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The RAND Study
In
1992, the widely respected RAND Corporation, a health care think tank, released
a study on the appropriateness of spinal manipulation for lower back pain.
Authored by a multidisciplinary panel headed by Paul Shekelle, M.D., the study
marked the first time that representatives of this prestigious group had officially
recognized spinal manipulation as an appropriate treatment for some patients
with lower back pain. RAND’s procedures involved an extensive review
of the scientific literature on the treatment of back pain, and a consensus
process among the participants to determine areas of agreement.
The rather limited nature of RAND’s endorsement of spinal manipulation must be seen in context to be properly understood. RAND is known for its thoroughgoing critical evaluations and the great caution of its assessments, which is part of the reason that its conclusions are often taken by federal officials as something close to the final word on health matters. While its conclusions on spinal manipulation failed to go as far as many chiropractors would have liked, they nonetheless were far more favorable than RAND’s recent pronouncements on other controversial medical issues such as heart surgery.
The national media were quick to grasp the significance of the RAND report. In the weeks and months immediately following its release, high-profile news reports appeared in American newspapers, magazines and electronic media, declaring that chiropractic was finally being "accepted." Of course, millions of chiropractic patients had already accepted it happily for years, but the RAND report marked the scaling of an inner wall of the health establishment.
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