What is Chiropractic?

Infants and adults can benefit from chiropractic care. In chiropractic, keeping the problem fixed and preventing its reoccurrence is just as important as the initial remedy.

What makes chiropractic physicians different from any other healthcare professional is the fact that chiropractors are the only professionals who are trained to diagnose and treat what are called spinal subluxations.  The word “subluxation” comes from the Latin words meaning “somewhat or slight" (sub) and “to dislocate” (luxate).  So the term ‘vertebral subluxation’ literally means a slight dislocation or misalignment of the bones in the spine. 

Chiropractors can correct the misaligned bone and allow it to return to its proper position. This procedure is appropriately called an adjustment, and the adjustment enables the body to heal. The chiropractic adjustment is a quick thrust applied to a vertebra for the purpose of correcting its position, movement or both.  Adjustments are often accompanied by an audible release of gas that sounds like a “crack.”  The sound sometimes shocks people a little bit the first couple times they get adjusted, but the sensation is usually relieving.  Occasionally, minor  discomfort is experienced, especially if the surrounding muscles  are in spasm or the patient tenses up during the chiropractic  procedure.  There are times when the audible “cracking” does not occur.   This is often due to either significant  muscle tightness or that the patient may be having a hard time relaxing during their adjustments.  However, the chiropractic adjustment is still important.  The leak is fixed. The wiring is fixed. Information is flowing again. To keep the wiring fixed, several adjustments over a course of time may be necessary, in addition to massage, physical therapy, stretching exercises, or strengthening exercises. In the chiropractic world, keeping the problem fixed and preventing its reoccurrence is just as important as the initial remedy.

There are actually five components that contribute to the vertebral subluxation complex (VSC).

1. Bone Component-where the vertebra is either out of position, not moving properly, or are undergoing degeneration.  This frequently leads to a narrowing of the spaces between the bones through which the nerves pass; often resulting in irritation or impingement of the nerve itself.
2. Nervous Component-is the disruption of the normal flow of energy along the nerve fibers, causing the messages traveling along the nerves to become distorted.  The result is that all of the tissues that are fed by those nerves receive distorted signals from the brain and, consequently, are not able to function normally.  Over time, this can lead to a whole host of conditions, such as peptic ulcers, constipation and other organ system dysfunction.
3. Muscular Component-since nerves control the muscles that help hold the vertebrae in place, muscles have to be considered to be an integral part of the vertebral subluxation complex.  In fact, muscles both affect, and are affected by the VSC.  A subluxation can irritate a nerve, the irritated nerve can cause a muscle to spasm, the spasmed muscle pulls the attached vertebrae further out of place, which then further irritates the nerve and you have a vicious cycle.  It is no wonder that very few subluxations just go away by themselves.
4. Soft Tissue Component-the VSC will also affect the surrounding tendons, ligaments, blood supply, and other tissues as the misaligned vertebrae tug and squeeze the connective tissue with tremendous force.  Over time, the soft tissues can become stretched out or scarred, leaving the spine with either a permanent instability or restriction.
5. Chemical Component-is the change in the chemistry of the body due to the VSC.  Most often, the chemical changes, such as the release of a class of chemicals called “kinins,” are pro-inflammatory; meaning that they increase inflammation in the affected area.

These changes get progressively worse over time if they are not treated correctly, leading to chronic pain, inflammation, arthritis, muscle trigger points, the formation of bone spurs, loss of movement,  as well as muscle weakness and spasm.  Chiropractors have known the dangers of the vertebral subluxation complex ever since the birth of the profession. More and more scientific research is demonstrating the tremendous detrimental impact that subluxation have on the tissue of the body.  In order to be truly healthy, it is vital that your nervous system be functioning free of interference from subluxations.  Chiropractors are the only health professionals trained in the detection, location, and correction of the vertebral subluxation complex through chiropractic care.

