To be able to judge whether any health treatment is safe and effective, we need evidence.
Evidence on a treatment is gathered by conducting fair scientific tests of the treatment.
Chiropractic is a health profession, and not a single treatment. Evidence about chiropractic generally refers to one or more of the treatments that chiropracors can offer.
Studies that examine health treatments, including treatments offered by chiropractors, can reach different conclusions on whether the treatments are safe and effective. This can happen for a number of reasons, including differences in the design of the study, bias, or simply chance. When this happens, more high quality research is needed to determine whether the treatment is effective and safe.
When we use a treatment and feel better, this can be because of phenomena such as the placebo effect, and not because of the treatment itself.
Positive evidence
There is good evidence that chiropractic is an effective treatment for:
• persistent lower back pain
This means that scientific trials conducted to investigate the effect of chiropractic on lower back pain found that it did have a beneficial effect.
A 2011 Cochrane review of studies of chiropractic intervention – treatments offered by chiropractors, including spinal manipulation – found that it is not possible to confirm or refute that chiropractic treatments are any more effective than conventional treatments for persistent lower back pain. Conventional treatments include painkillers, exercise and physiotherapy.
Some positive evidence
There is some mostly poor-quality evidence that manipulation of bones, joints and soft tissue, as practised by chiropractors, may be an effective treatment for some other musculoskeletal problems. These include:
- acute (new-onset) back pain,
- acute and sub-acute neck pain
- chronic neck pain when combined with exercise
- shoulder girdle pain
- frozen shoulder
- tennis elbow, when treatment is combined with exericse
- hip osteoarthritis
- knee osteoarthritis, some kinds of knee pain, some kinds of heel pain, when treatment is combined with exericse
- migraine and headache originating from problems in the neck
This evidence is not conclusive, and not strong enough to form the basis of a recommendation to use the treatment for these conditions.
More high quality research is needed to determine whether manual treatments are effective for these health conditions.
Negative evidence
There is some evidence that chiropractic treatments are not an effective treatment for:
- non-spinal pain
- infantile colic
- carpel tunnel syndrome
- asthma
- painful periods
This means that scientific trials found that chiropractic treatments had no beneficial effect when used to treat these conditions.
Inconclusive or no evidence
There is a lack of good-quality evidence on the effectiveness of chiropractic treatments for other conditions for which it is used by some practitioners. These include:
- allergies
- fibromyalgia
- high blood pressure
- mental health conditions, such as depression, phobias or anxiety disorders
This means that good-quality fair tests into the effectiveness of chiropractic treatments for these conditions have not been conducted.
