End Medical Mis-Management of LBP

The medical "debate" has been going on for years...is spinal adjusting (a.k.a manipulation) effective for Low Back Pain? The original Meade study (British Medical Journal 1990) demonstrated that chiropractic was much more effective for LBP than conventional medical care.

In 1993 the province of Ontario, Canada hired the esteemed health care economist Pran Manga, PhD to examine the benefits of chiropractic care for low back pain (LBP) and to make a set of recommendations on how to contain and reduce health care costs. His report
A Study to Examine the Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain cited research demonstrating that: (1) chiropractic manipulation is safer than medical management for LBP;   (2) that spinal manipulation is less safe and effective when performed by non-chiropractic professionals;   (3) that there is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management;   (4) and that there would be highly significant cost savings if more management of LBP was transferred from medical physicians to chiropractors. He also stated that "A very good case can be made for making chiropractors the gatekeepers for management of low-back pain in the Workers' Compensation System in Ontario."

In 1994 Medicine was horrified when the Agency for Health Care Policy and Research (AHCPR) confirmed the untested, questionable or harmful nature of many current medical therapies for LBP , and also stated that, of all forms of management they reviewed, only chiropractic care could both reduce pain AND improve function.

Meade did a 1995 follow-up study in
British Medical Journal, that once again demonstrated that those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals, especially for chronic (long-term) LBP!

A recent study in
SPINE Journal revealed that health care expenditures for back pain sufferers were a staggering $90.7 billion in 1998 and that prescription drugs accounted for more than 13% of that figure. Considering that muscle relaxants are associated with slower recovery, and that steroid injections offer minimal relief, one has to ask why drug use costs continue to climb? Even care by physical therapists has been shown to prolong low back pain.

A chronic pain study at the University of Washington School of Medicine recently compared which
treatments were most effective at reducing pain for neuromuscular diseases and found that chiropractic scored the highest pain relief rating (7.33 out of 10), scoring higher than the relief provided by either nerve blocks (6.75) or opioid analgesics (6.37).

A recent
4-year retrospective study of 700,000 health plan members revealed that offering chiropractic services within a managed-care environment could save insurers 27% in back pain episode-related costs! The Cost-effectiveness Page documents many other studies with similar findings.

In December 2004, the
British Medical Research Council published 2 papers in the British Medical Journal demonstrating both the efficacy and cost-effectiveness of chiropractic compared with medical management. These two papers found:

  Manipulation, with or without exercise, improved symptoms more than medical care did after both 3 and 12 months

  The authors concluded: “We believe that this is the first study of physical therapy for low back pain to show convincingly that both manipulation alone and manipulation followed by exercise provide cost effective additions to care in general practice.”


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