Spinal adjustments to correct subluxations are what make doctors of chiropractic unique in comparison with any other type of health care professional. The term “adjustment” refers to the specific force chiropractors apply to vertebrae that have abnormal movement patterns or fail to function normally.

The objective of the chiropractic adjustment is to reduce the subluxation, which results in an increased range of motion, reduced nerve irritability, reduced muscle spasm, reduced pain and improved function.The chiropractic adjustment is a quick thrust applied to a vertebra for the purpose of correcting its position, movement or both. Adjustments are often accompanied by an audible release of gas in the spinal joints that sounds like a “crack.” The sound sometimes surprises people the first time they get adjusted, but the sensation is usually relieving. Occasionally, minor discomfort is experienced, especially if the surrounding muscles are in spasm or the person tenses up during the chiropractic procedure. There are times when the audible “cracking” does not occur. This is often due to either significant muscle tightness or the person having a hard time relaxing during their adjustments. Some adjusting techniques are designed to move the spine in a way that does not produce the audible sound at all. Chiropractic is so much more than simply a means of relieving pain.

Ultimately, the goal of receiving adjustments should be to restore the body to its natural state of optimal health. In order to accomplish this, chiropractors can use and recommend a variety of natural healing methods, including adjustments, massage, trigger point therapy, nutrition, exercise rehabilitation, and counseling on lifestyle issues that impact your health. The primary focus is simply to remove those things which interfere with the body’s natural normal healing ability.The adjustment of the spine is the primary objective of a chiropractor. There are some chiropractors who also adjust the extremities and use other forms of physiological therapeutics including the use of electrical stimulation, ultrasound, traction, neuromuscular re-education, and a variety of manual therapies. Increasingly, chiropractors’ offices are becoming full service wellness centers providing a variety of wellness services. A new trend that chiropractic wellness centers offer is wellness coaching. Some programs offer coaching at the wellness center, while others offer wellness coaching via telephone, email, or online instant messenger in an effort to make it more convenient. Chiropractic wellness centers may offer seminars in a variety of subjects such as spinal alignment, improved posture, and ergonomics, as well as programs on weight management, relaxation, smoking cessation, nutrition, and exercise. Some even offer pre- and post-natal healthy baby programs. The increasing number of chiropractic centers providing extensive wellness programs makes it convenient and affordable for just about anyone to adopt a wellness lifestyle.Chiropractors are doctors who understand that within each of us is an innate wisdom or healthy energy that will express itself as perfect health and well-being if we allow it to. Therefore, the focus of chiropractic care is to remove any physiological blocks to the proper expression of the body’s innate wisdom. Once these interferences are reduced, improved health is the natural consequence. Who wouldn’t want that?


Conditions Treated

 

• Back Pain
• Disc protrusion/extrusion/herniation
• Joint Pain
• Stenosis
• Achilles Tendonitis
• Spinal Degeneration
• Sciatica
• Headaches
• Carpal Tunnel Syndrome
• Whiplash,
• Sports Injuries,
• Neck Pain
• Stiff Neck
• Car Accident Injuries
• Arthritis
• Frozen shoulder
• Hip pain
• Pulled hamstrings
• Radiating Arm and Leg Pain
• Sprained Ankles
• Rotator Cuff Tendonitis and Tears
• Tennis Elbow
• Heel pain/achilles tendinitis

We heal injuries caused by automobile accidents, sports injuries, and workplace injuries. We can help reverse the effects of injuries caused by repetitive motion, poor posture, and poor lifting habits.

You may be wondering... how can the same chiropractic treatment which effectively treats my back pain also optimize my health? The answer can be found by looking into the relationship between the spine and the nervous system.

As you may already know, the nervous system is the master controller of all living cells, tissues and organs; orchestrating and coordinating all cellular functions. The spinal column encases the nervous system (spinal cord and nerve roots) and is responsible for its protection.

Because of this intimate relationship, biomechanical and structural problems in the spinal column can irritate parts of the enclosed nervous system. This irritation can result from noxious inflammatory biochemicals released during tissue injury or may result from direct mechanical pressure. In either case, the functioning of the nervous system is negatively influenced as is the functioning of the cells, tissues and organs which are supplied by the affected nerve(s).

