Spinal manipulation and chiropractic research
There have been many studies conducted to date that consistently report beneficial responses to spinal manipulative therapy (such as that performed by a chiropractor) (4-22). The Agency for Health Care Policy and Research (AHCPR) recommends treating lower back pain with spinal manipulation in the first four weeks of symptoms, with or without non-prescription pain killers and in conjunction with mild exercise such as walking or swimming, followed by conditioning exercises after about two weeks (4). They stress the importance of resuming normal daily activities as quickly as possible and found that more than four days of bed rest can be counterproductive.
The United Kingdom’s Clinical Standards Advisory Group CSAG (9) advocates conservative care consisting of simple analgesics and physical therapy including manipulation, active exercise, and physical activity. They specifically did not recommend inactivity or a policy of "wait and see" by stating:
"Responsibility for primary management: The main responsibility for preventing chronic low back pain and disability lies with the family doctor, occupational health service, physiotherapist, osteopath or chiropractor who is caring for the patient at this early stage. Early active rehabilitation is highly effective in preventing long term pain and disability."
Other studies conducted by the RAND Corporation and authored by Shekelle et al, published for the first time that members of the medical community went on record stating that spinal manipulation is an appropriate treatment for certain low back pain conditions (10). Additional studies comparing treatment methods, costs, time off work, and other issues have also been published but will not be elaborated at this time (please note references for additional information) (11-22).
