Editorials

Chiropractic for low back pain

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7152.160 (Published 18 July 1998) Cite this as: BMJ 1998;317:160

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

  1. E Ernst, Professor,
  2. W J J Assendelft (E.Ernst@exeter.ac.uk), Senior researcher
  1. Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, Exeter EX2 4NT
  2. Institute for Research in Extramural Medicine, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, Netherlands

    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 of low back pain recommend spinal manipulation, including chiropractic, as a symptomatic treatment for acute uncomplicated cases where pain fails to resolve spontaneously within the first months.1 How 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 …

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