Chiropractic treatment belongs in conservative approach to spine care

We appreciate the article “Rethinking spine care” (March 24, p. 14) and the important issues it raises regarding the healthcare system’s need to reassess treatment of spinal problems in light of new information on the sharp increase in the frequency of spinal surgery, associated runaway costs, and the disappointment and mixed results that many patients experience.

The article notes that some hospitals have implemented programs requiring surgical candidates to undergo physical therapy and psychological counseling prior to their procedures. This conservative care approach should include all legitimate, evidence-based options. In respect to spinal pain, particularly low-back pain, chiropractic services have been proven to provide effective relief for many patients and at a lower cost to payers. One study (Liliedahl et al., 2010) looking at the records of 85,000 Blue Cross and Blue Shield beneficiaries in Tennessee over a two-year period, found that low-back pain care initiated with a chiropractic physician saved 40% on healthcare costs.

Another (Keeney et al., 2012) observed that 42.7% of back pain patients whose first provider was a surgeon eventually underwent surgery, compared with only 1.5% whose first provider was a chiropractic physician.

Back pain and the disability it causes is a problem in the U.S. and globally, and it only stands to worsen with the aging population. If more health systems partner with conservative care providers to screen and treat those patients whose conditions can be helped without surgery, we will see lower costs, better outcomes and more satisfied patients.

Anthony Hamm, D.C.

President American Chiropractic Association