CHIROPRACTIC VERSUS STANDARD MEDICAL CARE FOR LOW BACK PAIN

Chiropractic care could be an unexpected ally for the medical profession. The two professions have shared a rocky history with medicine having a history of denigrating the chiropractic art, philosophy and science, and chiropractic having a history of doing its best to keep people away from the dangers of excessive medication and surgery. Recent research has made it clear that when the two work together magic can happen.

Previous research has shown that Chiropractic can be more effective, less costly and provide higher patient satisfaction than standard medical care when it comes to treating low back problems.

Low back painOne study published in the American Journal of Public Health in 2002 titled: “Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: Results from the UCLA low-back pain study” examined the difference in satisfaction between patients assigned to chiropractic versus medical care for treatment of low back pain in a managed care organization. Satisfaction scores (on a 10-50 scale) after 4 weeks of follow-up were compared among 672 patients randomized to receive medical or chiropractic care. The mean satisfaction score for chiropractic patients was greater than the score for medical patients.

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Another study published in the Journal of Manipulative Physiological Therapeutics in 2005 titled “Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain” identified relative provider costs, clinical outcomes, and patient satisfaction for the treatment of low back pain. Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction.

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Another study also published in the Journal of Manipulative Physiological Therapeutics in 2010 titled “Cost of care for common back pain conditions initiated with chiropractic doctor versus medical doctor/doctor of osteopathy as first physician: Experience of one Tennessee-based general health insurer” determined if there were differences in the cost of low back pain care when a patient was able to choose a course of treatment with a medical doctor versus a chiropractor (DC). Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD.

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And another study published in the British Medical Journal in 1995 titled “Randomised comparison of chiropractic and hospital outpatient management for low back pain: Results from extended follow up” compared the effectiveness over three years of chiropractic and hospital outpatient management for low back pain. Improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear. Those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals.

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So, one might argue a case that chiropractic should replace medical care when it comes to low back pain. But the most recent study makes a better case for the two professions to share a more complementary relationship.

In a recent study published in Spine titled “Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results of a pragmatic randomized comparative effectiveness study” changes in pain levels and physical functioning in response to standard medical care versus medical care plus chiropractic for the treatment of low back pain among 18 to 35-year-old active-duty military personnel was assessed. Disability scores decreased in both groups during the course of the study, but were significantly better in the chiropractic group. Pain scores were also significantly better in the group that received chiropractic. Functional scales were significantly higher chiropractic group.

The paper concluded that chiropractic in conjunction with medical care offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute low back pain.

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And my conclusion? Why can’t we all just get along?

 

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