3063 New Back Pain "Clinics" Sprout Up at Wal-Mart
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Dynamic Chiropractic – September 13, 2004, Vol. 22, Issue 19

New Back Pain "Clinics" Sprout Up at Wal-Mart

Is Retail Behemoth Going Behind Chiropractic's Back?

By Editorial Staff
Two years ago, the world's largest employer dropped the hammer on the chiropractic profession when Wal-Mart Stores, Inc., announced that effective Jan. 1, 2003, it would no longer provide coverage for chiropractic services to its employees. The company didn't offer any explanation for its decision, but merely announced in one of its newsletters, Open Enrollment News, that chiropractic services would no longer be covered. This from a business that, less than two months after the announcement, set a then-single-day sales record of $1.43 billion on Nov. 29, 2002.

If that wasn't enough, the retail giant has now added insult to injury by partnering with a Colorado company that offers treatments designed to strengthen back muscles to relieve pain ­ and all without the services of a doctor of chiropractic.

Earlier this year, the Denver Post reported on a relationship between Wal-Mart and America's Back, a private company that has opened back pain clinics in nine selected Wal-Mart superstores throughout Colorado, and plans to open four more by the end of the year. The clinics, conveniently located at the front of each store, charge $10 for a few minutes of care on equipment similar to Nautilus weight machines and devices found at rehabilitation clinics, and are the brainchild of a man who personally "guarantees" a person's back will get better after being treated.

"I wanted to put it in an environment that is accessible to everybody," says America's Back Chief Executive Officer Alan Pitts, who founded the company in August 2002. "Everybody knows where a Wal-Mart is."

According to the America's Back Web site, patients who visit a clinic for care work with a "certified trainer," who develops a "customized plan" to improve the health and fitness of the patient's lower back. The program uses "unique technology" to isolate and strengthen the back muscles, thus alleviating low back pain.

According to the Denver Post article, however, the employees who run the America's Back clinics aren't licensed, educated health care professionals such as chiropractors or medical doctors. The "certified trainers" are so named simply because they have been trained on how to use the company's proprietary equipment. Instead of performing a thorough examination and diagnosis, the "customized plan" consists of the "trainer" asking the customer a series of questions about their back health. Customers are then required to sign a form that releases the company from any liability before being treated on the equipment.

As for the "unique technology" touted by the clinic? It consists of a lumbar extension machine, which restrains a person's hips and legs so that the lower back muscles are isolated and used to push a series of weights. Exercising with the weights strengthens those muscles and helps to relieve pain. While the technology may be somewhat new in the retail store landscape, it is hardly "unique": lumbar extension machines have been used by health care professionals for decades, and dozens of studies on their effectiveness have been published.

"I Personally Guarantee Your Back Will Get Better"

A search on the America's Back Web site revealed no information on Mr. Pitts' educational background or his personal experience with back pain. However, a statement by Mr. Pitts on the site detailes the reasons why the company was created, and guarantees that patients will get better ­ provided they continue being treated at an America's Back clinic.

"I started America's Back just over a year ago because ordinary people like you and I did not have access to specific technology that can reduce low-back pain.

"There is a permanent solution for low-back pain. If you spend five minutes once a week at one of our facilities, I personally guarantee your back will get better."

Interestingly, Mr. Pitts does not say how long patients must continue being treated weekly before a "permanent solution" to their back pain will occur. This raises the obvious question: If being treated at America's Back provides a "permanent" remedy, as Mr. Pitts suggests, why would someone have to keep returning to a clinic every week for care? ]
Still Cashing in on Chiropractic?

It's no secret that back pain is a multibillion-dollar business. It is the second-leading cause for doctor visits in the United States (behind colds and related respiratory infections). Each year, more than 65 million Americans suffer at least one episode of back pain ­ and spend upwards of $25 billion to treat it. All told, back pain sufferers cost the U.S. more than $100 billion annually in medical bills, disability and lost productivity at work. For those reasons alone, it makes sense that a company such as Wal-Mart would form a relationship with an organization related to back pain care.

Nevertheless, some health care providers have taken issue with the new clinics, on the grounds that it is unwise to try and treat back pain without first determining its cause. Stefan van Duursen, clinical director for Denver Physical Therapy, notes that there is no one-size-fits-all treatment for back pain. The condition can be complicated and can sometimes be a precursor to more serious disorders, such as a tumor or disease.

"A general cure? I'd be careful with that," van Durrsen said.

Others see a different reason for Wal-Mart's partnership with America's Back ­ money. The more a person is in pain, the more likely that person is to spend money on items that will relieve the pain ­ and the more money spent on back pain, the less that person has to spend on other things.

"It gives us a unique outlet to take care of our customers in another fashion," explaines Sharon Weber, a spokesperson with Wal-Mart, about the back pain clinics. "People have so little time."

"Big-box retailers are trying to recreate the main street," adds Pam Stubing, an analyst for the New York City investment firm Ernst & Young. "The more you're going to stay within the store, the more you're going to shop ­ and buy."

And while Wal-Mart no longer provides chiropractic coverage for its employees, it continues to make money on chiropractic products and services in ways other than the addition of the America's Back clinics. A search of the company's Web site (www.walmart.com) on June 8, 2004, revealed no less than 80 chiropractic textbooks for sale, including many reference materials used in the typical chiropractic college setting, some of which were offered at substantial savings. More than half of the books had a sale price of over $50, even after adjusting for Wal-Mart's highly publicized discount service.


  1. Alsever J. In-store back-pain clinics ride on shoulders of Wal-Mart. Denver Post, April 25, 2004.
  2. Harrison J. World's largest employer axes chiropractic. Dynamic Chiropractic, Nov. 30, 2002. www.chiroweb.com/archives/20/25/20.html.
  3. Business brief, April 13. Rocky Mountain News, April 13, 2004.
  4. "It's easy." Accessed at the America's Back Web site (www.americasback.com), June 8, 2004.
  5. Newsweek examines back pain. Dynamic Chiropractic, May 20, 2004. www.chiroweb.com/archives/22/11/13.html.
  6. Search for "chiropractic." Search conducted on the Wal-Mart Web site (www.walmart.com), June 8, 2004.
  7. "Welcome to America's Back." Accessed at the America's Back Web site (www.americasback.com), June 8, 2004.

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