Chiropractic for low back pain

BMJ 1999;318:261 ( 23 January )

Letters

Chiropractic for low back pain

Experts in both UK and US believe that chiropractic works

Efficacy of spinal manipulation for low back pain has not been reliably shown

Chiropractic is one of safest forms of treatment available

Evidence for manipulation is stronger than that for most orthodox medical treatments

Editorial included topics unrelated to its title

Authors' reply

Experts in both UK and US believe that chiropractic works

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

EDITOR $---$ Ernst and Assendelft's editorial on chiropractic for low back pain seems to have been written more in a spirit of professionalaversion than in one of critical doubt.¹ This impression isconditioned by previous commentaries by these authors in the popularpress and the biomedicalliterature.

The question is, why? There is substantial scientific evidence that the manipulation that chiropractors (and indeed osteopathsand some physiotherapists) do for back pain is both effectiveand safe. This evidence has been reviewed by multidisciplinarypanels of experts in both the United Kingdom and the United States,which has resulted in the production of two national clinicalpractice guidelines for acute back pain that totally disagreewith these authors. The only randomised controlled trial of overallchiropractic management for back pain, ² ³ in contrast tomanipulation alone, is not mentioned in this editorial. Yet thistrial (included erroneously by one of these . . . [Full text of this article]

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