The resulting ailment(s) depends on the cells, tissues and organs affected as well as the extent of nervous system compromise.

In short, because the body's innate recuperative powers are affected by and integrated through the nervous system, correcting spinal abnormalities which irritate the nervous system can lead to a number of favorable results in patients suffering from various, seemingly non-spinal health conditions.

What Chiropractors Do

Practically speaking, chiropractors are primarily concerned with locating and treating vertebral subluxations.

A vertebral subluxation is a complex of functional and/or structural and/or pathological articular (joint) changes that compromise neural integrity and may influence organ system function and general health.

Using a number of unique and highly refined skills, the chiropractor checks the patient's spine for any misalignments, fixations or other abnormalities (vertebral subluxations). If subluxations or other abnormalities are detected, the chiropractor will generally apply a gentle force in a corrective manner to the affected spinal area.

Chiropractors use many specialized techniques to identify and treat these spinal abnormalities and optimize overall health. In addition to spinal adjustive techniques, soft tissue techniques such as massage, dietary and nutritional counseling, physical therapies, and lifestyle modification programs are commonly employed.

How Chiropractic Differs

There is a significant and very important difference between the way chiropractors and medical doctors approach health ailments.

When evaluating and treating patients, chiropractors take a holistic approach which includes identifying and correcting the cause(s) of the patient's health ailment. In contrast, the medical approach tends to focus more on the treating the symptoms of a condition rather than focusing primarily on the actual cause(s).

Chiropractors believe that correcting the cause of the problem provides significant long-term benefits over only treating the symptoms.

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The Benefits of Chiropractic

Short-term and regular chiropractic care have a number of benefits including:

• spinal and extremity pain relief
• headache relief
• increased mobility and range of motion
• decreased stiffness and muscular spasms
• arthritic joint pain relief
• increased joint health
• increased performance and energy
• increased sense of well being and relaxation
• increased balance and coordination
• reduced degeneration and risk of injury
• enhanced tissue healing
• decreased tissue inflammation

Government Studies on Chiropractic

There have been a number of large investigations conducted on chiropractic by the American, Canadian, New Zealand, Swedish and Australian governments over the last few decades. In all cases, their findings have supported the effectiveness and efficacy of Chiropractic.

Canada's 1993 Manga Report strongly recommended chiropractic care over medical care for the treatment and management of most low-back conditions. The 1994 AHCPR Study from the U.S. Department of Health and Human Services suggested that chiropractic spinal manipulation was a conservative and safe treatment for many low-back conditions and should be utilized prior to any surgical interventions in most cases.

Doctors of Chiropractic have now become integral to the development of governmental guidelines for the treatment of back conditions in Canada and the U.S. In addition, many hospitals are extending privileges to chiropractors and referrals between medical doctors and chiropractors are becoming increasingly common.

• US - "The Agency on Health Care Policy and Research Study"
• CANADA - "The Manga Report"
• NEW ZEALAND - "The New Zealand Commission Report"
• SWEDEN - "The Sweden Report"
• AUSTRALIA - "The Australian Report"

US - The Agency on Health Care Policy and Research Study

On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released Clinical Practice Guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of diagnostic and treatment methods for acute low back pain.

The guidelines were created by the AHCPR panel to provide primary care clinicians with information and recommended strategies for the assessment and treatment of acute low back problems. The AHCPR panel was made up of 23 members consisting of medical doctors, chiropractic doctors, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer representative.

The following conclusions were made in this landmark study:

• Conservative treatment such as spinal manipulation should be pursued in most before cases considering surgical intervention;
• Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.

