham therapies or a collection of treatments with no proof of effectiveness or potential to cause harm.
The treatment is no better than other therapies, study finds.
By LEE BOWMAN
Scripps Howard News Service
Spinal manipulation by chiropractors and others to treat back pain is no better, but no worse, than other common treatments for sore backs, according to a new analysis.
Although some earlier studies in recent years have suggested that spinal manipulation might provide better relief to some patients than other therapies, Tuesday's report in the Annals of Internal Medicine levels the field for medical interventions that include exercise, physical therapy and medications.
Back pain is second only to the common cold as a reason for people to seek medical care, with an estimated 80 percent of the population suffering at least one episode during a lifetime.
Spinal manipulation involves adjusting individual vertebrae that have abnormal movement patterns or are in the wrong alignment, using the hands and body movement. The procedure is performed primarily by chiropractors, but also by physical therapists, osteopathic physicians and allopathic physicians.
While spinal manipulation is a recommended treatment in national guidelines on back pain, scientific studies on its effectiveness remain mixed.
"There is no evidence that spinal manipulation is better than other things that your physician can now recommend to you," said Dr. Paul Shekelle, a researcher for the Rand Health think tank in Santa Monica and the Greater Los Angeles Veterans Affairs Healthcare System and co-author of the new study.
A 1992 Rand study had given a slight edge to spinal manipulation. Shekelle said the new conclusion is different because new information is available.
"What we have learned since our last study is that some of the methods to treat back pain, such as bed rest, are worse than doing nothing," Shekelle said. "Spinal manipulation hasn't changed. But the medical therapy has improved because we're getting rid of those therapies that cause harm."
The new analysis looked at dozens of recent experiments comparing spinal manipulation with other therapies. The researchers found evidence that manipulation was superior only to sham therapies or a collection of treatments with no proof of effectiveness or potential to cause harm.
