Chiropractic is a regulated profession in UK, along with medicine and dentistry.

Chiropractors are spinal health care experts ^[1], carrying out spinal diagnosis and therapy at a sophisticated and refined level ^[2].

Chiropractic care is reported safe ^{[3] [4]}, effective ^{[5] [6]} and cost efficient ^{[7] [8]}.

Over recent decades research, government enquiries and international guidelines have recommended spinal manipulation ^{[9] [10] [11] [12] [13]}.

Spinal manipulation has also been recommended by the American College of Physicians and American Pain Society^[14].

Treatment in our clinic is consistent with current recommendations for both back and neck pain ^{[15] [16]}, and headache ^{[17] [18]}.

Recently, chiropractic standards of care were further endorsed by a study expert ^[19].

Treatment costs and payments for lost production and disability related to back and neck pain are increasing alarmingly ^[20].

The chiropractic profession offers a valuable cost efficient contribution to today's health care.

All chiropractors with the clinic are also certified in Cox® Distraction technique, the subject of several Federally funded research projects by the Health Resources and Services Administration (HRSA) with favourable outcomes ^[21].

Dr Shurr is an authorized instructor of this technique for Britain and Europe, recognized by the Postgraduate Faculty of the National University of Health Sciences, Lombard, Illinois ^[22].

Dr Jeff Shurr FC DCC

Doctor of Chiropractic

Clinic Director

References

1    http://www.wfc.org/website/WFC/website.nsf/WebPage/IdentityConsultation

2    Commission of Inquiry, Chiropractic in New Zealand. Report of the Commission of Inquiry (Wellington, New Zealand: P. D. Hasselberg, Government Printer, 1979)

3    Coulter ID, Hurwitz EL et al. The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, California: RAND. Document No. MR-781-CR.

4    Cassidy JD, Boyle E, Cote P, He Y, Hogg-Johnson S, Silver F L, Bondy S J. Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Spine. 2008, 33(4S) Neck Pain Task Force(Supplement): p. S176-S183.

5    Clinical Practice Guidelines of the Agency for Health Care Policy and Research (AHCPR), Department of Health and Human Services, USA, 1994.  Manipulation of the low back is recommended during the first four weeks of symptoms, with or without medication, in conjunction with low-stress exercise followed by conditioning exercises after two weeks

6    European guidelines for the management of acute nonspecific low back pain in primary care. (T7) van Tulder et al. www.backpaineurope.org.  Consider (referral for) spinal manipulation for patients who are failing to normal activities.   Professionals with competent skills should provide spinal manipulation.  Risk of serious complication after spinal manipulation is low.

7    Workers’ Compensation Studies: California (1972), Wisconsin (1978), Florida (1988), Utah (1991), State of Victoria, Australia (1992).  There is considerable statistical evidence that patients suffering from low back pain recover quicker and return to work earlier, with a 45-55% saving in overall costs, inclusive of treatment costs and compensation for lost time, when the treatment is chiropractic rather than medical.

8    Ligoretta AP, Metz RD, Nelson CF, et al (2004) "Comparative analysis of individuals with and without chiropractic coverage, patient characteristics, utilization and costs."  Arch Intern Med 164:1985-1992.  A major California study involving 1.7 million members of an HMO demonstrated that adding a chiropractic benefit reduced overall healthcare cost of plan members.”

9    Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. December 1994.

10    Rosen M Breen A et al. (1994). Management guidelines for back pain, Appendix B in Report of a clinical standards advisory group committee on back pain, Her Majesty’s Stationery Office (HMSO), London.

11    Manniche C et al: Low-Back Pain: Frequency Management and Prevention from an HDA Perspective. Danish Health Technology 1999, 1(1)

12    The New Zealand Acute Low Back Pain Guide (1999 review) and Assessing Yellow Flags in Acute Low Back Pain: Risk Factors for Long-term Disability and Work Loss (1997).

13    Available at www.backpaineurope.org

14    Chou R , Qaseem A, Snow V, Casey D, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-91.

15    Haldeman S, Dagenais S (2008) What Have we Learned about the Evidence -Informed Management Chronic Low Back Pain? The Spine Journal, 8:266-277

16    Hurwitz EL, Carragee EJ, van der Velde G, Carroll L J, Nordin M, Guzman J, Peloso PM, Holm LW, Cote P, Hogg-Johnson S, Cassidy J D, Haldeman S. Treatment of neck pain: Noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008, 33(4S) Neck Pain Task Force(Supplement): p. S123-S152

17    Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache Duke University Evidence-based Practice Center  Douglas C. McCrory, MD, MHSc, Donald B. Penzien, PhD, Vic Hasselblad, PhD, Rebecca N. Gray, DPhil,.  Des Moines (IA): Foundation for Chiropractic Education and Research; 2001. Product No.: 2085 (18)

18    The Spine Journal 2009 (Oct 15) [Epub ahead of print] Mitchell Haas, DC, Adele Spegman, PhD, RN, David Peterson, DC, Mikel Aickin, PhD, Darcy Vavrek, ND. Center for Outcomes Studies, Western States Chiropractic College, 2900 NE 132nd Ave., Portland, OR 97230, USA

18    http://www.acatoday.org/press_css.cfm?CID=3769

20    Martin BI, Deyo RA et al. (2008) Expenditures and Health Status Among Adults with Back and Neck Problems, JAA 299 (6): 656-664.  65% increase in spine care costs drugs for spine care increased 188% (from $7.3 Billion - $19.8 billion per annum) spine problems costs $89 billion in 2005, 9% of total US expenditure on health. patients with chronic low back pain reporting physical functional limitations increased from 20.7% to 24.7% (from 1 in 5 to 1 in 4)

21    http://www.coxtechnic.com/

22    http://www.coxtechnic.com/seminars/handsonworkshops.html