Evidence-Based Care That Includes Chiropractic Manipulation More Effective Than Usual Medical Care. The BackLetter January 2008; 23(1):3.
COMMENTS: A Canadian randomized controlled trial study – Chiropractic Hospital-Based Intervention Research Outcomes Trial (C.H.I.R.O.) – found that care for acute low back pain that included chiropractic manipulation had more favorable patient outcomes that family physician-directed care.
The patients selected for this study had pain of no more than four weeks’ duration and had symptoms that met the Quebec Task Force Classification category I (back pain without radiation into the lower extremities) or II (back pain with radiation above the knees). Those assigned to the group that received spinal manipulation had care that included twice-weekly spinal manipulation. Outcome measures utilized the Roland Morris Disability Questionnaire. Those that received spinal manipulation had clinically significant reduction in scores than those who received usual medical care.
One researcher, Malcolm Jayson, M.D., at the 2007 International Society for the Study of the Lumbar Spine in Hong Kong where the study was presented stated that “usual [medical] care” often represents “usual neglect.” The lead researcher, Paul Bishop, D.C., Ph.D., M.D., said that this was their third study that showed that family physician-directed care for acute low back pain was “highly guideline discordant.” The editor of The BackLetter observed that the implementation of evidence-based care into primary care settings is “slow.” Paper will be published in the journal Spine.