Does Chiropractic Care Really Work? What Do The Insurance Companies Say?

 

If chiropractic care helps patients get better faster and costs the patient and/or insurance company less, shouldn’t EVERY low back pain patient FIRST see a chiropractor before any other type of doctor?  That is in fact, what should be done, based on a recent report!

On October 20, 2009, a report was delivered on the impact on population, health and total health care spending.  It was found the addition of chiropractic care for the treatment of neck and low back pain “…will likely increase value-for-dollar in US employer-sponsored health benefit plans.”  Authored by an MD and an MD/PhD, and commissioned by the Foundation for Chiropractic Progress, the findings are clear; chiropractic care achieves higher satisfaction and superior outcomes for both neck and low back pain in a manner more cost effective than other commonly utilized approaches.

The study reviews the fact that low back and neck pain are extremely common conditions consuming large amounts of health care dollars. In 2002, 26% of surveyed US adults reported having back pain in the prior 3 months, 14% had neck pain and the lifetime prevalence of back pain was estimated at 85%.  LBP accounts for 2% of all physician office visits where only routine examinations, hypertension, and diabetes result in more.  Annual national spending is estimated at $85 billion in the US with an inflation-adjusted increase of 65% compared to 1997. Treatment options are diverse ranging from rest to surgery, including many various types of medications.  Chiropractic care, including spinal manipulation and mobilization, is reportedly also widely utilized with almost half of all patients with persisting back pain seeking chiropractic treatment.

In review of the scientific literature, it is noted that 1) chiropractic care is at least as effective as other widely used therapies for low back pain; 2) Chiropractic care, when combined with other modalities such as exercise, appears to be more effective than other treatments for patients with neck pain.  Other studies reviewed reported patients who had chiropractic coverage included in their insurance benefits found lower costs, reduced imaging studies, less hospitalizations, and surgical procedures compared to those with no chiropractic coverage.  They then utilized a method to compare medical physician care, chiropractic physician care, physiotherapy-led exercise and, manipulation plus physiotherapy-led exercise for low back pain care.  They found adding chiropractic physician care is associated with better outcomes at “…equivalent to an incremental cost-effectiveness ratio of $1837 per QALY (Quality-adjusted Life Year).” 

Learn more www.backsmartchiropractic.com  call 770-888-4288 for a Free Consultation.

Carpal Tunnel, What Does Research Really Show

So often we hear, “…well if it’s so good, show me the proof!”  Chiropractic case management of CTS has been well established for many years.  And yet, we still hear skepticism from patients, MD’s, insurers, employers, and others about the benefits of chiropractic management of CTS.  If we can, “show them the data” regarding the effectiveness of chiropractic for CTS patients, we will finally be able to help more people with this potentially disabling condition. 

So, let’s take a look at the evidence that supports the benefits of chiropractic for CTS:

1) Davis PT, Hulbert JR, Kassak KM, et al. “Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trial”

J Manipulative Physiol Ther. 21.5 (June 1997): 317-326.

The most important finding reported in this 91 patient study was that chiropractic treatment was equally effective in reducing CTS symptoms as medical treatment.  The chiropractic care included ultrasound, nighttime wrist supports and manipulation of the wrist, arm and spine.  Medical care included ibuprofen (800 mg, 3x/day for 1 wk, 800 mg, 2x’day for 1 wk, &  800 mg as needed for 7 wks) plus a night wrist splint.  Both groups did equally well but given the side-effect potential of ibuprofen on the stomach, liver, and kidneys, a strong argument for the non-drug, chiropractic approach can be made.

2)  Bonebrake AR, Fernandez JE, Marley RJ et al. “A treatment for carpal tunnel syndrome: evaluation of objective and subjective measures” J Manipulative Physiol Ther. 13.9 (Nov-Dec 1990): 507-520

CTS sufferers (n=38) received chiropractic spinal manipulation and extremity adjusting.  Also,   soft tissue therapy, dietary modifications or supplements (B6) and daily exercises were prescribed. After treatment, results showed improvement in all strength and range of motion measures.  Also, a significant reduction in pain and distress ratings was reported.

