Hot off the presses of Risk and Insurance online. This is not a surprise, there have been many studies demonstrating the cost effectiveness of chiropractic. This one is important because it comes out when we are in the midst of healthcare reform. Will the most proven, most cost effective treatment be included in a significant way?
“Supporters of chiropractic treatment praised the findings, saying that the cost-effectiveness of the method has been documented in several studies.”
“Glenn Manceaux, president of the American Chiropractic Association, pointed to a study published in a 2005 issue of the Journal of Manipulative and Physiological Therapeutics that found chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes. In addition, a study published in a 2003 edition of Spine medical journal found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications, he said.”
“Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surgery and hospital-based care,” he said.
I’ll be the first to admit it– I don’t think this was a good idea but it seemed fun a few years ago. I’m probably the only chiropractor in San Francisco who dressed up. Here I am with my favorite patient Monica Levin. Thanks to Monica for providing the picture.
The first recommendation is to promote self-management. This means to suggest to patients with LBP to exercise and try to continuing doing ones normal activity, as much as possible. The next one is pain medication – first acetaminophen (unfortunately this has also been proven to increase the risk of cardiovascular events). The final recommendation is exercise or manual therapy (i.e. spinal manipulation) or acupuncture.
Another interesting feature is what the guidelines proscribe. All of the following are treatments/diagnostic tests that are NOT allowed (because they either don’t work or aren’t needed):
Medical/Surgical treatments
SSRIs for pain management
Facet injections
Radiofrequency facet joint denervation
IDET (Intradiscal Electrothermal Annuloplasty)
PIRFT (Percutaneous Intradiscal Radiofrequency Thermocoagulation)
Diagnostic tests:
Plain film x-ray under any circumstances
MRI to be offered only to rule out red flags or for surgical referral.
People always call our office and ask if they should see their doctor first before consulting me. Unfortunately it is very likely that your health care provider will ignore these and all other guidelines and do what they have always done, even if the scientific evidence indicate it is not effective.
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