During the past few years, two reports about the treatment of low-back pain have placed chiropractic in a favorable light. One, issued by the RAND Corporation, concluded that spinal manipulation was appropriate for some cases of low-back pain. The other, produced by the Agency for Health Care Policy and Research (AHCPR), judged manipulation useful for controlling symptoms while awaiting the spontaneous recovery that occurs within a month in most patients with low-back problems.
Although chiropractors have promoted these reports as endorsements of chiropractic, they are not. They merely support the use of manipulation in carefully selected patients. Only a few of the research studies on which their conclusions were based involved manipulation by chiropractors; most were done by medical doctors and physical therapists whose practices are not identical to those of chiropractors. Most chiropractors manipulate the vast majority of patients who walk through their door, some use techniques that have not been studied scientifically, and many urge all of their patients to undergo monthly or even weekly "preventive maintenance" visits throughout their life. In addition, many chiropractors emphasize a technique that is more vigorous (and therefore less safe) than the controlled manipulation used by other practitioners. The only places where "chiropractic" and "chiropractors" are mentioned in the body of the AHCPR report are in the passages about the make-up of the AHCPR expert panel.