Hospital-based Study: Chiropractic More Effective at Reducing Disability
In a test of Federal guidelines for back pain treatment, doctors assigned patients with acute low back pain to either 4-weeks of hospital-based chiropractic, or to family physician-directed usual care that typically included medications, physical therapy, and exercises. After 8, 16, and even 24 weeks, there was significantly less disability in patients that received chiropractic care.
The findings by Paul B. Bishop, DC, MD, Ph.D. and co-workers were reported in the December 2010 issue of the prestigious orthopedic journal Spine.
Patients treated with chiropractic also received Tylenol and a progressive walking program, whereas family physician-directed usual care included a broad range of medications, injections, physical therapies and exercise recommendations.
The current study was the first ever test of the huge Federal treatment guidelines for low back pain that were directed and published by the U.S. Agency for Healthcare Policy and Research (now the U.S. Agency for Healthcare Research and Quality) in December 1994.
At that time a scientific panel, working on behalf of the National Institutes of Health, concluded that a month of spinal manipulation was “safe and effective” for acute low back pain, and also concluded that typical physical therapy was not effective treatment. Further, the guidelines called on physicians to advise patients to stay active instead of confining patients to bed, a practice common prior to 1994.
The research comes on the heels of research that demonstrated the largest insurance company in Tennessee paid almost 40% less for chiropractic. Prior studies demonstrated that even chronic and severe back pain cases have longer lasting improvement associated with chiropractic but not physical therapy. Together with findings of greater patient satisfaction, these studies support the idea that chiropractic should be a cornerstone of any national healthcare conservative spine care program.
You should feel confident that whether you are referring your family and friends for chiropractic, or are receiving chiropractic care yourself, you are following the best possible path toward spine health.
Rob Leach, DC, MS, FICC, CHES
To read about the Chiropractic Hospital Based Interventions Research Outcomes Study: http://www.ncbi.nlm.nih.gov/pubmed/20889389
To see the online draft document of the original US AHCPR Federal Guidelines for the treatment of Acute Low Back Pain: http://www.ncbi.nlm.nih.gov/books/NBK16626/
To read the November/December 2010 research demonstrating lower costs for back pain treatment in BCBS of Tennessee members: http://www.jmptonline.org/article/S0161-4754%2810%2900216-2/abstract
For a review of studies that document increased patient satisfaction with chiropractic care: http://www.ncbi.nlm.nih.gov/pubmed/16523145
To read about current evidence of less back disability after patients with chronic back pain at a hospital received chiropractic instead of pain management: http://www.ncbi.nlm.nih.gov/pubmed/18564952
For a study that shows LBP patients going to an orthopedic department in a hospital experience two thirds less sick leave than patients receiving conventional treatment: