"There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low-back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low-back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low-back pain."

Lead investigator of the study, Pran Manga, Ph.D., however, did warn that spinal adjustments performed by health care professionals other than qualified doctors of chiropractic were potentially harmful and less effective:

"Indeed, several existing medical therapies of low-back pain are generally contraindicated on the basis of the existing clinical trials. There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by nonchiropractic professionals."

On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released clinical practice guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of the diagnostic and treatment methods used for acute low back pain. Their findings included:

• The risk of serious complications from lumbar spinal manipulation is rare;
  
• Conservative treatment such as spinal manipulation should be pursued in most cases before considering surgical intervention;
  
• Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.

Prior to entering chiropractic college, the aspiring chiropractor requires 2-4 years (depending on the college attended and the state one wishes to practice in) of premed undergraduate studies. Once completed, the student must next complete 4-5 academic years of studies at a chiropractic college. This includes extensive training in anatomy, physiology, pathology, neurology, radiology, differential diagnosis, chiropractic adjustive techniques, biomechanics, and other health-related studies.

In addition, prior to graduation each student must successfully complete several hundred clinical hours of "real" patient management in a clinical setting under professional supervision. Most chiropractic colleges also require students to partake in clinical externship programs that place them in actual chiropractic offices, further enhancing their clinical practice skills.

Near or soon after graduation, the new doctors of chiropractic must successfully complete rigorous National and State Board examinations prior to obtaining a license to practice chiropractic. Once licensed, most states require that chiropractors receive annual continuing education to ensure that a high level of competency is maintained.

Just as it would be ludicrous to believe that visiting a dentist once per lifetime would ensure permanently healthy teeth and gums it's equally as silly to think that visiting a chiropractor a few times will ensure a lifelong healthy spine. Our spinal tissues undergo daily bombardment of stresses originating from bad postural habits, suboptimal work environments, psychological stress, and hectic lifestyles just to name a few.

For these reasons, after the resolution of acute problems patients are given the option to receive periodic spinal checkups which acts to minimize the likelihood of future recurrences or development of new problems. The preventative approach in health care has been gaining much recognition as of late and there has been a large push in the medical community and health insurance industry to incorporate preventative programs into mainstream medicine.

It's really that simple. Periodic care to prevent future problems - safe, natural, convenient care now to avoid nasty and complex problems later.