Chiropractic Cost-Effectiveness Supplement

The Chiro.Org Blog

SOURCE:   Virginia Chiropractic Association

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The following studies detail the cost effectiveness and overall efficacy of chiropractic care, and the procedures that doctors of chiropractic provide their patients.

This presentation is divided into several parts:

  • Background studies, detailing that LBP is much more complex than the literature leads us to believe;

  • Cost-Effectiveness Studies;

  • Worker’s Compensation Studies (National studies) and

  • Worker’s Compensation Studies (State specific studies)


Prognosis in Patients with Recent Onset Low Back Pain in Australian Primary Care: Inception Cohort Study
British Medical Journal 2008 (Jul 7); 337: a171 ~ FULL TEXT

This study contradicts the Clinical Practice Guidelines that maintain that recovery from acute low back pain is usually rapid and complete.   Their findings with 973 consecutive primary care patients was that recovery was slow for most patients, and almost 1/3 of patients did not recover within one year (when following standard medical recommendations).

This study was designed to determine the one year prognosis of patients with low back pain. 973 patients with low back pain that had lasted less than 2 weeks completed a baseline questionnaire. Patients were reassessed through a phone interview at six weeks, three months and 12 months. The study found that the prognosis claimed in clinical guidelines was more favorable than the actual prognosis for the patients in the study. Recovery was slow for most patients and almost 1/3 of patients did not recover within one year.


Low Back Pain In A General Population. Natural Course And Influence Of Physical Exercise–A 5-Year Follow-Up
Spine. 2006 (Dec 15); 31 (26): 3045-51

This study contradicts the common belief that low back pain will extinguish with simple core exercises. This study provided significant benefits for only 1 out of 5 LPB sufferers.   Researchers followed 790 patients who initially sought care for low back pain from 70 different caregivers. After 5 years, only 21% of patients studied reported no continued pain while only 37% reported no disability. Pain and disability scores dropped significantly at 6 months, then remained flat at 2 yrs and 5 yrs. Nonspecific regular exercise did not affect recovery. Between 27% and 66% of the study population experienced a recurrence of low back pain.


An Examination Of Musculoskeletal Cognitive Competency In Chiropractic Interns
J Manipulative Physiol Ther. 2007 (Jan); 30 (1): 44-49

Prior studies have concluded that musculoskeletal medical education is inadequate; yet, musculoskeletal complaints are one of the most common reasons for seeking physician care.  
The researchers in this study compared the results of 154 fourth-year chiropractic interns that completed the Basic Competency Examination in musculoskeletal medicine. Most interns passed the test with results that were considerably better than those of recent medical graduates and physical therapy doctorate students. The chiropractic intern scores were also higher than those of orthopedic staff physicians. The 51%-64% success rate of chiropractors was almost double the 20%-30% rate of medical students and doctors.


Clinical Course in Patients Seeking Primary Care for Back Or Neck Pain: A Prospective 5-Year Follow-Up Of Outcome And Health Care Consumption
Spine. 2004 (Nov 1); 29 (21): 2458-65

In this study the results of a questionnaire mailed to patients who had sought primary care for nonspecific back or neck pain were reviewed. The researchers attempted to examine the long term clinical course of back and neck pain in the group of primary care patients. Researchers found that about 50% of the original patients continued to report pain and disability at both the one-year and five-year follow-up, however the outcome scores did not deteriorate overall. Researchers concluded that due to the frequency of recurring or continual pain in patients, health policies and clinical decision models for long-term outcome must allow for these factors.


Estimates And Patterns Of Direct Health Care Expenditures Among Individuals With Back Pain In The United States
Spine. 2004 (Jan 1); 29 (1): 79-86

In this study researchers analyzed data from a 1998 Medical Expenditure survey. $26 billion was attributed to back pain. Individuals with back pain spent 60% more on overall health care than those without back pain. This cost analysis study conflicts with the experts that claim back pain is a benign, self-limiting condition.

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