Research

Eklund, A., Jensen, I., Lohela-Karlsson, M., Hagberg, J., Leboeuf-Yde, C., Kongsted, A., Bodin, L., & Axén, I. (2018). The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain-A pragmatic randomized controlled trial. PLoS

One, 13(9), e0203029. https://doi.org/10.1371/journal.pone.0203029

This study concluded persistent and recurrent low back pain responds well to an initial course of manual care (as performed by chiropractors in the study). Maintenance care, had on average 12.8 fewer days with bothersome low back pain over 12 months. 

Farabaugh R, Hawk C, Taylor D, Daniels C, Noll C, Schneider M, et al. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review. Chiropr Man Therap. 2024 Mar 6;32(1):8. doi: 10.1186/s12998-024-00533-4.

This study was designed to compare costs of chiropractic and medical care in patients with spinal related pain in the USA. After assessing literature looking at many studies, the study concluded "patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management. "

The Bronfort Report
A comprehensive summary of the scientific evidence showing that common chiropractic techniques such as spinal manipulation/ mobilization to be effective for low back pain; migraine and cervicogenic headache; cervicogenic dizziness and several other conditions. The full article can  be viewed here
http://www.chiromt.com/content/18/1/3

2009 National Institute of Clinical Excellence (NICE Guidelines)
NICE provides national guidance and medical advice to health professionals in the UK. The recommendations aimed at GP's for non-specific low back pain include:
-consider offering a course of manual therapy including spinal manipulation of up to 9 sessions over up to 12 weeks.
full article
http://www.nice.org.uk/nicemedia/live/11887/44343/44343.pdf

The Manga Report
One of the largest existing analysis of scientific literature on low back pain to date. This unbiased independent study was commissioned by the Ontario Ministry of Health and showed Chiropractic treatment is cost-effective, safe, has a high rate of patient satisfaction and is more effective than medical treatment for low back pain. Manga et al found "an overwhelming case in favour of much greater chiropractic services in the management of low-back pain".
Link to the full article:
http://www.chiro.org/LINKS/GUIDELINES/Manga_93.shtml

CHIRO study (Chiropractic Hospital Based Interventions Research Outcomes)
A study comparing acute low back pain patients. "Compared to family physician directed usual care, full clinical based guidelines including chiropractic spinal manipulative therapy is associated with significantly greater improvement in condition-specific functioning".
http://www.ncbi.nlm.nih.gov/pubmed/20889389

RAND study (Research And Development)
A literature review looking at the literature from 1952 to 1991 on the use of spinal manipulation.
full paper link:
http://www.chiro.org/LINKS/FULL/The_Appropriateness_of_Spinal_Manipulation_for_Low-back_Pain.pdf

UK BEAM trial
Back pain, exercise and manipulation (UK BEAM). A randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal Nov 2004; 329; 1377 (doi: 10.1136 /bmj 38282. 669225.AE)

Medical Research Council
"Low back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment"; Meade et al.

Faculty of Occupational medicineOccupational health guidelines for the management of low back pain at work - principle recommendations. London 2000.
Carter & Birrel 2000

Chiropractic treatment in workers with musculoskeletal complaints
Mark Blokland DC et al: Journal of the Neuromusculoskeletal system vol 8 No 1. Spring 2000

Musculoskeletal Services Framework - Department of health July 2006The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychological approach: a) guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercises. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.

Royal College of General Practitioners
Clinical guidelines for the management of Acute low back pain (1996, 1999, 2001).

Non-rigid stabilisation procedures for the treatment of low back pain
National institute for Health and Clinical Excellence June 2006 states that Chiropractic intervention can be used in the treatment of acute low back pain.

European guidelines for the management of acute nonspecific low back pain in primary care.2005 Recommends the consideration of spinal manipulation for patients failing to return to normal activities.

Whedon, J. M., Toler, A. W. J., Goehl, J. M., & Kazal, L. A. (2018). Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events. Journal of Manipulative and Physiological Therapeutics, 41(5), 383–388. https://doi.org/10.1016/j.jmpt.2018.01.004

“Chiropractic care of low back pain is both safe and effective; a recent systematic review and meta-analysis found that for treatment of acute low back pain, spinal manipulation, as performed by chiropractors, provides a clinical benefit equivalent to that of NSAIDs, with no evidence of serious harms.”

The Swiss Master in Chiropractic Medicine Curriculum: Preparing Graduates to Work Together With Medicine to Improve Patient Care

B. Kim Humphreys, DC, PhD⁎ and Cynthia K. Peterson, DC, MMedEd

OBJECTIVE:   In 2007, chiropractic became 1 of the 5 medical professions in Switzerland. This required a new chiropractic program that was fully integrated within a Swiss medical school. The purpose of this article was to discuss the Master in Chiropractic Medicine (MChiroMed) program at the University of Zürich, including advantages, opportunities, and challenges.

DISCUSSION:   In 2008, the MChiroMed program began with its first student cohort. The MChiroMed program is a 6–year Bologna model 2–cycle (bachelor and master) "spiral curriculum," with the first 4 years being fully integrated within the medical curriculum. A review of the main features of the curriculum revealed the advantages, opportunities, and challenges of this program in comparison with other contemporary chiropractic educational programs. Advantages and opportunities include an integrated curriculum within a university, medical school, and musculoskeletal hospital, with their associated human and physical resources. Many opportunities exist for high-level research collaborations. The rigorous entrance qualifications and small student cohorts result in bright, motivated, and enthusiastic students; appropriate assessments; and timely feedback on academic and clinical subjects. Early patient contact in hospitals and clinical facilities encourages the integration of academic theory and clinical practice. The main challenges faced by this program include difficulty recruiting a sufficient number of students because of the rigorous entrance requirements and curriculum overload resulting from undertaking a full medical curriculum and chiropractic modules.

CONCLUSIONS:   The MChiroMed program is a unique chiropractic curriculum that integrates medical and chiropractic education within a spiral curriculum at a world-class Swiss university medical school. The expectation is that graduates, with their expanded diagnostic and therapeutic knowledge, skills, and experience, will become future experts in primary spine care in Switzerland. It is hoped that this curriculum model will be adopted by other countries and jurisdictions seeking to enhance the role of chiropractic in health care.