The GCC’s Plethora
Well. The GCC’s ‘independent’ review of the effectiveness of chiropractic has finally been published: Effectiveness of manual therapies: the UK evidence report (although not yet on the GCC’s website).
Paid for by the GCC (see page 77), this document runs to 113 pages and there is additional commentary by two others, adding a further 13 pages.
It’ll take time to read through and digest fully, but here’s a handy summary of what they did — and didn’t — find evidence for. They have listed conditions in three categories: effective, inconclusive and ineffective.
Spinal manipulation/mobilization is effective in adults for:
- acute, subacute, and chronic low back pain;
- migraine and cervicogenic headache;
- cervicogenic dizziness;
- a number of upper and lower extremity joint conditions.
Thoracic spinal manipulation/mobilization is effective for:
- acute/subacute neck pain.
When combined with exercise, cervical spinal/manipulation is effective for:
- acute whiplash associated disorders;
- chronic neck pain.
The evidence is inconclusive for cervical manipulation/mobilization alone for:
- neck pain of any duration.
The evidence is inconclusive for any type of manipulation/mobilization for:
- mid back pain;
- tension-type headache;
- temporomandibular joint disorders;
- premenstrual syndrome;
- pneumonia in older adults.
Spinal manipulation is not effective for (compared to sham manipulation):
- stage 1 hypertension when added to an antihypertensive diet.
For children, the evidence is inconclusive regarding the effectiveness of spinal manipulation/mobilization for:
- otitis media (ear infections);
- enuresis (bed wetting).
but shows it is not effective for:
- infantile colic;
- improving lung function in asthma when compared to sham manipulation.
They also considered the evidence for massage.
The evidence regarding massage shows that for adults it is an effective treatment option for:
- chronic lower back pain;
- chronic neck pain.
The evidence is inconclusive for:
- knee osteoarthritis;
- myofascial pain syndrome;
- migraine headache;
- premenstrual syndrome.
For children, the evidence is inconclusive for:
- infantile colic.
Of course, a lot hangs on what they mean by ‘effective’, ‘ineffective’ and ‘inconclusive’, what they included and excluded from their scope and how they came to their conclusions. It will also be interesting to see if anything differs from the independent Cochrane reviews.
No doubt this will be dissected very carefully over the coming days, but at face value, it is a damning indictment of a vast number of claims chiropractors have been making.
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