The end of chiropractors?Peninsula Medical School questions chiropractic

22 March 2006

Using an osteopath or chiropractor to ease back pain is less effective than many people believe, new research claims.

A review of studies into spinal manipulation found 'little evidence' for its effectiveness for a series of problems, according to research to be published in next month's Journal of the Royal Society of Medicine .

Chiropractors and osteopaths manipulate the spine to treat back and neck pain. It's a popular treatment, and there are about 16,000 licensed chiropractors in the UK.

Experts at the Peninsula Medical School in Devon reviewed 16 studies where spinal manipulation was used to treat conditions such as back pain, neck pain, period pains, asthma and allergy.

Spinal manipulation 'no better than conventional treatments'

They concluded that spinal manipulation was not effective for any condition except for back pain - and for that, it wasn't better than conventional treatments. The researchers said the treatment could cause side effects including pain and headaches, and even, in rare cases, a stroke.

They added that the public had been led into thinking the treatment itself is effective because the practitioners are regulated in the UK.

Professor Edzard Ernst of the Peninsula Medical School said: 'There is little evidence that spinal manipulation is effective in the treatment of any medical condition. 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.

'Wake-up call' to chiropractors

Professor Ernst said the findings confirmed fears that in alternative medicine, regulation often served as a substitute for research, and added that the findings should be a 'wake-up call' to the chiropracic profession. He called for rigorous clinical trials.

But the British Chiropractic Association said the researchers had based their findings on a review of negative articles.

It said: 'The usefulness of manipulation is that it can be added, substituted or modified as part of a package of care that provides management, pain control, advice and recognises risks to a good recovery.

'Recent clinical trials funded by the Medical Research Council show that manipulation is effective and cost-effective within such a package for back pain.'