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Dr. Kava practices evidence-based healthcare. This means that we use the best available scientific evidence to guide us in our treatments. The following research reviews provide information about current topics related to chiropractic care.
Chiropractic Manipulation in Acute Discogenic Sciatica
Synopsis.
Results. Manipulation compared with placebo 6 months after therapy was much better for low back pain (effect size 1.68) and leg pain (effect size 1.08).
Study Quality. Overall, this was a high quality study.
Conclusion. Chiropractic care delivered a very large clinically important pain reduction benefit at six months, and no patient experienced an adverse event.
Clinical Comment. This high quality study was designed and implemented by medical doctors. Practitioners managing patients with acute back pain and sciatica with protruding discs should consider chiropractic care as a first option. The magnitude of these findings is impressive.
Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J 2006;6:131-7.
Chiropractic Reduces Surgery Rates
Synopsis. This study is an analysis of claims data from a managed-care health plan over a 4-year period. The use rates of advanced imaging, surgery, inpatient care, and radiographs were compared between employer groups with and without a chiropractic benefit.
Results. On a per-episode basis, the rates in the group with coverage were reduced by the following: surgery (32.1%); computed tomography (CT)/magnetic resonance imaging (MRI) (37.2%); plain-film radiography (23.1%); and inpatient care (40.1%). For patients with neck pain, the use rates were reduced per episode in the group with chiropractic coverage as follows: surgery (49.4%); CT/MRI (45.6%); plain-film radiography (36.0%); and inpatient care (49.5%).
Research Quality. Reasonable quality with the conclusions following the data.
Conclusion. For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs.
Nelson CF, Metz RD, LaBrot T. Effects of a Managed Chiropractic Benefit on the Use of Specific Diagnostic and Therapeutic Procedures in the Treatment of Low Back and Neck Pain. JMPT 2005;28:564-569.