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Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence

Chiro.Org Blog: After controlling for demographic factors and multiple severity indicators, patients suffering nonspecific work-related LBP who received health services mostly or only from a chiropractor had a lower risk of recurrent disability than the risk of any other provider type. Even without an improvement in days until recurrent disability, our findings seem to support the use of chiropractor services, as chiropractor services generally cost less than services from other providers. […]

Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain

Chiro.Org Blog: The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest. These differences raise concerns regarding the use of physiotherapists as gatekeepers for the worker’s compensation system. […]

Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

Chiro.Org Blog: In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. […]

This On-site Chiropractic Clinic Is Saving a Minnesota Manufacturer Big Money

Chiro.Org Blog: And when it comes to the bottom line, the results have been better than Friendship Homes and Northwestern expected. For every $1 that the company has invested in the program, it is saving $8 by avoiding more-costly and less-effective treatments, spending less on insurance payments and keeping more workers on the job in the first place, which generates savings through less lost tine for workers and less overtime to compensate for absences. […]

A Systematic Review Comparing the Costs of Chiropractic Care to other Interventions for Spine Pain in the United States

Chiro.Org Blog: This review identified 25 cost comparison studies related to chiropractic care for spine pain in the US and published in English since 1993. Although findings from the studies reviewed generally suggested that chiropractic care may be associated with lower health care costs when compared to care from other HCPs, the methods used in these studies differed widely, limiting their interpretation and generalizability. Additional research using more rigorous methods is needed to determine if differences in health care costs noted in these studies are attributable to the type of health care received for spine pain or patient sociodemographic, clinical, or other factors that may be unrelated to health care. […]

Cost Analysis Related to Dose-response of Spinal Manipulative Therapy for Chronic Low Back Pain

Chiro.Org Blog: This study shows that manipulation can have a modicum of benefit in LBP-related pain and disability without significantly increasing treatment or societal costs. In the main results paper reporting pain and disability on 100-point scales, Haas et al found an 8.6-point advantage in pain (p=.002) and 7.5-point advantage in disability (p=.011) for SMT 12 compared to the control at 12 weeks. In this study, we found that this benefit may occur without significant increases in costs of treatment or lost productivity. […]

Cost-effectiveness of Spinal Manipulative Therapy, Supervised Exercise, and Home Exercise for Older Adults with Chronic Neck Pain

Chiro.Org Blog: Total costs for spinal manipulative therapy (SMT) + home exercise and advice (HEA) were 5% lower than HEA (mean difference: –$111; 95% confidence interval [CI] –$1,354 to $899) and 47% lower than supervised rehabilitative exercise (SRE) + HEA (mean difference: –$1,932; 95% CI –$2,796 to –$1,097). SMT+HEA also resulted in a greater reduction of neck pain over the year relative to HEA (0.57; 95% CI 0.23 to 0.92) and SRE+HEA (0.41; 95% CI 0.05 to 0.76). […]

Cost-Effectiveness Of General Practice Care For Low Back Pain: A Systematic Review

Chiro.Org Blog: Findings of this systematic review suggest that although GP care alone was often associated with lower treatment costs from the healthcare sector’s perspective, it may not provide a cost saving for society if the costs associated with loss of earnings or productivity are taken into account. When considering costs relative to effects, GP care alone may not be cost-effective in managing sub-acute or chronic LBP. Adding advice, education and exercise to usual GP care, clinical intervention and/or occupational rehabilitation, and acupuncture appeared to dominate over usual GP care. Adding exercise and behavioural counselling to usual GP care, adding exercise and/or spinal manipulation to guideline-based GP care, and using the Alexander technique also appeared cost-effective. The cost-effectiveness of GP care can be improved by referring patients to receive additional services, such as advice and exercise, or by the GPs providing the additional services themselves. […]

Cost-Effectiveness of Non-Invasive and
Non-Pharmacological Interventions for Low Back Pain

Chiro.Org Blog: Thirty-three studies were identified. Study interventions were categorised as: (1) combined physical exercise and psychological therapy, (2) physical exercise therapy only, (3) information and education, and (4) manual therapy. Interventions assessed within each category varied in terms of their components and delivery. In general, combined physical and psychological treatments, information and education interventions, and manual therapies appeared to be cost effective when compared with the study-specific comparators. There is inconsistent evidence around the cost effectiveness of physical exercise programmes as a whole, with yoga, but not group exercise, being cost effective. […]

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

Chiro.Org Blog: A major strength of the study was the large amount of low back pain claims made available to us for analysis. The data were from 3,159,362 claims generated by approximately 66,0000 persons over the 2000-2009 decade in North Carolina, in several different pathways of healthcare services. This study and the series of papers it has generated on the treatment of low back pain, neck pain [25] and headache, [26] provides unique economic examination for healthcare policy makers and legislators. When costs are viewed vertically as if in “silos” (eg, DC-only costs, MD-only costs), increasing utilization of one particular provider is seen as a net cost increase. However, when costs are viewed across the silos, as this study has done, an increase in utilization of one provider group can result in a net cost decrease given its effect on the patient population. This is an opportunity to view costs laterally versus a confined, vertical analysis. […]

Tracking Low Back Problems in a Major Self-InsuredWorkforce: Toward Improvement in the Patient’s Journey

Chiro.Org Blog: This comprehensive new study from the Journal of Occupational and Environmental Medicine reveals that chiropractic care costs significantly less than other forms of low back care, and appears to comply with guideline recommendations more closely than than any of the other 4 comparison groups. […]

Costs of Routine Care for Infant Colic in the UK and Costs of Chiropractic Manual Therapy as a Management Strategy Alongside a RCT for this Condition

Chiro.Org Blog: As effective treatment for children with infant colic remains elusive, the costs of managing the condition is gaining increasing attention. Although it is uncommon for clinicians to be quizzed about the cost-effectiveness of their treatments, [1] particularly where the clinicians’ services are covered by a national health plan, it is increasingly appropriate to ask this question, when prudence in health care expenditure is required. […]

Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials

Chiro.Org Blog: Preliminary evidence from this review shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. […]

Prevention of Low Back Pain: Effect, Cost-effectiveness, and Cost-utility of Maintenance Care – Study Protocol for a Randomized Clinical Trial

Chiro.Org Blog: This study protocol describes a randomized controlled clinical trial in a multicenter setting investigating the effect and cost-effectiveness of preventive manual care (chiropractic maintenance care) in a population of patients with recurrent or persistent LBP. Four hundred consecutive study subjects with recurrent or persistent LBP will be recruited from chiropractic clinics in Sweden. […]

The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

Chiro.Org Blog: This study provides evidence of the comparative effectiveness of chiropractic care relative to medical-only services on the functional health of older adults during acute episodes of back care. Our results are the first to show the importance of examining chiropractic use within an episode of care in traditional practice settings, rather than focusing on visit frequency alone. Moreover, we evaluated the effects of the treatments received during the episodes on ADLs, IADLs, and LBFs, which are critically important measures that inform patients, clinicians, and payers about the benefits and harms of certain treatments relative to others. Given the literature supporting a minimally effective chiropractic treatment level for back problems, this research provides additional support that such therapeutic levels are indeed beneficial in terms of protecting older persons from functional declines and self-rated health over as much as 2 years. […]