Two Chiropractic Techniques Outperform Conventional Medicine for Low Back Pain in Older Adults
In the first randomized controlled trial of chiropractic care for older adults, and one of the first to compare different methods of chiropractic adjustment to each other and to conservative medical care, Hondras et al evaluated the effects of these three approaches for 240 people with subacute and chronic low back pain. High-velocity and low-velocity chiropractic techniques (combined with standardized exercise recommendations) resulted in similar levels of improvement, with both chiropractic methods substantially outperforming the medical care group, who received the same exercise instructions along with pain medication.
Chiropractic Superior to Medical Care in British National Health Service Hospital Study
A small but influential study by Wilkey et al featured a head-to-head comparison of chiropractic care versus medical care for chronic low back pain in a British Naional Health Service hospital pain clinic. The chiropractic and pain clinic groups started with similar levels of pain, although the chiropractic group was on average a decade older than the medical group and chiropractic subjects had endured their pain for a mean of three years longer (7 vs. 4 years). Nevertheless, improvement in pain intensity at week 8 was 1.8 points greater (on a 0 to 10 scale) for the chiropractic group than for the pain clinic group, a substantial difference. Most importantly, disability scores demonstrated a much larger benefit from chiropractic care, with a greater than 5-fold difference in the degree of improvement. These data measured effects through the end of the 8-week treatment period. Within a year after publication of this study, Great Britain's National Health Service changed its guidelines for chronic low back pain to include coverage for spinal manipulation.