Is Chiropractic An Evidence-Based Health Care?

The history and development of chiropractic, in many ways, mirrors the advance of medical understanding over the past century. During the late 1800’s, the concept of “spinal irritation” was popular in medical circles and the practice of chiropractic was consistent with many aspects of scientific thought at the time.

These theories seem quaint today, but at the time, the sophisticated workings of the human nervous system – and the spinal cord which the bones of the spine protect – were barely known and many branches of medicine were searching for theories to explain how the human body worked.

As science advanced, so did understanding of the neurological principles which underlie the effectiveness of chiropractic treatment. Today, these principles form the foundation of chiropractic education.

Evidence-based health care

Chiropractic has undergone considerable scrutiny from individuals and organizations within the health care and scientific communities, as well as from chiropractors themselves. This scrutiny has been welcomed and embraced by the profession and has resulted in a significant body of evidence around the efficacy of chiropractic care.

For example, in the area of neck pain and low back pain, more than fifty randomized, controlled clinical trials have been conducted assessing the efficacy of spinal manipulation.1

A leader in chiropractic research

The Canadian Memorial Chiropractic College (CMCC) has been a leader in chiropractic research for more than five decades. The College has dedicated itself to the development of an ongoing, productive research program. Faculty have been successful in obtaining research grants from funding agencies and have published extensively in peer-reviewed and refereed chiropractic journals, as well as in multidisciplinary journals such as the British Medical Journal, Spine, Annals of Internal Medicine, Pain and the New England Journal of Medicine.

Over the years, CMCC has developed relationships with faculty in other academic institutions in North America. Research collaborations have taken place with faculty from the University of Toronto, University of Waterloo, McMaster University, University of Western Ontario, Institute for Work and Health, St. Michael’s Hospital, Sunnybrook Health Sciences Unit, University of Calgary, University of Saskatchewan, The Texas Back Institute, and St. Joseph’s Hospital, Hamilton.

In 1996, CMCC partnered with the University of Waterloo to establish Canada’s first chiropractic research clinic within a university.

New headache study

In 1999, CMCC received a three-year, $1 million grant from the Ontario Ministry of Health and Long Term Care to study chiropractic and medical treatments for tension headaches. This is a multi-disciplinary project with collaborators from the Wellesley Central site of St. Michael’s Hospital and McMaster University.

Colic and asthma research

Most recently, a research report published in the Journal of Manipulative and Physiological Therapeutics concluded that “spinal manipulation is effective in relieving infantile colic.”2 The study was a randomized, controlled clinical trial with a blinded observer and compared the effect of chiropractic treatment with a commonly prescribed medication used to relieve infantile colic.

Another study, published in the New England Journal of Medicine in October 1998, looked at chiropractic as complementary therapy for children with medically-managed asthma. It concluded that spinal manipulation did not provide additional benefits.3 This is another example of how research continues to inform chiropractic treatment.

Medical Research Council partnership

In 1998, the Medical Research Council of Canada (MRC) and the Canadian Chiropractic Association (CCA) established two Research Fellowships and two Doctoral Research Awards in chiropractic research. The MRC matches the CCA’s contributions dollar for dollar with the mutual goal of improving the health of Canadians through new knowledge generated by research.

In the same year, the Medical Research Council of Canada (MRC) partnered with the Canadian Memorial Chiropractic College (CMCC) to offer two Doctoral Research Awards for faculty. In 1999, MRC and CMCC renewed this partnership to offer two Research Fellowships and one Doctoral Award to pursue research in specific chiropractic-related areas.

Ongoing research will no doubt further expand knowledge of how the spine, and the neural pathways which it protects, affects health.

May, 2000

 


1. See appendix of research references in the Media Fact File.
2. The Short-Term Effect of Spinal Manipulation in the Treatment of Infantile Colic, Wiber JMM et al, Journal of Manipulative and Physiological Therapeutics, Vol. 22, No. 8, October 1999.
3. A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma, Balon J et al, The New England Journal of Medicine, Vol. 339, No. 15, October 1998.

Canada’s First Chiropractic Research Chair

Canada’s first Chiropractic Research Chair was recently awarded to Dr. Greg Kawchuk DC, PhD at the University of Calgary.

In receiving the award, Dr. Kawchuk has hurdled a stringent peer review process established by the Canadian Institutes of Health Research, The Canadian Chiropractic Association, the Canadian Chiropractic Research Foundation, and the Foundation for Chiropractic Education and Research. As a result, the Chair becomes the first research position in Canada specifically devoted to chiropractic research that is supported directly by the Federal Government.

Dr. Kawchuk will hold the position of Assistant Professor in the Faculty of Kinesiology at the U of C. This historic endeavour and The CCA’s significant long term commitment to facilitating chiropractic research has grown out of the association’s mission statement which clearly sets out “helping Canadians live healthier lives” as paramount. This is completely congruent with Health Canada.

Both CIHR and government recognize the large numbers of Canadians who access alternative and complementary approaches to health care, particularly chiropractic. The joint partnership program is a strong commitment, which ensures talented investigators are provided with the resources and training needed to address the health challenges faced by Canadians and chiropractic patients. As a result, Canadians will enjoy the health benefits that are created by chiropractic research.