Spinal Manipulation Doesn't Work For Any Condition, New Research Finds

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Spinal Manipulation Doesn't Work For Any Condition, New Research Finds

http://www.medicalnewstoday.com/medicalnews.php?newsid=40315

A study to be published in next month's issue of the Journal of the

Royal Society of Medicine has raised serious questions about the

efficacy of spinal manipulation treatment.

Spinal manipulation is commonly practiced by chiropractors and

osteopaths. It is a popular form of manual treatment for back and

neck pain with an estimated 16,000 licensed chiropractors in the UK.

" There is little evidence that spinal manipulation is effective in

the treatment of any medical condition, " said Professor Edzard Ernst

of the Peninsula Medical School at Exeter.

" The findings are of concern because chiropractors and osteopaths are

regulated by statute in the UK.

" Patients and the public at large perceive regulation as proof of the

usefulness of treatment. Yet the findings presented here show a gap

and contradiction between the effectiveness of intervention and the

evidence. "

Professor Ernst's paper examined all systematic reviews published on

spinal manipulation between 2000 and May 2005. Sixteen papers were

included in the research relating to the following condition: back

pain, neck pain, primary and secondary dysmenorrhoea, infantile

colic, asthma, allergy and cervicogenic dizziness.

" Collectively these data did not demonstrate that spinal manipulation

is an effective intervention for any of these conditions, except for

back pain where it is superior to sham manipulation but not better

than conventional treatments, " write the authors.

" Considering the possibility of adverse effects, this review does not

suggest that spinal manipulation is a recommendable treatment. "

The study also highlights the risk of spinal manipulation treatment.

" Spinal manipulation [sM] has been associated with frequent, mild

adverse effects and with serious, probably rare implications, " write

the authors.

" Therefore the risk-benefit balance does not favour SM over other

treatment options such as therapeutic exercise. This statement is not

in agreement with several national guidelines…but we suggest that

these guidelines be reconsidered in the light of the best available

data, " they conclude.

Professor Ernst said the findings confirm fears that in `alternative'

medicine regulation often serves as a substitute for research.

" Previous studies have shown that regulation of chiropractors was

followed by a decrease in research activity, " said Professor Ernst.

" The evidence presented here should be seen as a wake-up call to the

chiropractic profession.

" One way forward is more rigorous clinical trials to test the

efficacy of spinal manipulation, after all, the treatment is not

without risk and chiropractors must demonstrate why it should be a

recommendable medical treatment option, " Professor Ernst said.