Other interesting finds included:

• The risk of serious complications from lumbar spinal manipulation is rare;
• There is currently no evidence supporting the use of trigger point, ligamentous and facet injections, needle acupuncture or dry needling as treatment for acute back problems;
• The panel found no evidence of benefit from the application of physical agents and modalities such as ice, heat, massage, traction, ultrasound, cutaneous laser treatment, transcutaneous electrical nerve stimulation (T.E.N.S.) and biofeedback techniques.

         i.            Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S, et al. Agency for Health Care Policy and Research Publication No. 950642 (1994) - U.S. Department of Health and Human Services.

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CANADA - The Manga Report

As the largest existing analysis of scientific literature on low back pain, the 1993 Ontario Ministry of Health commissioned study drew international attention when it recommended the management of low back pain be moved from medical doctors to chiropractic doctors.

Due to serious financial problems with the Canadian governments, the different types of treatments for low back conditions were evaluated in an effort to reduce and contain health care costs. Their findings showed chiropractic manipulation was the most cost effective and efficacious care for low back pain.

The researchers also stated that studies on the prevalence and incidence of low back pain suggest that it is the leading cause of disability and morbidity in middle-aged persons, and is by far the most expensive source of workers' compensation costs North America.

The Canadian Government report concluded with the following findings:

• On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate;
• There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain;
• Indeed, several existing medical therapies of low back pain are generally contraindicated on the basis of the existing clinical trials. There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by nonchiropractic professionals;
• There is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management;
• There would be highly significant cost savings if more management of low back pain was transferred from physicians to chiropractors. Evidence from Canada and other countries suggests potential savings of many hundreds of millions annually;
• Workers' compensation studies report that injured workers with the same specific diagnosis of low back pain returned to work much sooner when treated by chiropractors than by medical physicians;
• There is good empirical evidence that patients are very satisfied with chiropractic management of low back pain and considerably less satisfied with medical physician management;
• The use of chiropractic has grown steadily over the years and chiropractors are now accepted as a legitimate healing profession by the public and an increasing number of medical physicians;
• In our view, the following offers an overwhelming case in favor of much greater use of chiropractic services in the management of low back pain:

• the effectiveness and cost effectiveness of chiropractic management of low back pain
• the untested, questionable or harmful nature of many current medical therapies
• the economic efficiency of chiropractic care for low back pain compared with medical care
• the safety of chiropractic care
• the higher satisfaction levels expressed by patients of chiropractors.

The following recommendations were also included in the report:

• There should be a shift in policy to encourage and prefer chiropractic services for most patients with low back pain;
• Chiropractic services should be fully insured under the Ontario Health Insurance Plan;
• Chiropractic services should be fully integrated into the health care system;
• Chiropractors should be employed by tertiary hospitals in Ontario;
• Hospital privileges should be extended to all chiropractors for the purposes of treatment of their own patients who have been hospitalized for other reasons, and for access to diagnostic facilities relevant to their scope of practice and patients' needs;
• Chiropractic should have access to all pertinent patient records and tests from hospitals, physicians, and other health care professionals upon the consent of their patients;
• Since low back pain is of such significant concern to workers' compensation, chiropractors should be engaged at a senior level by Workers' Compensation Board to assess policy, procedures and treatment of workers with low back injuries;
• 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;
• The government should make the requisite research funds and resources available for further clinical evaluations of chiropractic management of low back pain, and for further socioeconomic and policy research concerning the management of low back pain generally;
• Chiropractic education in Ontario should be in the multidisciplinary atmosphere of a university with appropriate public finding;
• Finally, the government should take all reasonable steps to actively encourage cooperation between providers, particularly the chiropractic, medical and physiotherapy professions.

         i.            The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.

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NEW ZEALAND - The New Zealand Commission Report

This 377 page report, Chiropractic In New Zealand, was the most comprehensive and detailed independent examination of chiropractic ever undertaken at that time. The report withstood judicial hearings and extensive investigations by the Commission in New Zealand, the United States, Canada, England and Australia.

