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Posted on 07-31-2013

Chiropractic Spinal Adjustments Coupled With Specific Rehabilitative Exercises Provides the
Most Effective Care

I. Contemporary research supports the value Chiropractic care coupled with exercise for improving spinal function.

A 1996 study in JMPT followed 174 patients given 5 weeks of spinal manipulative therapy in combination with supervised trunk exercises followed by an additional 6 weeks of supervised exercise alone. There was a sustained reduction in medication use at the 1 year follow up in this spinal manipulation therapy and trunk stabilization exercise group. Continuance of exercise during the follow-up year, regardless of type was associated with a better outcome. This approach is called a Aclinically important improvement over time@ that is considered superior to the expected natural history of long-standing chronic low-back pain. For the management of chronic low-back pain, trunk exercise, in combination with spinal manipulation therapy, seemed to be beneficial and worthwhile.1

A 1990 study in the British Medical Journal followed 741 patients, randomized them into chiropractic care and traditional hospital outpatient treatment. Results demonstrated that chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain. The benefit of about 7 percent points on the Oswestry scale was seen at two years. The benefit of chiropractic treatment became more evident throughout the follow-up period. Secondary outcome measures also showed that chiropractic was more beneficial. It was concluded that for patients with low-back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile long-term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain.2

A 1999 study in JMPT randomized patients into a trial comparing acupuncture, non-steroidal anti-inflammatory drugs, and spinal manipulation. The results demonstrated that spinal manipulation was the only intervention that achieved statistically significant improvements, with a reduction of 30.7 percent on the Oswestry Disability Scale and reductions on the visual analog scale of 50

 

1 Bronfort G, Goldsmith CH, Nelson CF, Boline PD, Anderson AV. “Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial.” J Manipulative Physiol Ther. 1996 Nov-Dec;19(9):570-82.

2 Meade TW, Dyer S, Browne W, Townsend J, Frank AO. “Low back pain of mechanical origin: randomized comparison of chiropractic and hospital outpatient treatment.” BMJ. 1990 Jun 2;300(6737):1431-7.

3 Giles LG, Muller R. “Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a non-steroidal anti-inflammatory drug, a spinal manipulation.” J Manipulative Physiol Ther. 1999 Jul-Aug; 22(6):376-81.

4 McMorland G, Sutter E. “Chiropractic management of mechanical neck and low-back pain: a retrospective, outcome-based analysis.” J Manipulative Physiol Ther. 2000 Jun;23(5):307-11.
5 Nansel DD, Waldorf T, Cooperstein R. AEffect of cervical spinal adjustments on lumbar paraspinal muscle tone: evidence for facilitation of intersegmental tonic neck reflexes@. J Manipulative Physiol Ther. Feb: 16(2): 91-5. 1993.

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