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| Low Back Pain and Chiropractic |
What Does Chiropractic "Treat"?
The first chiropractic patient had been deaf for 17 years. His hearing returned. The second patient had a heart condition; the condition was relieved. As the fame of the new healing art spread, thousands soon praised chiropractic for saving them from a wide variety of ills, among them headaches, colds, allergies, asthma, arthritis, seizures, ear infections, stomach trouble, and gynecological problems, And yet, chiropractic is not a treatment for diseases at all! Its purpose is to correct spinal nerve stress (vertebral subluxations), a severe abnormality that interferes with the body's proper functioning.
Misconception
In view of this, why is it that so many people persist in thinking of chiropractic as a "treatment" for back and neck problems?
One reason must be that because chiropractors work on the spine, people assume that they are back doctors. That's like saying that medical doctors treat only the stomach and the skin because they give you pills that go to the stomach and shots that go in through the skin.
"But," I hear you say, "M.D.s go through the stomach and skin to affect the entire body," and you are right - the stomach and skin serve as "portals of entry" to the entire body.
Similarly, the spine is the chiropractor's "portal of entry"; chiropractors work on the spinal column because that's the best way to relieve spinal nerve stress. But that is in no way to say that chiropractors are "backache doctors."
Low Back Pain
Go why do we have a pamphlet entitled Low Back Pain? Simply because among the hundreds of conditions that the "flesh is heir to," there are a lot of people who suffer from bad backs.
How many? The fact is that 85 percent of the population will experience disabling low back pain at least once during their lives! That's almost all of us. The problem is so bad that at any one time, according to one researcher, 6.8% of the U.S. adult population is suffering from an episode of back pain lasting more than two weeks.1 That's a lotta bad backs.
Cost
The estimated cost of lower back problems in the U.S. is over $50 billion a year.2
The Standard Medical Approach
The standard medical approach to back pain varies depending on the severity of the condition. Usually muscle relaxers, pain killers, and rest are prescribed in the hope that the backache will go away.
The above, in conjunction with physical therapeutics such as traction, diathermy, ultrasound, hot packs, cold packs, and various other procedures, are sometimes used.
If the problem doesn't improve or actually worsens then it's possible that disc damage tests like a myelogram, MRI, or CAT scan, in addition to X-rays, may be performed.
Surgery
Finally, surgery is often resorted to. An operation called a laminectomy may be performed in which adjacent vertebrae are surgically fused as the disc material is scraped away from the vertebrae.
The medical approach is at times necessary. It must be remembered, however, that the myelogram, a test often used to determine whether or not there's disc damage, is very unreliable. An inaccuracy rate of over 40% has been reported, meaning that some people who had no disc damage were told they in fact had disc damage whereas others who actually had disc damage were told that the myelogram showed them to be damage free.
Surgery, too, has its attendant problems. According to some studies, more than half of all spinal surgery for lower back problems should never have been performed. Many people who have had back surgery report a recurrence of their symptoms within a year or two of the operation. In some cases the surgery makes no difference whatever. And in some cases it does give long-term relief.
The Chiropractic Approach
Chiropractors have proved to be a blessing to millions with back problems, often saving them from pain, disability, and standard medical treatments such as drugs and surgery. And yet, we reiterate, chiropractic is not a treatment for back problems. The chiropractor's job is to make the spine healthier by correcting vertebral subluxations and relieving spinal nerve stress. As a result of this process, many back or neck problems may clear up. That is why anyone suffering from a back problem should see a chiropractor to make sure first and foremost that there is no spinal nerve stress and, to have it relieved if it is found. This may make the difference between health and disability, comfort and pain.
Studies on Chiropractic Effectiveness
10-Year British Medical Research Study
In 1980 the British government, through the British Medical Research Council, initiated a 10-year study on low back pain. Completed in 1990, the study was reported in the June 1990 British Medical Journal.
Chiropractic was compared with the medical (hospital outpatient) care of patients with acute (short-term) and chronic (long-term) mechanical low back pain - the most costly cause of work loss due to injury in the Western world.
