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Chiropractic Research Review

For Treating Chronic Low Back Pain, Look to Chiropractic

Although usually not life-threatening, back pain - particularly chronic low back pain (LBP) - is a significant cause of functional disability, and evidence suggests that up to 90% of the costs are attributable to only 5-10% of LBP patients.

The diffuse nature of back pain complicates definitive diagnosis and treatment strategies, resulting in wide variance in management between and within the health professions.

This feasibility study compared practice activities and one-month outcomes for 93 chiropractic patients and 45 medical patients with chronic, recurrent low back pain. Patients were drawn from 40 private chiropractic clinics in the Portland, Oregon metropolitan area; the outpatient clinic of the Department of Family Medicine at Oregon Health Sciences University; and five other Portland-area family medicine clinics. Chiropractic care included spinal manipulation and various forms of physiotherapeutic modalities; medical care frequently involved the prescription of anti-inflammatory agents. Chiropractic care averaged four patient visits, while medical care averaged only one patient visit.

image - Copyright – Stock Photo / Register Mark

Results: Patients treated by chiropractors showed better overall improvement and satisfaction at one month than patients treated by family physicians. Chiropractic patients showed improvement across all outcomes: pain severity (31% improvement); functional disability (29% improvement); sensory pain quality (36% improvement); and affective pain quality (57% improvement). By comparison, medical patients showed only minimal improvements (6% improvement in pain severity, 1% improvement in functional disability) while showing deterioration in sensory (29% deterioration) and affective (26% deterioration) dimensions of pain quality.

Satisfaction scores were also significantly higher in chiropractic compared with medical patients, raising the possibility that nonclinical factors may influence patient response to treatment. In their concluding remarks, the authors note the multifaceted nature of treating and preventing low back pain and suggest that "Chiropractors and family physicians need to be cognizant of the influence of nonclinical factors on patient progress."

Note: This is a very informative paper suggesting that patients with chronic LBP should consider chiropractic care. Tell your patients!

Nyiendo J, Haas M, Goodwin P. Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medical physicians: a practice-based feasibility study. Journal of Manipulative and Physiological Therapeutics, May 2000:23(4), pp239-45.
Reprints: Tel: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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