According to the researchers,

Their report includes the following findings:

• Chiropractic is a branch of the healing arts specializing in the correction by spinal manual therapy of what chiropractors identify as biomechanical disorders of the spinal column - they carry out spinal diagnosis and therapy at a sophisticated and refined level;
• Chiropractors are the only health practitioners who are necessarily equipped by their education and training to carry out spinal manual therapy;
• General medical practitioners and physiotherapists have no adequate training in spinal manual therapy;
• Spinal manual therapy in the hands of a registered chiropractor is safe;
• The education and training of a registered chiropractor are sufficient to enable him/her to determine whether there are contraindications to spinal manual therapy in a particular case, and whether the patient should have medical care instead of or as well as chiropractic care;
• Spinal manual therapy can be effective in relieving musculoskeletal symptoms, such as back pain and other symptoms known to respond to such therapy, such as migraine;
• In a limited number of cases where there are organic and/or visceral symptoms, chiropractic treatment may provide relief, but this is unpredictable, and in such cases the patient should be under concurrent medical care if that is practicable;
• In the public interest and in the interests of patients, there must be no impediment to full professional cooperation between chiropractors and medical practitioners;
• It is wrong that the present law, or any medical ethical rules, should have the effect that a patient can receive spinal manual therapy which is subsidized by a health benefit only from those health professionals least qualified to deliver it;
• The responsibility for spinal manual therapy training, because of its specialized nature, should lie with the chiropractic profession and part-time or vacation courses in spinal manual therapy for other health professionals should not be encouraged.

         i.            New Zealand Report. Hasselberg PD. Government Printer, Wellington - 1979.

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SWEDEN - The Sweden Report

Up until the late 1980's, Sweden had no legislation regulating the practice of chiropractic, although there were approximately 100 chiropractors in Sweden educated in accredited chiropractic colleges. In 1987, a commission on Alternative Medicine in Sweden conducted a detailed investigation of chiropractic education. They had the scientific literature assessed by university medical faculty and additionally commissioned a demographic survey by Statistics Sweden. Subsequent to the report, the Swedish government passed legislation recognizing and regulating the chiropractic profession in Sweden. Then, together with the governments from Denmark, Finland and Norway, it established a school of chiropractic at the University of Odense in Denmark to provide a regional chiropractic college for students from those countries.

The reports findings included:

• Doctors of chiropractic should become registered practitioners and be brought within the national insurance system in Sweden;
• Training for Doctors of Chiropractic follows a 4-5 year course of university level training and was found to be the equivalent to Swedish medical training - chiropractors have "competence in differential diagnosis" and should be regulated on a primary care basis";
• "Measures to improve cooperation between chiropractors, registered medical practitioners and physiotherapists are vital" in the public interest.

i.            Ref 11 Supra.

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AUSTRALIA - "The Australian Report"

In July of 1984 the Australian Federal Minister for Health asked their Medicare Benefits Review Committee to "consider requests for extending the scope of Medicare (government-funded health care) arrangements to provide benefits for certain paramedical services" - which included chiropractic services.

The Committee recommended funding for chiropractic in hospitals and other public institutions, and stated:

         i.            Second Report Medicare Benefits Review Committee. Thompson CJ. Commonwealth Government Printer, Canberra, Australia, Chapter 10 (Chiropractic) - June 1986.

 

 

Comparison Studies

Chiropractic Care versus...

• "Chiro Care, Second To None"
• Standard Medical Care
• Outpatient Hospital Care
• Physiotherapy + Corset + Analgesics
• Mobilization
• Massage
• Exercise + Deep Heat
• Bed Rest
• Codeine
• Back School + Corset + Traction
• Deep Heat

Do You Know That Chiropractic Care Is Second To None?

According to a study conducted by Ontario's Ministry of Health, "...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system." The same study also found, "...injured workers ... diagnosed with low-back pain returned to work much sooner when treated by chiropractors than by physicians."

According to the British Medical Research Council Study, spinal manipulation performed by chiropractors was found more effective than alternative treatments for low-back pain.