"Of those with jobs 21 % of patients given chiropractic treatment (sic) had time off work because of back pain compared with 35% of hospital patients.... Between one and two years the frequency and duration of absence from work were less in those treated by chiropractic."3
Of the chiropractic group, medical group, and control group, only the chiropractic group showed significant reduction in pain level. In fact, chiropractic was significantly more effective for patients with chronic and severe pain. This improvement was maintained at a two-year follow-up.
In fact, as a result of the study, the British medical profession is advocating inclusion of chiropractic services in the British National Health system.
Florida Workers' Compensation Study
Claims from 10,000 closed workers' compensation cases decided in the state of Florida during the fiscal year 1985-86 showed that under standard medical care the patient was disabled for 59 days as compared with 39 days under chiropractic. A person with a back-related injury was less likely to become disabled and, if disabled, was incapacitated for a shorter period of time.
Because of the shortened disability time the average cost of chiropractors' services was more than 50% lower than that of medical doctors for the same conditions.4
Utah Study
The findings of a 1988 study of 5,268 back injury claims from 1986 were consistent with those of the Florida study. The cost of chiropractic care was less than half that of medical care for similar conditions.
The study showed lumbar disc displacement cost $14,157,94 (surgical) and $6,810.36 (non-surgical) under medical care and $1,762.18 under chiropractic care.5
Oregon Study6
A 1971 Oregon study of 237 cases undergoing non-surgical care for comparable types of diagnosis:
Percentage able to return to work after one week:
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Under medical care: |
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41% |
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Under chiropractic care: |
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82% |
California Study7
In 1972 C. Richard Wolf, M.D., utilized records provided by the California Division of Labor Statistics and Research for an independent study of back injuries routinely reported to the division. The study compared 500 people sent to medical doctors and 500 sent to chiropractors. The results are as follows:
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Average Number Work Days Lost |
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% Complete Recovery Reported |
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Medical Doctor |
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32.0 |
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34.8 |
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Chiropractor |
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15.6 |
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51.0 |
Conclusion
Thus, studies have shown chiropractic to be more beneficial and cost-effective than standard American medicine for lower back complaints. It would therefore appear that the prudent thing for those with back injuries and lower back sprain/strains would be to consult with a doctor of chiropractic before resorting to medical treatments which cost more, are less effective, and are more traumatic to the body.
But why are the results so overwhelmingly in favor of chiropractic over medical care? Again, because painkillers, muscle relaxers, Valium, braces, physical therapy, and surgery are not designed to correct spinal nerve stress or vertebral subluxations. Chiropractic is!
References
1. Deyo R. A. (1987): Description Epidemiology of Lower-Back Pain and its Related Medical Care in the United States. Spine 12(3):264-268.
2. Low Back Pain, the $50 Billion Problem, conference sponsored by the Institute for Low Back Care. Abbott Northwestern Hospital, Minneapolis, September 30. 1982.
3. MeadeT. W., Dyer S. et al (1990) Low Back Pain of Mechanical Origin: Randomised Comparison of Chiropractic and Hospital Outpatient Treatment, British Medical Journal 300 (June):1431-37.
4. Wolk S. (1988) Chiropractic vs. Medical Care: A Cost Analysis of Disability and Treatment for Back-Related Workers' Compensation Cases. Foundation for Chiropractic Education and Research, 1701 Clarendon Blvd., Arlington, Va 22209, September 1988 report.
5. Jarvis K B, (1988, Aug. 15) Issues in Medical Cost Containment, AASCIF Convention-Lecture, Salt Lake City, UT.
6. A study of Time Loss Back Claims, Workmen's Compensation Board, State of Oregon, Portland, March 1971.
7. Industrial Back Injury by C. Richard Wolf, M.D. Dec 1972. Complied by the International Chiropractors Association, 1110 North Glebe goad, Suite 1000, Arlington, VA 22201. (703) 528-5000.
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