Chiropractic for low back pain

BMJ 1998;317:160-160 ( 18 July )

Editorials

Chiropractic for low back pain

We don't know whether it does more good than harm

The first 150 words of the full text of this article appear below.

Chiropractic includes various techniques used in the hope of correcting vertebral disc displacements, freeing spinal joint adhesion, inhibiting nociceptive impulses, or correcting spinal misalignment. Several national guidelines on the treatment oflow back pain recommend spinal manipulation, including chiropractic,as a symptomatic treatment for acute uncomplicated cases wherepain fails to resolve spontaneously within the first months.¹How solidly are these recommendations based on evidence?

There are many controlled trials of spinal manipulation and no fewer than 51 reviews.² Surprisingly, in the review of Shekelle et al,³ which provided the basis for the recommendations mentionedabove, the subset of randomised clinical trials on acute low backpain which generated these favourable recommendations did not contain one single trial of chiropractic. A recent systematicreview restricted to chiropractic manipulation included only eightrandomised controlled trials, all of which were methodologicallyflawed and "did not provide convincing evidence for the effectivenessof chiropractic . . . [Full text of this article]

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Relevant Article

Chiropractic for low back pain: Alan Breen, Eva Leerberg, Michael D Pedigo, Gordon Waddell, Lynton G F Giles, E Ernst, and W J J Assendelft
BMJ 1999 318: 261. [Extract] [Full Text]

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Breen, A., Leerberg, E., Pedigo, M. D, Waddell, G., Giles, L. G F, Ernst, E, Assendelft, W J J (1999). Chiropractic for low back pain. BMJ 318: 261a-261 [Full text]

Rapid Responses:

Read all Rapid Responses

Chiropractic for Low Back Pain: Roy M Love
bmj.com, 20 Jul 1998 [Full text]
Untitled: Robert A King
bmj.com, 21 Jul 1998 [Full text]
Untitled: Lynn Whitaker
bmj.com, 22 Jul 1998 [Full text]
more good than harm: Charles Pfeifle
bmj.com, 23 Jul 1998 [Full text]
Untitled: Christopher Davis
bmj.com, 24 Jul 1998 [Full text]
Low back pain and beneficial effect of chiropractic.: Klaas J Postma
bmj.com, 24 Jul 1998 [Full text]
Untitled: Alan Breen
bmj.com, 4 Aug 1998 [Full text]
Chiropractic: L G F Giles
bmj.com, 4 Aug 1998 [Full text]
Untitled: Michael Pedigo
bmj.com, 4 Aug 1998 [Full text]
Chiropractic for low back pain: A Scott Lakernick
bmj.com, 18 Aug 1998 [Full text]
Take a closer look at the evidence for safety: Neil Osborne
bmj.com, 18 Aug 1998 [Full text]
Mobilisation and manipulation are vastly different: Garland D Glenn
bmj.com, 11 Sep 1998 [Full text]
JUST A JOURNALISTIC ARTICLE: Michele Spangaro
bmj.com, 21 Dec 1998 [Full text]
Confusing a Profession with a Treatment Modality Again: Gregory T Wright
bmj.com, 20 Jul 1999 [Full text]