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Quality of chiropractic research of upper extremity conditions

Most publications are anecdotal case histories.

Readers weigh in, and I respond.

First, the details.

  • Researchers reviewed the medical literature for terms: chiropractic, shoulder, elbow, wrist, hand, forearm, and arm, with MeSH terms for each region.
  • The resulting articles were assessed for quality.

And, the results.

  • 64 articles were found.
  • Mostly case reports
    • 36 case reports for the shoulder
    • 8 case reports for the elbow
    • 14 case reports for the wrist/hand
  • 6 clinical studies (3 shoulder, 1 elbow 2 wrist)

The bottom line?
The authors concluded, “There is a small amount of chiropractic research into upper limb conditions.” What evidence is available is comprised mostly of “case studies (level 4 evidence) and a small number of higher-level publications (level 1-3 evidence).”

Most treatments address both spinal and peripheral structures, using joint and soft tissue methods.

“There is a need for … higher-level evidence, in particular, randomized controlled trials for the chiropractic treatment of upper limb conditions.”

Question: don’t schools of chiropractic require their faculty to conduct clinical research? Or is this type of research considered a low priority among chiropractic opinion leaders?

4/6/08 14:26 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.