I usually don’t dwell too much on chiropractic, because so many other bloggers deal with it so well. Basically, it is the belief in the “vertebral subluxation processes” that is used to treat and cure a purported vast range of diseases that no scientifically verified connection to vertebrate anatomy. Modern chiropractic has tried to divorce itself from the vertebral subluxation, and evolved to the the main chiropractic treatment technique that involves manual therapy, including manipulation of the spine, other joints, and soft tissues. Chiropractic treatment also includes exercises and health and lifestyle counseling.
So, what does real science say about chiropractic? Not much.
- Radiculopathy. The quality of evidence about the effectiveness of manual therapies for radiculopathies ranges from moderate to nonexistent.
- Whiplash and other neck pain. The quality of evidence ranges from weak to low, but moderate results.
- Headache. A recent meta-review of spinal manipulation shows that it probably has no effect on migraine headaches. Other reviews found inconclusive or weak evidence supporting manual therapies for tension headache.
- Other reviews have found no evidence of significant benefit for chiropractic in asthma, baby colic, bedwetting, carpal tunnel syndrome, fibromyalgia, gastrointestinal disorders,kinetic imbalance due to suboccipital strain (KISS) in infants, menstrual cramps, or pelvic and back pain during pregnancy.
One of the areas that has always had some clinical evidence, and lots of anecdotal evidence of success with chiropractic has been lower back pain. However, a recent publication in the Cochrane Reviews even eliminates that last bastion. According to the article, Spinal manipulative therapy for acute low-back pain, which reviewed 20 randomized clinical trials (with a total of 2674 participants), spinal manipulative therapy is no more effective in participants with acute low-back pain than inert interventions. In other words, chiropractic is no more effective than any other recommended therapy for lower back pain, like taking a non-steroidal anti-inflammatory drug.
Basically, chiropractic evidence is barely more than placebo. Which means that it has barely any clinical significance.
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