The AMA Said What?

The AMA Said What?

Recently noted in the Journal of the American Medical Association is a study that is a long time coming. The goal of the study was to “systematically review studies of the effectiveness and harms of spinal manipulative therapy (SMT) for acute (less than six weeks) low back pain”.

Twenty-six clinical trials were used to measure the improvements in pain and function and assess any harm. Fifteen clinical trials of 1,711 patients found spinal manipulative therapy is associated with pain relief. Another 12 clinical trials of 1,381 patients found an association with improvement in function with spinal manipulative therapy. No clinical trials reported any serious adverse effect.

Compare this with recent studies on drugs used for back pain. Acetaminophen is ineffective in the treatment of low back pain and provides minimal short-term benefit for people with osteoarthritis. Compared with placebo, NSAIDS do not provide an important effect on spinal pain and only one out of six receive any benefit.

Richard A. Deyo, MD MPH has spent decades studying spinal care. He makes several points:

• Fifty-nine percent of consumers surveyed by Consumer Reports were highly satisfied with chiropractic care compared to 55% for physical therapists and 34% for primary MDs.

• Serious complications for low back manipulative therapy are very rare, while NSAIDS users commonly see kidney and intestinal tract adverse effects.

• Costs were no higher for chiropractic patients.

It is quite unusual for the AMA to validate manipulative therapy, but I’m really glad that they did!

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Until next time…

Yours in health,

Dr. T

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