The World's Best Evidence-Based Care For Spinal Health


"Compared to care from medical doctors and physiotherapists, care from chiropractors during the disability episode ("curative"), during the health maintenance care period (main exposure variable, "preventive"), and the combination of both (curative and preventive) was associated with lower disability recurrence HRs (hazard ratios)." "Those cases treated by chiropractors had less use of opioids and fewer surgeries."

"Compared to family physician-led usual care, full clinical guidelines-based treatment including chiropractic spinal manipulative therapy is associated with significantly greater improvement in condition specific functioning."

"On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain."


  • Manga, et al. (1993). The Manga Report: The effectiveness and cost-effectiveness of chiropractic management of low back pain. Richmond Hill, Ontario, CANADA. Kenilworth Publishing (an independent report Commissioned by the Ontario Provincial Government)
  • Cifuentes et al. (2011) Health Maintenance Care in Work-Related Low Back Pain and its Association with Disability Recurrence. Journal of Occupational and Environmental Medicine 53(4): 396-404
  • Bishop et al. (2010) The Chiropractic Hospital-Based Interventions Research Outcomes (CHIRO) Study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. The Spine Journal 10(12): 1055-64


"A meta-analysis of 16 studies at 3-4 months showed significant effects for four of six pain outcomes: patient assessed pain, morning stiffness, number of painful and/or tender points, and NSAID (non-steroidal anti-inflammatory drug) consumption [significantly reduced NSAID consumption]."


  • Goldberg RJ, Katz J. (2007) A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 129(1-2): 210-233

Vitamin D

"In the research investigations to date, patients found to have deficient vitamin D concentrations had been variously diagnosed with fibromyalgia syndrome, hyperesthesia, rheumatic disorders, osteoarthritis, back pain, bone and joint pain, muscle weakness, and other chronic somatic complaints." "Some researchers have found vitamin D deficiency to occur in up to 85% of chronic musculoskeletal pain cases, especially those involving the lower back."


  • Stewart Leavitt, Ph.D. Vitamin D - A Neglected "Analgesic" for Chronic musculoskeletal Pain. Pain Treatment Topics June 2008


Key Concepts and Take Home Points:

  1. Proper joint motion + sufficient intake of omega-3 fatty acids and vitamin D are required to a) resolve inflammation and pain and b) to restore and maintain function and quality of life.
  2. Chiropractic adjustments and supplementation with omega-3 and vitamin D is the world's most evidence-based and most effective protocol for the recovery and maintenance of spinal health and function.