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Chiropractic Research Review

Chiropractic Favorable to Medical Care for Chronic LBP

Four out of five adults suffer from back pain at some point in their lives, and most do not seek medical intervention. Most of those who do seek care go to a chiropractor or a primary care physician.

Information is needed to determine the outcome of each form of low back pain (LBP) treatment and the predictive variables of chronic LBP.

This study had three objectives: to determine long-term outcomes of LBP treatment; to evaluate prognostic factors; and to appraise the efficacy of medical
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vs. chiropractic care in back- and leg-pain patients. Eight hundred thirty-five patients of 60 chiropractors and 111 MDs were involved in the study, in which pain, disability, and satisfaction were measured at six and 12 months. Researchers used tools including the Visual Analog Scale and the Revised Oswestry Disability Questionnaire to determine outcomes.

Results: In general, long-term pain and disability were similar in chiropractic and medical patients, with both groups showing substantial improvement from treatment. There were a few significant differences, however. The primary results are listed below:

* Chiropractic care showed better outcomes than traditional medical care for patients with radiating pain below the knee combined with LBP, though not for LBP alone or LBP/pain above the knee.

* Overall, chiropractic patients were more satisfied with all aspects of their care than medical patients.

* Regarding leg pain, pain below the knee was seen in 40% of MD patients vs. 28% of DC patients; no leg pain associated with LBP was observed in 27% of MD patients vs. 41% of DC patients.

* The most accurate prognostic factors were baseline outcome values; below-knee pain combined with doctor type; low income; smoking; comorbidity; and depression.

Differences in studies of LBP prognosis may make interpretation of results difficult, according to the authors, but these studies are still key to physicians in predicting treatment outcomes for patients with LBP.

Nyiendo J, Haas M, Goldberg B, et al. Pain, disability, and satisfaction outcomes and predictors of outcomes: A practice-based study of chronic low back pain patients attending primary care and chiropractic physicians. Journal of Manipulative and Physiological Therapeutics 2001:24(7), pp. 433-439.

Chiropractic Research Review

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