New Research Shows Manipulation Superior to Acupuncture, Drugs

A randomized, controlled clinical trial published in the leading specialist medical journal ‘Spine’ reveals that chiropractic “manipulation” is superior to both drugs and acupuncture in the treatment of chronic spinal pain (people with pain lasting more than 13 weeks).

The study, conducted at a multidisciplinary spinal pain outpatient unit in an Australian public hospital, involved 115 patients randomly assigned to receive one of three interventions: medication, needle acupuncture or chiropractic manipulation.

“Considering that the patients in this study had experienced chronic spinal pain syndrome for an average of 8.3 years in the spinal manipulation group, it is notable that manipulation, during a maximum treatment duration of nine weeks, achieved asymptomatic status for every fourth patient (27%). This result is superior to the percentages for acupuncture (9.4%) and medication (5%) for short-term outcomes”

Patients were randomly sent for either medication, Chiropractic manipulation or Traditional Chinese Acupuncture.The patients were assessed four times: at the initial visit, and two, five and nine weeks after the initial treatment using the Oswestry Questionnaire for low back and thoracic spine pain (“back” pain), the Neck Disability Index (NDI) for neck pain, and the Short-Form-36 Health Survey questionnaire (SF-36). Visual analogue scales (VAS) were used to assess subjective pain intensity.

Patient assessments for the three groups also indicated superiority for chiropractic manipulation for all tests except the VAS for neck pain. This superiority is demonstrated in the percentage of improvement that patients in each.

One of the study’s most remarkable findings was that patients in the manipulation group reported a 47 percent improvement on the SF-36 questionnaire, compared to only 15 percent for the acupuncture group and 18 percent for the medication group. This finding is all the more significant because the SF-36 does not measure back pain per se, but gives a perception of the level of one’s overall health. In addition to these results, the authors included the following comments in their report: “The results of this efficacy study suggest that spinal manipulation, if not contraindicated, may be superior to needle acupuncture or medication for the successful treatment of patients with chronic spinal pain syndrome, except for those with neck pain. The NDI showed that for neck pain, acupuncture achieved a better result than manipulation.

“Medication apparently did not achieve a marked improvement in chronic spinal pain and caused adverse reactions in 6.1% of the patients. The adverse symptoms disappeared once medication was stopped. “The results of this study can be generalized because the study sample had a broad socio-economic background and a wide age range.

“In summary, the significance of the study is that for chronic spinal pain syndromes, it appears that spinal manipulation provided the best overall short-term results, despite the fact that the spinal manipulation group had experienced the longest pre-treatment duration of pain.”

Giles LGF, Muller R. Chronic spinal pain - a randomised clinical trial comparing medication, acupuncture, and spinal manipulation