Abstract
The recent NICE guidelines for the early management of chronic back pain recommend 'offering a course of manual therapy including spinal manipulation, comprising up to a maximum of nine sessions over a period of up to 12 weeks' (1). Even before the document was published, the President of the 'British Chiropractic Association' wrote to all chief executives of English Primary Care Trusts (2). In this letter, he pointed out that NICE had 'assessed the effectiveness, safety and cost-effectiveness of available treatments' and suggested that a 'wider provision of spinal manipulative therapy services by the NHS could be achieved by contracting with chiropractors currently working within the private sector' (2).
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