According to medical researcher TW Meade, M.D. "...chiropractic is a very effective treatment, more effective than conventional hospital outpatient treatment for low-back pain, particularly in patients who had back pain in the past and who got severe problems".

         i.            The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.

        ii.            Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and Hospital Outpatient Treatment. Meade, TW et al British Medical Journal - 1990;300:1431-1437.

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Chiropractic Treatment vs. Standard Medical Care

Patient Evaluations	Chiro Care	Family M.D.
Mean number of days incapacitated after first visit	11 days	40 days
Restricted for greater than one week	17%	48%
Perception of doctor's confidence in diagnosing and treating low-back pain	60%	23%
Satisfied With Their Treatment	66%	22%

         i.            Patient Evaluations of Care from Family Physicians and Chiropractors. ACA Journal of Chiropractic - 1989.

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Chiropractic Treatment vs. Outpatient Hospital Treatment by P.T.'s and M.D.'s

In this study, British medical researchers found chiropractic treatment significantly more effective than hospital outpatient treatment, especially in patients with chronic and severe back pain. Significantly fewer patients needed to return for further treatments at the end of the first and second year in those who received chiropractic care (17% compared with 24%). In addition, "two and three years after patients with back pain were treated by chiropractors, they experienced far less pain than those who were treated by medical doctors."

         i.            The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.

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Chiropractic Treatment vs. Physiotherapy

Spinal manipulation provided greater improvement of symptoms in those suffering from persistent back and neck complaints compared with physical therapy. The patients receiving spinal manipulation also had greater improvements of physical functioning in fewer visits.

         i.            Randomized Clinical Trial of Manipulative Therapy and Physiotherapy for Persistent Back and Neck Complaints: Results of One Year Follow Up. Koes, B.W. et al. British Medical Journal - 1992;304:601-605.

Chiropractic Treatment vs. Physiotherapy + Corset + Analgesics

Statistical benefit for spinal manipulation at 3 weeks.

         i.            Manipulation in the Treatment of Low-back Pain: A Multicentre Study. Doran D and Newell DJ. British Medical Journal - 1975;2:161-164.

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Chiropractic Treatment vs. Mobilization

Those receiving spinal manipulation achieved a 50% reduction in their pain levels more rapidly than those receiving mobilization (therapy commonly used by Physical Therapists).

         i.            A Benefit of Spinal Manipulation as Adjunctive Therapy for Acute Low-back pain: A Stratified Controlled Trial. Hadler NM et al. Spine - 1987;12:703-706.

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Chiropractic Treatment (spinal manipulation) vs. Massage

In a group of patients, those receiving spinal manipulation obtained pain relief in a shorter period of time compared with massage. Also, significantly more subjects were able to return to work 6 months after treatment in the chiropractic treatment group compared with the massage therapy group (60% vs. 36%).

A Canadian study found spinal manipulation resulted in significantly greater back mobility compared with massage at 2 weeks (30% vs 15%).

         i.            The Efficacy of Manual Treatment in Low-back Pain: A Clinical Trial. Arkuszewski Z. Manual Medicine - 1986;2;68-71.

        ii.            A Randomized Trial of Manipulation for Low-back Pain in a Medical Setting. Godfrey CM et al. Spine - 1984;9:301-304.

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Chiropractic Treatment vs. Exercise Combined With Deep Heat Applications

Those receiving spinal manipulation experienced pain relief in a shorter period of time (3.5 vs. 5.8 treatments).

         i.            Acute Low-back Pain: Comparison of Two Conservative Treatment Approaches. Farrell JP and Twomey LT. Med J Aust - 1982;1:160-164.

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Chiropractic Treatment vs. Bed Rest

50% of the individuals in the spinal manipulation group were pain free in 1 week compared with only 27% of those receiving bed rest only.

         i.            Low-back pain Treated by Manipulation. Coyer AB and Curwin I. British Medical Journal - 1955;1:705-707.

