This 2008 JMPT article reports a Delphi consensus by 40 experienced chiropractors (representing 15 chiropractic colleges and 16 US states) that produced practice recommendations and standardized care parameters for low back disorders. Key consensuses include support for spinal manipulation/mobilization (acute and chronic), adjunctive exercise, a typical initial therapeutic trial of 6–12 visits over 2–4 weeks, recommended visit-frequency/duration tables for acute/subacute/chronic/recurrent stages, outcome measurement suggestions, and explicit contraindications (red flags) for high-velocity lumbar manipulation.
Questions this document answers
40 clinically experienced doctors of chiropractic
At least 80% of panelists marking 7–9 on the RAND/UCLA 1–9 appropriateness scale (median 7–9)
6–12 visits over a 2–4 week period
Acute: <6 weeks; Subacute: 6–12 weeks; Chronic: ≥12 weeks
3× weekly for 2–4 weeks (reevaluate at 2–4 weeks)