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Evidence Based Medicine Guidelines

Key references, reviews and guidelines for evidence-based teaching in chiropractic:

This table contains links to the evidence for the management of patients with the main conditions seen by chiropractors. Management approaches can be guided by them as they provide an indication, at a high level, of the science supporting the diagnosis and treatment of these disorders. They are not meant to explain the mechanisms behind interventions, but to indicate the kind of approaches to patient care that must be acknowledged in an evidence-based course that aims to optimize patient outcomes.

Please note, these are 'Evidence Based Medicine Guidelines', to access Gateways to EBM resources please see the Evidence Based Medicine page.

Articles and documents are placed in the loose categories listed below and there may be some cross over between sections. Where passwords are required to access the full text this is mentioned.


Van der Windt DAWM et al.
Therapeutic ultrasound for acute ankle sprains.
Cochrane Database of Systematic Reviews, 2002, Issue 1.

Kerkhoffs GMMJ et al.
Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults
Cochrane Database of Systematic Reviews 2002, Issue 3.

Back Pain up  

van Tulder M, et al., on behalf of the COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care
Chapter 3: European guidelines for the management of acute nonspecific low back pain in primary care
European Spine Journal, Volume 15, Supplement 2, March, 2006, s169-s191.

Airaksinen O, et al.
European guidelines for the management of chronic nonspecific low back pain.
European Spine Journal, Volume 15, Supplement 2, March, 2006, s192 - s300.
MyBU username/password.

National Institute for Health and Clinical Excellence (NICE)
Low back pain: Early management of persistent non-specific low back pain.

National Institute for Health and Clinical Excellence, May 2009.

Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M
Low back pain evidence review
Royal College of General Practitioners, 1999.

Nachemson A, et al.
Back pain, neck pain: an evidence based review: summary and conclusions
Swedish Council on Technology Assessment in Health Care, 2000.

GL-Chou et al.
Interventional therapies, surgery, and interdisciplinary
rehabilitation for low back pain, an evidence-based clinical practice guideline from the American Pain Society (PDF)
Spine, Volume 34, Number 10, pp 1066–1077, 2009.

Burton AK et al.
European guidelines for prevention in low back pain (PDF)
European Spine Journal, Volume 15, Supplement 2, March, 2006 S136-S68.

Vleeming A, Albert HB, Ostgaard HC, Stuge B, Sturesson B
European guidelines on the diagnosis and treatment of pelvic girdle pain European Commission Research Directorate General, 2008.

Headache / Migraine upa  

National Clinical Guideline Centre, Clinical Guideline 150, 2012

Diagnosis and management of headaches in young people and adults
National Clinical Guideline Centre

Steiner TJ, MacGregor EA, Davies, PTG
Guidelines for all healthcare professionals in the diagnosis and managment of migraine, tension-type, cluster and medication-overuse headache.
British Assocation for the Study of Headache (BASH), 2007.

Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV
Spinal manipulation versus amitriptyline for the treatment of chronic tension-type headaches: a randomised clinical trial
Journal of Manipulative & Physiological Therapeutics, Mar-Apr 18(3), 148-54, 1995.
MyBU username/password.

Wight S, Osborne N, Breen, AC
Incidence of ponticulus posterior of the atlas in migraine and cervicogenic headache.
Journal of Manipulative & Physiological Therapeutics, Volume 22(1) January 1999, pp15-20.
MyBU username/password.

Nilsson N, Christensen HW, Harvigsen J
The effect of spinal manipulation in the treatment of cervicogenic headache
Journal of Manipulative & Physiological Therapeutics, Volume 20(5) June 1997, pp326-30.
MyBU username/password.

Vernon H, Jansz G, Goldsmith CH, McDermaid C
A randomized, placebo-controlled clinical trial of chiropractic and medical prophylactic treatment of adults with tension-type headache: results from a stopped trial
Journal of Manipulative & Physiological Therapeutics, Volume 32(5) June 2009, pp344-351.
MyBU username/password.

Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV
The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache
Journal of Manipulative & Physiological Therapeutics, Volume 21(8) October 1998, pp511-9.
MyBU username/password.

Fernandez-de-las-Penas C, et al.
Are manual therapies effective in reducing pain from tension-type headache: a systematic review (PDF).

Clinical Journal of Pain 22(3) Mar-Apr 2006, pp278-85.

