This study published in the Journal Spine, points out there are guidelines based on the research for patients with acute mechanical low back pain (AM-LBP) and these recommendation have been internationally accepted and they include seeing a chiropractor for this low back pain. Yet despite this most people skip this step because their MD does not recommend it or their insurance company does not cover it and they utilize medications, cortisone injections, or maybe physical therapy first. If that does not work they move to surgery, and then another (future posts will address repeat surgeries and failed back syndrome).

This study is immensely important from what I’ve seen. My father is a chiropractor, I grew up thinking once there is solid research that recommends chiropractic everyone will use it because it’s safe and cost effective. I remember being very excited in 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released Clinical Practice Guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of diagnostic and treatment methods for acute low back pain and recommended chiropractic manipulation for back pain. This was going to change everything I thought. I was wrong, those guidelines were primarily overlooked by the medical and insurance industries and this trend continues to this day.

After chiropractic school, I worked for five years at night while I was building my Honolulu and San Francisco practices as a clinical reviewer for the California Workers Compensation system. There I had to evaluate whether a requested procedure (whether it’s surgery, a medication (occasionally Viagra-I will explain in a future post or ask me), chiropractic care, physical therapy, etc) was right for a patient at that particular time. Too often I saw conservative measures breezed over in favor of more expensive, more dangerous surgeries. Not to get on a soap box but the reason for this is MONEY and medical doctors, specifically surgeons, desire to maintain power. Yet it is important to note that even though guidelines are typically put together by medical doctors after reviewing the data the guidelines recommend chiropractic care but these recommendations are often overlooked by doctors in the field.

The study states, “Multicenter clinical trials have demonstrated that most AM-LBP patients do not receive CPG-based treatments”. This means in most studies to date low back patients do not receive clinical practice guidelines based treatments, aka they aren’t following what the guidelines directly recommend, which is chiropractic.

This study, published in the most well-respected medical journal on the topic of the spine,  looks at what would happen if the guidelines were enforced and chiropractors where fully utilized in the system rather than skipped over for medications or physical therapy, both of which have a place in the healthcare system but neither of which does what chiropractors do.

The study found that patients who received chiropractic care had significantly greater improvement in pain and function than medical care without the chiropractic component.

Hopefully now chiropractors will be better utilized for back pain patients this is important to all individuals who are suffering from back pain and not getting the relief the seek so are living in pain, stuck on or abusing pain medications, or worse have undergone a surgery that puts them at serious risk when there are safer research-supported options available.

Dr. Andrew Cohen, D.C. integrates much of what he learned from reviewing complex low back cases and research into his chiropractic practice. If you live in the Bay Area and are suffering from back pain schedule an appointment today online.