Costs and outcomes of chiropractic treatment for low back pain

Brown A, Angus D, Chen S, Tang Z, Milne S, Pfaff J, Li H, Mensinkai S
Record ID 32005000361
English, French
Authors' objectives:

The aim of this study was to review the clinical and economic implications of chiropractic care in the treatment of lower back pain (LBP). This report is intended to help decision makers who are involved in the provision of chiropractic services for LBP.

Authors' results and conclusions: Clinical Review: The inclusion criteria were met by 18 systematic reviews, two RCTs since the end of 2002, and two non-RCTs. Overall results suggest that for acute and chronic LBP, chiropractic treatment gives outcomes similar to those of standard medical care and physical therapy. The results of the review suggest that serious adverse events are unlikely to occur with chiropractic treatment for LBP. Economic Review: Ten papers were included for the review of economic evidence. Nine studies were conducted in the US and one in Australia. No full cost-effectiveness studies were identified. Four studies were cost comparisons and six were cost consequence studies. There was variation in the reported relative costs of chiropractic care, medical care and physical therapy for the treatment of LBP. The consequence analyses in the six cost-consequence studies were consistent with the results of this report. Chiropractic services are partially funded in the provincial health care plans of Manitoba, Saskatchewan, Alberta and British Columbia.
Authors' recommendations: Chiropractic care for LBP is similar in effectiveness to that of standard medical care and physical therapy. The evidence from other countries is inconclusive about the costs for chiropractic treatment of LBP, relative to physical therapy or medical care. A well-designed Canadian study that compares the cost-effectiveness of LBP care provided by chiropractors, physical therapists, and primary care physicians would be of benefit.
Authors' methods: Systematic review
Project Status: Completed
URL for project:
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Chiropractic
  • Complementary Therapies
  • Costs and Cost Analysis
  • Low Back Pain
  • Manipulation, Chiropractic
Organisation Name: Canadian Coordinating Office for Health Technology Assessment
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
Contact Name:
Contact Email:
Copyright: Canadian Coordinating Office for Health Technology Assessment (CCOHTA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.