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Chiropractic Research Review

Chiropractic Manipulation for Chronic Spinal Pain

The immense public health impact of chronic spinal pain syndromes, and their significant associated costs for health care budgets worldwide, underscore the need for effective long-term interventions.



In a study designed to compare the relative effectiveness of different protocols for managing chronic spinal pain, 77 patients were randomly assigned to receive one of three interventions: needle acupuncture, nonsteroidal anti-inflammatory medication (NSAIDs) or chiropractic spinal manipulation. Subjects were treated for 30 days, and symptom changes were assessed by way of the Oswestry Back Pain Disability Index, the Neck Disability Index, and three visual analog scales of local pain intensity.

After 30 days, spinal manipulation was the only intervention to achieve statistically significant improvement. Patients receiving chiropractic care demonstrated a 30.7% reduction in Oswestry scores and a 25% reduction in neck disability index scores. Visual analog measurements showed a 50% reduction for low back pain, 46% reduction for upper back pain, and 33% reduction for neck pain. Intervention by way of acupuncture or NSAIDs did not result in significant improvements in any of the outcome measures.

The authors point out several potential limitations to these results, including the short-term nature of the study and problems with managing the study due to funding difficulties. Nonetheless, they suggest that their findings demonstrate the added benefit of chiropractic manipulation over acupuncture and NSAIDs for patients with chronic pain syndromes.

Giles LG, Muller R. Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. Journal of Manipulative and Physiological Therapeutics, July/August 1999:22(6), pp376-81.
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Chiropractic Research Review

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