To Your Health
June, 2011 (Vol. 05, Issue 06)
Chiropractic care not only has catapulted to the top of the list for back pain care; chiropractic patients are also extremely positive about their treatments. TRICARE, the health program for military personnel and retirees, evaluated patients' response to chiropractic care.
The enormously high patient satisfaction rates astounded the TRICARE administrators, with scores that ranged from 94.3 percent in the Army. The Air Force tally was also high, with 12 of 19 bases scoring 100 percent; and the Navy also reported ratings in the 90 percent or higher. Even the TRICARE outpatient satisfaction surveys (TROSS) rated chiropractors at 88.54, which was 10 percent "higher than the overall satisfaction with all [health care] providers."
T.W. Meade, MD, of the Wolfson Institute of Preventive Medicine in London, surveyed patients three years after treatment and found that "significantly more of those patients who were treated by chiropractic expressed satisfaction with their outcome at three years than those treated in hospitals – 84.7 percent vs. 65.5 percent."
The Treatment of Choice
The truth is now emerging. There is broad agreement internationally that surgery should not generally be considered until there has been a trial of conservative nonsurgical care. Here are a few of the many examples supporting chiropractic's use as the first-line treatment for back pain:
Dr. Manga conducted two studies in the 1990s and noted, "There should be a shift in policy now to encourage the utilization of chiropractic services for the management of low back pain, given the impressive body of evidence on the effectiveness and comparative cost-effectiveness of these services, and on the high levels of patient satisfaction."
An editorial in the Annals of Internal Medicine published jointly by the American College of Physicians and the American Society of Internal Medicine in 1998 noted that "spinal manipulation is the treatment of choice": "The Agency for Health Care Policy and Research (AHCPR) recently made history when it concluded that spinal manipulative therapy is the most effective and cost-effective treatment for acute low back pain ... Perhaps most significantly, the guidelines state that unlike nonsurgical interventions, spinal manipulation offers both pain relief and functional improvement. One might conclude that for acute low back pain not caused by fracture, tumor, infection, or the cauda equina syndrome, spinal manipulation is the treatment of choice."
William Lauerman, MD, chief of spine surgery and professor of orthopedic surgery at Georgetown University Hospital, stated: "I'm an orthopedic spine surgeon, so I treat all sorts of back problems, and I'm a big believer in chiropractic."
Dr. Deyo has mentioned chiropractic as a solution: "Chiropractic is the most common choice, and evidence accumulates that spinal manipulation may indeed be an effective short-term pain remedy for patients with recent back problems."
Dr. Waddell also suggests chiropractic care as a solution: "There is now considerable evidence that manipulation can be an effective method of providing symptomatic relief for some patients with acute low back pain."
And Jo Jordan, PhD, has written that spinal manipulation may be the "lone ray of light" for back pain treatment.
Be Safe, Not Sorry
In 2006, doctors performed at least 60 million surgical procedures of all types; one for every five Americans. No other country does nearly as many operations. Not only are surgeries rampant, but many are being shown to be ineffective and dangerous.
According to Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health, medical care is now the third-leading cause of death in the U.S., causing 225,000 preventable deaths every year as tools to make them safer go unused.
So, what's the take-home message? Most people experience back pain, and much more often than not, it's caused by something that doesn't require extreme intervention, like a tumor, fracture, infection, etc. When back pain strikes, chiropractic is a great first choice, but too many people end up taking medication – or even worse, they end up in a vicious cycle of medical care that eventually can lead to the operating room – for back pain that could have been managed conservatively in the overwhelming majority of cases. That's something to think about the next time your back hurts.
J.C. Smith, MA, DC, graduated from Life Chiropractic College in Marietta, Ga., in 1978.