Why were chiropractors overlooked in spine care article?
The article “Rethinking spine care” (March 24, p. 14) was certainly timely. But I found it interesting that nowhere in the article was mention made of chiropractic care in addressing the current boondoggle of spine management in this country, even though it’s highly recommended as a first-line treatment by both national and international guidelines, as well as prestigious scientific journals.
Of the 56 million Americans who have back pain, only 5% need surgery, says Dr. Charles Rosen, an orthopedic surgeon and co-founder of the Associ- ation for Medical Ethics. Yet there are nearly 1.2 million unsuspecting patients undergoing surgery for spinal problems every year who face a failure rate approaching 74% (Spine, Feb 15, 2011). Thus, even in the face of evidence-based research, spine surgery rates continue to escalate, leaving a wake of impairment and disability, as well as opioid dependency and huge costs.
Enter the solution: conservative care. In the wake of the Patient Protection and Affordable Care Act and its mandate to reimburse providers for evidencebased care only, systems are turning to conservative providers to treat that 95% cohort of spine pain patients who might otherwise undergo an unnecessary surgical procedure. The most recent, better-designed studies strongly suggest that chiropractic care can not only reduce the immediate cost of an episode of care, but reduce spine pain recidivism. Two representative studies worth noting are: Consumer Reports (May 2009), surveyed more than 14,000 consumers and found that 88% of those who tried chiropractic manipulation said it “helped a lot,” and 59% were “completely” or “very” satisfied; the Journal of Occupational and Environmental Medicine (April 2011) published a joint study from the Center for Disability Research at the Liberty Mutual Research Institute, the University of Massachusetts Lowell and the Center for Health Economics, Epidemiology and Science Policy of United Biosource Corp., that concluded that there is a two-to-one chance of disability under a physical therapist’s care rather than care under a doctor of chiropractic (D.C.), and a 60% chance of disability under M.D. care, rather D.C. care. The study recommended chiropractic as a first-line treatment.
The major savings from chiropractic management come from fewer and lower costs of auxiliary services, far fewer hospitalizations and a highly significant reduction in recurrence and chronicity of spine problems, as well as disability.
All major research in the field of spine care now recommends chiropractic care prior to advanced imaging and/or a surgical consult. Yet chiropractic is systematically overlooked—why? Peter Furno, D.C. Indianapolis