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PATIENT SATISFACTION
There have been a number of studies that compare
chiropractic treatment with other treatments in regards to the
satisfaction experienced by patients. Chiropractors score very high
in these studies. According to those that matter - the patients -
chiropractors provide better care for back conditions than other
providers.
"The Outcomes and Costs of Care for Acute
Low Back Pain Among Patients Seen By Primary Care Practitioners,
Chiropractors, and Orthopedic Surgeons", New England Journal of
Medicine 1995, Vol, pp. 913-917. This study compared low
back pain patients seen by MD's, chiropractors, orthopedic surgeons,
or HMO providers. It found patients seen by chiropractors were
considerably more satisfied with the care they received than those
treated by the other providers. Specifically, those seen by
chiropractors were more likely to report that their care was
excellent (47.1% vs 30.3%), that a careful examination was performed
(96.1% vs 79.9%), and that the cause of their back pain was clearly
explained (93.6% vs 74.6%).
"Patterns and Perceptions of Care for
Treatment of Back and Neck Pain: Results of a National Survey."
Spine 2003; 28(3): 292-298. These researchers surveyed
over 2,000 adults asking if they had suffered from back or neck pain
in the past 12 months. Of those who had seen a chiropractor for
their pain, 61% said the treatment was "very helpful". Of those who
received medical care only 27% indicated it to be "very helpful".
"Patient Evaluations of Low Back Pain Care
from Family Physicians and Chiropractors", Western Journal of
Medicine 1989, Vol. 150(3), PP. 351-355. This study
compared patients seen by chiropractors to those seen by medical
doctors in a large US HMO. Patients of chiropractors were more
satisfied with the care they received. Chiropractic patients were
"very satisfied with care" 66% of the time vs 22% for MD patients;
stated the doctor seemed confident about back pain diagnosis (DC 61
% vs 23% MD); and felt the doctor was concerned about them (DC 58%
vs 20% MD).
Low BACK PAIN, NECK
PAIN & HEADACHES
The most common conditions seen by a chiropractor are
low back pain, neck pain and headaches. These studies highlight the
effectiveness of chiropractic in treating these conditions.
"Efficacy of Spinal Manipulation and
Mobilization for Low Back Pain and Neck Pain: A Systematic Review
and Best Evidence Synthesis." The Spine Journal 2004,4:335-356.
The authors of this review concluded that there are more randomized
controlled trials studying the effects of spinal manipulative
therapy (chiropractic adjustments) on low back pain than any other
treatment method. They concluded, based on the best evidence, that
chiropractic treatment can confidently be considered a viable
treatment for back and neck pain. Of the many therapies available,
chiropractic adjustments were shown to be one of the most thoroughly
studied and effective treatments. The only therapies with similar
proof of effectiveness were mobilization - another treatment used by
chiropractors - and medication.
"A Randomized Clinical Trial Comparing
Chiropractic Adjustments to Muscle Relaxants for Sub-Acute Low Back
Pain." JMPT 2004; 27:388-398. This study compared
chiropractic adjustments with the use of muscle relaxants and
placebo. Chiropractic adjustments were more effective than placebo
in reducing pain and similarly effective to muscle relaxants.
Chiropractic treatment was more effective than muscle relaxants in
reducing the patients Global Impression of Severity Scale.
"Chronic Spinal Pain - A Randomized
Clinical Trail Comparing Medication, Acupuncture and Spinal
Manipulation" Spine 2003; 28: 1490-1503. This study
compared the effects of chiropractic treatment with acupuncture and
medication for 115 patients with chronic spine pain. Chiropractic
manipulation proved to be the most effective treatment. Of those
treated by chiropractic, 27% showed a complete recovery. Patients
treated with Acupuncture showed only a 9% complete recovery, and
with medication the complete recovery rate was 5%.
