Wellness @ Work

Evidence-Based Health Care

Health care costs in the U.S. were more than 17.7-percent of the national gross domestic product (GDP) in 2019. Can you believe that? These skyrocketing health care costs can be slowed down through chiropractic care.

Chiropractic care works. Here is some evidence: ​

Chiropractic care lowers health care costs, according to a report that compared spinal care patients who received chiropractic care with those who did not. Those who had chiropractic care spent 10% to 23% less on their overall health care.

Government and private studies conducted around the world show chiropractic is more effective at helping injured employees return to work faster and with significantly lower costs. Spinal-related injuries and conditions are a big part of this group.

When it comes to work-related low back pain, the risk of the same disability happening again is lower for chiropractic patients than for those treated mainly by a physical therapist or a physician. According to a study published in the April 2011 issue of the Journal of Occupational and Environmental Medicine, patients receiving only or mostly physical therapy had “the highest proportion of recurrent disability (16.9%).” Those getting only or mostly chiropractic care, or no maintenance care at all, had “the lowest proportion of recurrent disability (6.5% and 5.5%).”

A report from the Centers for Medicare & Medicaid Services found Medicare beneficiaries were happy with the chiropractic care they received and were pleased with the relief of their symptoms. Nearly 95% of the patients said they did not have to wait any longer than one week for appointments. And, almost all the patients in the study reported their chiropractors listened carefully and spent sufficient time with them.

A study in Spine focused on patients with chronic lower back pain: those who received one month of chiropractic treatment, followed by nine months of maintenance therapy, had significant improvement in pain and disability.

A report, Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans? concluded with good news for health care plans. Chiropractic care is highly cost-effective and is a good value when compared to medical physician care. Also, chiropractic care works better than other therapies for treating low back and neck pain.

Patients in a Medicare “demonstration project” (released in 2010) had high marks for the care they received from their chiropractors. On a scale of 1 to 10, 87% of the patients surveyed gave their doctors of chiropractic a score of 8 or higher. And, a whopping 57% rated their chiropractor a perfect 10.

Research on the effect of chiropractic care on later surgery

As mentioned previously, large studies that compare general chiropractic care to surgical treatment can prove the overall value of chiropractic, in terms of any number of measurements, depending upon the study design. Such evidence can bolster the general argument that chiropractic care should be seen as a viable treatment option to surgery for treating lower back pain.

In contrast, studies that examine the association between chiropractic care and surgical intervention for a specific health issue are smaller and often focused on outcomes. These studies can show how chiropractic care for a specific condition can reduce the need for surgical intervention later on. Although these studies use smaller cohorts, they allow for a direct association of outcomes between chiropractic and standard care on later surgery.

How to avoid surgery: the association between spinal manipulation and discectomy

A recent article published in the journal BMJ Open used this direct association method to examine outcomes from either spinal manipulation or standard care on the need for later surgical discectomy to treat lower back pain as a result of disc herniation or sciatica.4

Records for 11,570 patients, with newly diagnosed lumbar disc herniation or sciatica, were divided evenly into chiropractic or standard care cohorts. Those in the chiropractic care cohort were matched to those in the standard care cohort, according to variables that could influence the likely need for future surgery, such as age, sex, and weight.

At the end of one year, 1.5% of patients sorted into the chiropractic care cohort underwent surgical discectomy, as compared to 2.2% of patients in the standard care cohort. At the two-year follow-up point, 2.4% of patients receiving standard care required surgery, in contrast to only 1.9% patients who underwent chiropractic care.4

Although the findings from the BMJ Open study are promising, its comparative approach should be applied to future randomized, controlled trials, as well as to other common conditions in regard to how to avoid surgery for patients for which chiropractic care has been shown beneficial.

This comparative-outcome methodology can help predict potential outcomes for chiropractic care, not only in terms of patient outcome for specific conditions, but also provider costs, and fewer patients going under the knife as a first option to pain or injury.

References

  1. Weeks WB, Leininger B, Whedon JM, et al. The association between use of chiropractic care and costs of care among older Medicare patients with chronic low back pain and multiple comorbidities. Journal of Manipulative and Physiological Therapeutics. 2016;39(2):63-75.e2.

  2. Fritz JM, Kim J, Dorius J. Importance of the type of provider seen to begin health care for a new episode low back pain: Associations with future utilization and costs. Journal of Evaluation in Clinical Practice. 2016;22(2):247-252.

  3. Legorreta AP, Metz RD, Nelson CF, et al. Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs. Archives of Internal Medicine. 2004;164(18):1985-1992.

  4. Trager RJ, Daniels CJ, Perez JA, et al. Association between chiropractic spinal manipulation and lumbar discectomy in adults with lumbar disc herniation and radiculopathy: Retrospective cohort study using United States’ data. BMJ Open. 2022;12(12):e068262.