A major study to assess the most appropriate use of available health care resources was reported in 1993. The study was conducted by three health economists led by University of Ottawa Professor Pran Manga, Ph.D. The report of the study is commonly called the Manga Report. The Manga Report overwhelmingly supported the efficacy, safety, scientific validity, and cost effectiveness of chiropractic for low-back pain. Additionally, it found that higher patient satisfaction levels were associated with chiropractic care than with medical treatment alternatives. The literature clearly and consistently shows that the major savings from chiropractic management come from fewer and lower costs of auxiliary services, fewer hospitalizations, and a highly significant reduction in chronic problems, as well as in levels and duration of disability.
Spinal manipulation is of benefit to some patients with acute low-back pain.
The RAND reports marked the first time that representatives of the medical community went on record stating that spinal manipulation is an appropriate treatment for certain low-back pain conditions. A particularly significant study of chiropractic was conducted between 1978-1980 by the New Zealand Commission of Inquiry. Spinal manual therapy can be effective in relieving musculo-skeletal symptoms such as back pain, and other symptoms known to respond to such therapy, such as migraine. Chiropractors are the only health practitioners who are necessarily equipped by their education and training to carry out spinal manual therapy. In the public interest and in the interests of patients, there must be no impediment to full professional cooperation between chiropractors and medical practitioners.