title: Chiropractic treatment approaches for spinal musculoskeletal conditions: a cross-sectional survey.
abstract: BACKGROUND
  There are several chiropractic spinal manipulative technique systems. However, there is limited research differentiating the efficacy of these techniques. Additionally, chiropractors may also use ancillary procedures in the treatment of musculoskeletal pain, a variable that also needs to be considered when measuring the efficacy of chiropractic therapy. No data is currently available regarding the frequency of usage of chiropractic technique systems or ancillary procedures for the treatment of specific musculoskeletal conditions. Knowing which technique systems and ancillary procedures are used most frequently may help to direct future research. The aim of this research was to provide insight into which treatment approaches are used most frequently by Australian chiropractors to treat spinal musculoskeletal conditions.
  
  
  METHODS
  Cross-sectional survey design. The survey was sent online to the members of the two main Australian chiropractic associations between 30(th) June 2013 and 7(th) August 2013. The participants were asked to provide information on treatment choices for specific spinal musculoskeletal conditions.
  
  
  RESULTS
  280 respondents. Diversified manipulative technique was the first choice of treatment for most of the included conditions. Diversified was used significantly less in 4 conditions; cervical disc syndrome with radiculopathy and cervical central stenosis were more likely to be treated with Activator; flexion distraction technique was used almost as much as Diversified in the treatment of lumbar disc syndrome with radiculopathy and lumbar central stenosis. More experienced Australian chiropractors use more Activator and soft tissue therapy and less Diversified technique compared to their less experienced peers. The majority of responding chiropractors used ancillary procedures such as soft tissue techniques and exercise prescription in the treatment of spinal musculoskeletal conditions.
  
  
  CONCLUSIONS
  This survey provides information on commonly used treatment choices to the chiropractic profession. Treatment choices changed based on the region of disorder and whether neurological symptoms were present rather than with specific diagnoses. Diversified technique was the most commonly used spinal manipulative therapy, however, ancillary procedures such as soft tissue techniques and exercise prescription were also commonly utilised. This information may help direct future studies into the efficacy of chiropractic treatment for spinal musculoskeletal disorders.
authors.affiliation: Macquarie University Sydney, Sydney, NSW 2109 Australia.
authors.forename: Mattijs
authors.initials: M
authors.lastname: Clijsters
authors.affiliation: Macquarie University Sydney, Sydney, NSW 2109 Australia.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fronzoni
authors.affiliation: Department of Chiropractic, Macquarie University Sydney, Sydney, NSW 2109 Australia.
authors.forename: Hazel
authors.initials: H
authors.lastname: Jenkins
keywords: Chiropractic; Manipulation; Manual therapy; Musculoskeletal; Prevalence; Technique systems; Treatment