What is the efficacy of chiropractic treatment for equine spinal dysfunction?

Clinical question and background

A common presenting sign in horses with spinal dysfunction/ pain is a nonspecific loss of performance [1]. Spinal manipulation and mobilisation techniques are manual treatments aimed at reducing pain, improving intervertebral mobility and restoring muscle function [1–7].

Literature search

Unlike studies in people, there is little research into the mechanisms and effect of chiropractic treatment in horses, although the concept has been introduced from an evidencebased standpoint [1,5–7]. For this reason, evidence-based research (EBR) into the efficacy of chiropractic for human neck and back pain was included in this review. Database searches were carried out in Cochrane Reviews, Medline and PEDro (Physiotherapy Evidence Database). Study types included in the searches were meta-analysis (MA), systematic reviews (SR) and randomised controlled trials (RCT). Keywords used in the searches included chiropractic, neck, back and horse.

Human studies

An MA into the effects of manipulation and mobilisation on subacute and chronic neck pain included a SR of 27 RCT (1522 participants) [4]. The effects of manipulation and mobilisation for acute lower back pain (LBP) were evaluated in a SR of 20 RCT (2764 participants), but only 6 RCT were considered to have a low bias [2]. A MA of spinal manipulation for chronic LBP was evaluated in a SR of 26 RCT (6070 participants) but only 9 studies had a low risk of bias, and only 3 studies were blinded [3] of which only one study reported the effect of blinding. […]