April 6, 2006 – There is little scientific evidence to support the alleged benefits of spinal manipulation in chiropractic and osteopathy. At least, that’s the conclusions drawn by the authors of a British study. They even advise avoiding these manipulations given the risks they entail.
To achieve such results, the Dr Edzard Ernst1 and one of his colleagues examined 16 syntheses2 published from 2000 to 2005 and comprising 239 studies in all. “Overall, the documented benefits are minimal for chronic low back pain, controversial for the treatment of migraine and none for other types of condition, eg stiff neck, childhood colic, asthma, allergies. or dysmenorrhea, ”explains Dr.r Ernst.
If a few studies show positive results, it is often because manipulations performed on the spine, more precisely called spinal manipulations, are combined with physical exercises, the researchers say. Only three studies, conducted by the same chiropractor, conclude to the effectiveness of spinal manipulations – only without other treatment – to treat low back pain, neck stiffness and migraine.
“The conclusions of the summaries of studies on spinal manipulations seem to be influenced by the authors,” notes the Dr Ernst. In general, studies conducted by chiropractors or osteopaths suffer from methodological shortcomings and are associated with positive results. “
Spinal manipulations are not without risk, according to Dr Ernst. “These manipulations are associated with frequent minor side effects and, more rarely, serious complications,” he says. This is why he judges that exercises – such as those prescribed in physiotherapy – would be preferable to them.
In light of the results of his synthesis, he even suggests that the British government review its guidelines for the treatment of low back pain.
Spinal manipulations are performed, with the hands, on the spine to adjust the vertebrae or muscles of the back, in order to amplify the movement of the joints, to release blockages or to alleviate pain. The researchers point out that the definition of spinal manipulation is still a subject of debate within the scientific community.
Martin LaSalle – PasseportSanté.net
1. The Dr Edzard Ernst holds a Chair in Complementary Medicine at the Peninsula School of Medicine, University of Exeter. He is also the editor of the British scientific journal Focus on alternative and complementary Therapies (FACT): www.quackwatch.org [consulté le 5 avril 2006].
2. Ernst E, Canter PH, A systematic review of systematic reviews of spinal manipulation, Journal of the Royal Society of Medicine, April 2006, Vol. 99, 192-6.