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Chiropractic Treatment vs. Codeine

Spinal manipulation provided significant improvement in the subjects overall pain score compared with the commonly prescribed pain medication, codeine.

         i.            Lumbar Spinal Manipulation on Trial: Part 1 - Clinical Assessment. Evans DP et al. Rheumatology and Rehabilitation - 1978;17:46-53.

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Chiropractic Treatment vs. Back School + Corset + Traction

Researchers found a statistically significant benefit with spinal manipulation at 4 weeks.

         i.            Multicentre Trial of Physiotherapy in the Management of Sciatic Symptoms. Coxhead CE et al. Lancet - 1981;1:1065-1068.

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Chiropractic Treatment vs. Deep Heat Applications

Patients receiving spinal manipulation experienced a significantly shorter time to pain relief than those receiving deep heat applications.

Distinct benefit for spinal manipulation vs diathermy (deep heat application used by P.T.'s) in return to light work at one month.

Another study found spinal manipulation provided better pain relief for those with less than 1 week of pain and in patients with their first attack of back pain.

         i.            Relative Therapeutic Efficacy of Vertebral Manipulation and Conventional Treatment in Back Pain Management. Nwuga VC. American Journal of Physical Medicine - 1982;61:273-278.

        ii.            Manipulation in the Treatment of Low-back Pain - A Randomized Clinical Trial. Rasmussen GG. Manuelle Medizin - 1979;1:8-10.

      iii.            Back Pain: A Randomized Clinical Trial of Rotational Manipulation of the Trunk. Glover JL et al. British Journal of Industrial Medicine - 1974;31:59-64.

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Cost Effectiveness Studies

It was estimated that 1992 low back pain costs in the US were a staggering $60 billion when production lost was taken into consideration. Research has indicated that low back pain disability is growing 14 times faster than the population. It's the leading cause of disability and morbidity in middle-aged persons, and is the most expensive source of workers' compensation costs in North America. In the 30-50 age group, low back pain is the single most expensive health care problem.

The escalating costs associated with low back pain have prompted legislators, policy makers and insurance companies to investigate cost-containment strategies. As you will see in the following studies, chiropractic care has been consistently identified as one of the most effective and cost effective treatments for the management of many low back conditions, in addition to a number of other neuromusculoskeletal disorders. Moreover, the volume of scientific evidence now being compiled makes a compelling case for the use of chiropractic as a means of controlling the escalating costs of our overburdened health care system.

         i.            Prevalence of Selected Impairments. United States - 1971. National Center for Health Statistics, Hyattsville, Maryland - 1975, DHHS Publication No. (PHS)75-1526 (Series 10, No. 9) and 1981 DHHS Publication No. (PHS) 87-1587 (Series 10, No. 159)

        ii.            Back Injuries in Industry: A Retrospective Study Part I Overview and Cost Analysis. Spengler et al. Spine, 1986 - 11(3):241-245.

• The Manga Report
• The Utah Study
• The Oakland University Study
• The Virginia Research Study
• The Florida Study
• The Av-Med Study
• The Australian Study

The Manga Report

The following excerpts from the Canadian government commissioned study clearly indicates the cost effectiveness of chiropractic treatment over standard medical treatment:

• The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.

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The Utah Study

In 1988 a Utah Workers' Compensation Board study found the total treatment costs for back-related injuries cost an average of $775.30 per case when treated by a doctor of chiropractic. When injured workers received standard medical treatment as opposed to chiropractic treatment, the average cost per case was $1,665.43.

They also found the mean compensation cost paid out by the Utah Worker's Compensation Board for patients treated by medical doctors was $668.39, while the mean compensation cost paid for patients treated by chiropractic doctors was only $68.38.

         i.            Cost per Case Analysis of Utah Industrial Back Injury Claims: Chiropractic Management vs. Medical Management for Diagnostically Equivalent Conditions. D.C. Tracts - 1989.

        ii.            Cost per Case Comparison of Back Injury Claims of Chiropractic versus medical Management for Conditions with Identical Diagnostic Codes. Jarvis KB, et al. Journal of Occupational Medicine - 1991;33:847-852.