Gesztelvi G, Bereczki D
Determinants of disability in everyday activities differ in primary and cervicogenic headaches and in low back pain
Psychiatry and Clinical Neurosciences, Volume 60(3) May 2006, pp271-276.

Melchart D, et al.
Acupuncture in patients with tension-type headache: randomised controlled trial
BMJ, August 13;331(7513) Epub 2005 July 29, pp376-82.

Dalby BJ
Chiropractic diagnosis and treatment of closed head trauma: review of the literature (PDF).
Journal of Manipulative & Physiological Therapeutics. Volume 16(6) Jul/Aug 1993, pp392-400.

Norton PJ, Asmundson, GJG

Anxiety sensitivity, fear and avoidance behaviour in headache pain (PDF)
Pain, Volume 111(1) September 2004, pp218-223.

Vernon H
Spinal manipulation in the management of tension-type migraine and cervicogenic headaches: the state of the evidence
Topics in Clinical Chiropractic, 9(1) 2002, pp14-20.

Yucel B, Ozyalcin S, Sertel HO, Camlica H, Ketenci A, Talu GK
Childhood traumatic events and dissociative experiences in patients with chronic headache and low back pain (PDF).
The Clinical Journal of Pain 18, 2002, pp394-401.

Bronfort G
Effectiveness of non-pharmacological treatments for headache (PDF).
European Journal of Chiropractic, 49, 2002, pp54-7.

Heikkila H, Johansson M, Wenngren BI
Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study (PDF)
Manual Therapy 5(3) 2000, pp151-7.

Limbs - Upper up  

Viikari-Juntura E
Risk factors for upper limb disorders. Implications for prevention and treatment (PDF).
Clinical Orthopaedics and Related Research, 351, 1998 pp39-43.

Agency for Healthcare Research and Quality (AHRQ)
Diagnosis and Treatment of Work-Related Musculoskeletal Disorders of the Upper Extremity
Agency for Health Care Research and Quality, US Department of Health and Human Services, 2002.

Tilscher H, Pirker-Binder I, Kollegger M, Pfeiffer F
Head, neck, shoulder, arm: workplace related? An increasing problem for women
(article is in German). 'Kpf-Nacken-Schulter-Arm-Beschwerden: arbeitsplatzbedingt?'
Manuelle Medizin, Volume 43(1) February 2005, 13-8.
MyBU username/password.

Manipulation and mobilisation in general up  

Bronfort et al.

Effectiveness of manual therapies: the UK evidence report (via GCC website).
Chiropractic & Osteopathy 18(3) 2010


Clar C, Tsertsvadze A, Court R, Hundt G, Clarke A, Sutcliffe, P
Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report.
Chiropractic & Manual Therapies 22:12, 2014.


Musculoskeletal Pain up  

Department of Health (DoH)

The Musculoskeletal Services Framework

Department of Health, July 2006.

tional Health and Research Medical Council (NHMRC)
Evidence-based management of acute musculoskeletal pain
Australian Acute Musculoskeletal Pain Guidelines Group. University of Queensland and the Commonwealth Department of Health and Ageing, June 2003.
National Health and Research Medical Council, Australia.

Breen A, Langworthy J, Bagust J
Improved early pain management for musculoskeletal disorders.

Health and Safety Executive, Report no.399, 2005.

Neck Pain upa  

Hurwitz EL et al.
Treatment of neck pain: noninvasive interventions: results of the bone and joint decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (PDF)
Spine, Volume 33(4 Supp) 2008, Neck Pain Task Force, ppS123-S52.

Spitzer WO
Scientific monograph of the Quebec task force on whiplash associated disorders: redefining "whiplash" and its management (PDF).
Spine, Volume 20(8 Supp) 1995, pp1S-73S.

Vasavada AN, Li S, Delp SL
Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles (PDF)
Spine, Volume 23(4) 1998, pp412-22.

Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG
Manipulation and mobilisation of the cervical spine: a systematic review of the literature (PDF)
Spine, Volume 21(15) 1996, pp1746-60.

Pain up  

Asmundson GJG et al.
Is the latent structure of fear of pain continuous or discontinuous among pain patients? Taxometric analysis of the pain anxiety symptoms scale
. The Journal of Pain, Volume 8(5) May 2007, pp387-95.
MyBU username/password.