(from the American Chiropractic Association)

December 8, 1994 is a date to remember. The setting was electric in a crowded auditorium at the Hubert H. Humphrey Building on Capitol Hill in Washington, D.C. The event was a press conference at which the results of a three year study by the Agency for Health Care Policy and Research (AHCPR), an agency of the U.S. Department of Health and Human Services, would be unveiled.

The 160-page document contains guidelines for the diagnosis and treatment of acute low back problems in adults. While it pertains to all disciplines, it has particular significance to Chiropractic because of its focus on the back and its consideration of the effectiveness of spinal manipulation. The document clearly recommends spinal manipulation as a "proven treatment" and as an early procedure to be sought by patients. More specifically, it makes three primary points:

1. Spinal manipulation is a recommended treatment for acute low back problems in adults;

2. Conservative treatment such as manipulation should be pursued - in most cases - before surgical interventions are considered; and

3. Prescription drugs such as oral steroids and antidepressant medications are not recommended for acute low back problems.

There are two main aspects of treatment recommended by the guidelines. First are the options for pain relief. The guidelines suggests that acetaminophen, aspirin and nonsteroidal anti-inflammatory drugs are safe and effective. Muscle relaxants and opioid analgesics are an option for short term treatment but may have significant side effects, including drowsiness. Moreover, medical science does not find muscle relaxants and opioids more effective than the safer alternatives. Another option, spinal manipulation (as performed by chiropractors, osteopaths and other therapists) is also safe and effective.

During his presentation, speaking for the American Chiropractic Association, Dr. Lowry R. Morton congratulated the AHCPR for its thorough investigation. He went on to say, "This guideline validates what chiropractors have asserted for nearly 100 years and what millions of chiropractic patients already know - spinal manipulation offers safe and effective relief for low back problems without drugs or surgery. Chiropractors are uniquely trained and extensively experienced in providing this form of conservative care to all Americans. And, according to a recent Harris Poll, patients are more satisfied with chiropractic care for back problems than with any other form of care." Dr. Morton also stated, "...the ACA is concerned that unlicensed or unqualified persons might be led to believe that they can use it with the same effectiveness as chiropractors. Spinal manipulation is as much an art as it is a science. It should not be used by unskilled persons."