3) Mariano KA, McDougle MA, Tanksley GW “Double crush syndrome: chiropractic care of an entrapment neuropathy” J Manipulative Physiol Ther. 14.4 (May 1991):262-5

In 1973, Upton and McComas first proposed the presence of the “double crush syndrome.” Their hypothesis was that when a nerve is pinched anywhere along its route, it makes the rest of the nerve more sensitive to otherwise “normal” stimulation. A case report of a man with both cervical radiculopathy and carpal tunnel syndrome, i.e., “double crush syndrome” was presented. Chiropractic management consisted of chiropractic manipulative therapy as well as ultrasound, electrical nerve stimulation, traction and a wrist splint. The experimental basis, clinical evidence, etiology, symptomatology and findings of this condition are discussed.  The Double Crush Syndrome helps explain why cervical/neck manipulation helps many CTS patients.

There are many additional articles that support the benefits of chiropractic for CTS.   If you, a friend or family member requires care for CTS, we would be honored to offer our services.

 YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288

Or Visit  www.backsmartchiropractic.com

Spondylolisthesis – What Is That?

Abigail was competing in a gymnastics tournament last year and during one of her floor routines, noticed a sharp pain in her low back after performing a series of back hand springs. She said she landed crooked on the last of four back hand springs which resulted in immediate pain in the middle of the low back at the beltline.  She has had pain in the low back before and initially, didn’t think this was any different from past episodes but when the pain didn’t improve after a week, she asked her parents if she could see their chiropractor for an adjustment.  Her chiropractor took her history and was alerted by the mechanism of injury – the rapid onset of pain after bending backwards and landing crooked during her routine.  The low back was carefully examined and during the range of motion testing, Abby’s backward bending test was very painful and limited in motion.  When bending backwards at an angle with pressure applied in the low back, sharp pain stopped the test immediately.  Her neurological tests were normal and she could bend over and touch her toes – in fact, that felt good.  Her chiropractor had a strong suspicion of what had happened and ordered an x-ray to see if the preliminary diagnosis was accurate.  The x-rays looked normal but with the history of extreme backward bending and immediate pain onset, a bone scan was ordered which was positive for a stress fracture in the back part of the vertebra.  Unfortunately, this meant no gymnastics for 3 months and the use of a low back brace was recommended.  The good news is that the back pain was gone within a month and follow-up x-rays 3 months later did not reveal a visible fracture line in the vertebra.  Abby was able to resume gymnastics and competed with success and no low back pain.

 So, what is spondylolistesis? It is the sliding forward of one vertebra over another (see arrow). It occurs in about 7% of the western population and up to 30-50% in cultures that carry their young on their back (like a back pack).  It is reported that most people who develop  spondylolisthesis acquire this between ages 6 and 16 due to a developmental weakness in that part of the spine, though the cause can be traumatic, like in Abby’s case where rapid, uncontrolled backward bending occurs.  It can also gradually occur over time (called “degenerative”), usually not found before age 50-60, where no single event can be recalled by the patient. There is also a congenital type that can be hereditary where one is born with it, though most authorities feel it is acquired at an early age.  The good news is that it is often stable and does not require surgery.  In the more severe case, the nerves and/or spinal cord can get pinched in which case surgery is necessary.  The symptoms would then include leg pain, weakness, and/or numbness with or without significant low back pain. Most cases however, can be successfully managed without surgery and do not compromise the nerves or cord. 

Chiropractic has been found to be very successful in managing patients with spondylolisthesis as the pain generator is often above or below the slipped vertebra.  In fact, in one report, chiropractic was found to be more beneficial than medical care for this condition (Mierau D, et.al., J Manip Physiol Therap 1987;10:49-55). If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.                              

 

                         

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288  

Or Visit    www.backsmartchiropractic.com