While research supports the value of spinal manipulation for chronic low back pain when performed by doctors of chiropractic, a new study published in JAMA Network Open suggests doctors of osteopathy and physical therapists don't enjoy the same success.
According to the randomized clinical trial involving 162 young adults (average age: 25 years) with chronic, mild to moderate LBP, both spinal manipulation and mobilization were no more effective than placebo in reducing low back pain and related disability. "Licensed clinicians (either a doctor of osteopathic medicine or physical therapist), with at least 3 years of clinical experience using manipulative therapies provided all treatments."
Participants were randomized into one of three groups and received six treatment sessions of spinal manipulation, spinal mobilization or placebo (sham cold laser) over the course of three weeks (two sessions per week for three weeks). Primary outcome measures assessed included 1) change in Numerical Pain Rating Scale (NPRS) score over the past seven days; and 2) change in Roland-Morris Disability Questionnaire score 48-72 hours after completion of the six treatments.
In their conclusion, the authors state: "Our findings indicated that spinal manipulation and spinal mobilization were no more effective than a well-chosen placebo in reducing pain and disability in patients with chronic low back pain. We conclude that these manipulative therapy techniques do not appear to be effective for chronic low back pain, at least among relatively young individuals with mild to moderate back pain."
Interesting ... but what if the treating clinicians had been doctors of chiropractic? Here are just a few of the studies supporting chiropractic spinal manipulation for chronic LBP:
Giles LG, et al. Spine, 2003 Jul 15;28(14):1490-502.
Senna MK, et al. Spine, 2011 Aug 15;36(18):1427-1437.
Because they have yet to pass national legislation protecting the chiropractic profession, Japanese DCs are in a similar situation that U.S. DCs faced. We were fortunate enough to be able to pass chiropractic licensure state by state. The DCs in Japan must accomplish this nationally, which has proved to be an extremely difficult task. And in spite of their efforts, Japanese DCs are currently faced with two chiropractic professions.
This article focuses on nine severe injuries that are generally not diagnosable until the third to fourth week following the date of injury, including how to diagnose these severe injuries. The discovery of any of these injuries early can make a significant difference in the case outcome.
There has long been an attempt by those who are not legitimate doctors of chiropractic to usurp the title of chiropractor from those who have earned their degree from an accredited chiropractic program. This generally happens in countries where the local doctors of chiropractic have yet to pass legislation requiring a degree from an accredited institution. The result is essentially two chiropractic professions. Nowhere is this danger more pronounced than in Japan.