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The Oakland University Study

After reviewing the health insurance claims for 395,641 chiropractic and medical care patients, Miron Stano, Ph.D., lead researcher, concluded:

• Stano/Medstat Research. Miron Stano, Ph.D. Oakland University.

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The Virginia Research Study

An economic analysis conducted in Richmond, Virginia in 1992 found chiropractic care to be a lower cost option for back-related ailments. The researchers concluded that if chiropractic care was insured to the extent of other medical specialties, it would likely emerge as a first option for many patients with certain medical conditions. They also believed this could result in a decrease in the overall treatment costs for these conditions.

Additional research conducted by The College of William and Mary and the Medical College of Virginia in 1992 on mandated health insurance coverage and the economic impact of chiropractic coverage revealed:

• The low cost of chiropractic is due not to its low rate of use, but to its apparently offsetting impacts on costs in the face of high rates of utilization. Chiropractic is a growing component of the health care sector, and it is widely used by the population.
• Formal studies of the cost, effectiveness, or both of chiropractic, usually measured against other forms of treatment, show it to compare favorably with them.
• By every test of cost and effectiveness, the general weight of evidence shows chiropractic to provide important therapeutic benefits, at economical costs. Additionally, these benefits are achieved with apparently minimal, even negligible, impacts on the costs of health insurance.
• The conclusion of this analysis is that chiropractic mandates help make available health care that is widely used by the American public and has proven to be cost-effective.
• A Comparison of the Costs of Chiropractors versus Alternative Medical Practitioners. Dean DH, Schmidt RM. University of Richmond, Richmond, Virginia - January 13, 1992.

• Mandated Health Insurance Coverage for Chiropractic Treatment: An Economic Assessment, with Implications for the Commonwealth of Virginia. Schifrin LG. The College of William and Mary, Williamsburg, Virginia, and Medical College of Virginia, Richmond, Virginia - January 1992.

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The Florida Study

This large State of Florida study examined 10,652 patients who sustained back-related injuries on the job. Their findings revealed that individuals who received chiropractic care compared with standard medical care for similar diagnoses experienced had a,

         i.            51.3 percent shorter temporary total disability duration

       ii.            lower treatment cost by 58.8 percent ($558 vs. $1,100 per case)

      iii.            20.3 percent hospitalization rate in the chiropractic care group vs. 52.2 percent rate in the medical care group.

i.            An Analysis of Florida Workers' Compensation Medical Claims for Back Related Injuries. Wolk S. Foundation for Chiropractic Education and Research, Arlington, VA. - 1988.

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The Av-Med Study

In this study, 80 patients who previously received medical treatment were subsequently referred to the Silverman Chiropractic Center. Of the 80 patients, 21 percent had just been diagnosed with spinal disc problems, 12 percent had been diagnosed as requiring surgery and 5 percent had received emergency room treatment. Following chiropractic treatment, none of the patients were required to have surgery, 86 percent of the patients needed no further care, and the estimated health care savings in the group of 80 was estimated to be $250,000.

• The Av-Med Study - 1993.

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The Australian Study

In this Australian study, 1,996 workers' compensation cases were evaluated in patients who experienced work-related mechanical low back pain. It was found that those individuals who received chiropractic care for their back pain returned to work 4 times faster (6.26 days vs. 25.56 days) and had treatment that cost 4 times less ($392 vs. $1,569) than those who received treatments from medical doctors. Also, in those patients who received chiropractic care there was a significantly lower incidence of progression to a chronic low back pain status.

Mechanical Low-Back Pain: A Comparison of Medical and Chiropractic Management Within the Victorian Work Care Scheme. Ebrall, PS. Chiropractic Journal of Australia - 1992;22:47-53.

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AZMulticare Chiropractic/Acupuncture Clinic
16655 N. 90th st. suite 101
Scottsdale, Az 85260
(480) 991-5555
drjeffrobinson@azmulticare.com