Question: I’ve had back pain for awhile and I was able to function through it for a time. But now it’s taking its toll on me, as well as my family. I never believed in chiropractors, but now I’ll try anything. What should I ask my physician about chiropractic?
El Paso, TX. Chiropractor, Dr. Alexander Jimenez has seen this scenario all too often and is happy to inform anyone about chiropractic care and it’s benefits.
About two out of every three people will likely experience significant low back pain at some point. A doctor might suggest any range of potential treatments and therapies. But one that almost is never considered is a referral for spinal manipulation.
It seems doctors have been mistaken for initial treatment of lower back pain.�It may be time for doctors to rethink their chiropractic biases.
Along with other less traditional therapies like heat, acupuncture and meditation, chiropractic appears to be as powerful as any other medical treatments doctors prescribe and as safe, if not safer.
Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors. Patients with back pain don’t seem as skeptical. A survey from 2002 through 2008 found that over 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.
Researchers have been looking at the evidence supporting spinal manipulation for a while. Nearly 35 years ago, a systematic review assessed the available research found that there may be some short-term benefits from the process. Two reviews from 2003 agreed for the most part, finding that spinal manipulation worked better than a “sham procedure”, or placebo, but no better or worse than other options.
Recently, in The Journal of the American Medical Association, researchers looked for new studies since 2011, in addition to those that had been performed before.
Evidence from 15 randomized controlled trials, which included more than 1,700 patients, revealed that spinal manipulation minimized their back pain of about 10 points on a 100-point scale. The evidence from 12 randomized controlled trials that overlapped of almost 1,400 patients showed that spinal manipulation also resulted in improved mobility and function.
In February, in Annals of Internal Medicine, another systematic review of non-pharmacologic therapies generally agreed with the recent trials. Based on this review, and other evidence, the American College of Physicians released new clinical practice guidelines for the noninvasive treatment of back pain. They recommended that patients should try spinal manipulation, heat, massage and acupuncture as first-line therapies.
Because of the fear of those injuries, physicians are hesitant to refer patients to chiropractors or physical therapists for care. However, in the studies outlined above, there were no serious adverse events reported. It is possible to find stories of injury to the spine from improper adjustments, but these are rare, and almost never involve the lower spine.
Some doctors are concerned about the cost of chiropractic, especially since many insurance carriers don’t cover chiropractic. Seeing a chiropractor costs more than taking many non-narcotic pain medications. However, more invasive interventions cost a lot of money. In addition, studies have proven that, in general, users of complementary and alternative medicine spend less for back pain compared to users of only traditional medicine.
Medication and surgery may also result in injuries and prescription pain medicines, like opioids, may result in huge costs, particularly when they’re misused.
Some physicians are uncomfortable that they do not have a clear picture of how spinal manipulation actually works. The reality is that doctors don’t understand why a number of other therapies work either.
Back pain is still the issue and no matter what you do, chiropractic is definitely an option to consider.
The information herein on "Bad Back: Time To Rethink Biases About Chiropractors" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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