AHCPR Clinical Practice Guideline # 14 -
1994. Acute Low Back Problems in Adults. US Department of Health and
Human Services. This US Clinical Practice Guideline was
created by a 23-member expert panel of medical doctors,
physiotherapists, chiropractors and PhD's. The guideline concluded
that low back pain could be relieved most effectively and safely by
two methods: non-prescription medication and/or spinal manipulation
(chiropractic adjustments). Most other therapies in use for low back
pain treatment were found to be either ineffective or poorly
supported by research. Side effects from medication were found to be
greater than those associated with manipulation, which were few and
rare.
"Manual Therapy, Physical Therapy or
Continued Care by a General Practitioner for Patients with Neck
Pain." Annals of Internal Medicine 2002; 136: 713-722. A
recent study compared chiropractic treatment with physical therapy
and treatment by general practitioners. The chiropractic treatment
of neck pain proved most effective. After 7 weeks, chiropractors had
a success rate of 68.3% which was two times higher than the success
rate of general practitioners.
"Efficacy of Spinal Manipulation for
Chronic Headache: A Systematic Review." J Manipulative Physiol Ther
2001 (Sept); 24 (7): 457-466. This review of the
available literature on chronic headaches indicated chiropractic
treatment to be as effective as medication in relieving chronic
migraine and tension-type headaches.
OTHER CONDITIONS
Many studies have shown chiropractic care to be
beneficial for more than just back and neck pain. This is because
all systems and organs of the body can benefit from a healthy spine.
Atlas Vertebra Realignment and Achievement
of Arterial Pressure Goal in Hypertensive Patients: A Pilot Study,
Journal of Human Hypertension 2007, 1-7. This recent
study examined the effect of neck manipulation on 50 patients with
high blood pressure. Those patients who received chiropractic upper
cervical treatment showed an average drop in systolic pressure of 14
points and drop in diastolic pressure of 8 points. This drop was
maintained during the entire 8 week study period. Those who did not
receive treatment but rather received a fake adjustment (placebo)
did not show this same drop.
The Short-Term Effect of Spinal
manipulation on the Treatment of Infantile Colic: A Randomized
Controlled Trial with a Blinded Observer. JMPT. 1999: 22(8):
517-522. This study compared chiropractic treatment of
colic with a commonly used medication. After 2 weeks of chiropractic
adjustments the colicky behavior had decreased from an average of
3.9 hours per day to an average of 1.2 hours per day (67%
reduction). In infants receiving medication there was a reduction
from an average of 3.4 hours per day to 2.4 hours per day (38%
reduction).
Self-Reported Nonmusculoskeletal Responses
to Chiropractic Intervention: A Multination Survey, JMPT,
28:294-203. This study examined 5,607 adults treated by
chiropractors to determine what percentage felt that their care had
created non-musculoskeletal benefits. Following a series of
chiropractic treatments, patients were asked to report if they
noticed being "definitely better" with regards to certain
non-musculoskeletal conditions (allergies, asthma, breathing,
circulation, digestion, hearing, ringing in the ears, sinus
problems, urination, vision). Approximately 1 in 4 patients reported
improvement ("definitely better") with at least one
non-musculoskeletal complaint. The most common areas of improvement
where for respiratory disorders (27%), digestive disorders (21%) and
circulatory problems (21%).
Chiropractors support and keep up to date with the present research
in order that they can come to a better understanding of how to most
effectively help patients. Chiropractors are constantly striving to
expand their knowledge so they can provide the best care possible.
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Chiropractic care has been shown through many
studies to be a safe and effective form of therapy.
Chiropractic is one of the most thoroughly studied therapies
for treatment of the spine. There have been approximately 50
randomized controlled trials studying chiropractic treatment
of low back pain alone. This webpage highlights some of the
studies published in renowned journals of physical medicine.
References:
• Non-Musculoskeletal Responses to Chiropractic Care. The
Chiropractic Report. Sept. 2005; Vol 19: No.5, p 1.
• Gregory Plaugher. 1993. Textbook of Clinical Chiropractic, A
Specific Biomechanical Approach. Baltimore, MD: Williams &
Wilkins.
• Carey CS, et al. Acute Severe Low Back Pain, Spine, 21, 1996
• Harris Poll
• The Chiropractic Manual, 2nd Edition, 1990
• Guidelines for Chiropractic Quality Assurance and Practice
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