In 1993 the Ministry of Health in Ontario Canada funded a major report on the effectiveness and safety of chiropractic treatment of lower back pain. This report became famous as the “Manga Report”. The report is entitled “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain.”
The findings, outlined below, overwhelmingly support the efficacy and cost-effectiveness of chiropractic for the treatment of low-back pain:
The specific Findings of the report were:
- Scientifically valid clinical studies support the fact that chiropractic management of low-back pain is more cost-effective than medical management
- Many medical therapies are of questionable validity or are clearly inadequate
- 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 complications for LBP patients.
- Chiropractic is more cost-effective. There would be highly significant cost savings if more management of LBP was transferred from medical physicians to chiropractors.
- There is good empirical evidence that patients are very satisfied with chiropractic management of LBP and considerably less satisfied with physician management
The specific Recommendations were:
- Chiropractic services should be fully insured under the Ontario Health Insurance Plan
- Chiropractic services should be fully integrated into the health care system. Because of the high incidence and cost of LBP, hospitals, managed health care groups, community health centers, comprehensive health organizations, and health service organizations and long-term care facilities should employ chiropractors on a full-time and/or part-time basis
A good case could be made for placing chiropractic as the gatekeepers for all musculoskeletal complaints that presented to hospitals.