The effectiveness of Chiropractic care

"A new study finds that care for low back pain initiated with a doctor of chiropractic saves 40% on health care costs when compared with care initiated through a medical doctor. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care that they would if they removed such restrictions." Journal of Manipulative and Physiologic Therapeutics, December, 2010.

"Patients receiving chiropractic care, on average 4.4 treatments over three weeks, showed a clinically and statistically significant improvement in self-rated hip pain. The chiropractic patients also had clinically important, but not statistically significant, improvement in Hip Disability & Osteoarthritis Outcome Subscales (HOOS) function in daily living, and hip related quality of life. Chiropractic care may provide a short-term benefit in decreasing hip pain for patients with hip osteoarthritis waiting for hip arthroplasty (surgery)." Journal of Manipulative and Physiologic Therapeutics, August, 2010.

"The report, "Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans?" concludes that chiropractic care "is likely to achieve equal or better health outcomes at a cost that compares very favorably to most therapies that are routinely covered in U.S. health benefit plans" and that covering chiropractic services for neck and low back pain "will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage that clinical outcomes improve." Mercer Health and Benefits, December, 2009.

"An Actuarial Analysis of the Impact of Chiropractic Care on the Costs of Medical Care for Patients with Common Spinal Diagnoses" indicates "that spinal patients who seek chiropractic coverage have materially lower health care costs than those who do not. The difference is consistent in all years and in between the two data sets. The difference range from 10% to 23% lower costs for those patients who sought [chiropractic] care." Milliman USA, September, 2009.

"Patients who received chiropractic or physical therapy had lower total health care costs and were less likely to have surgery than demographically similar Wellmark members who did not receive such services, and overall, 89% of all patients receiving physical medicine services reported improvement of at least 30% within 30 days." Wellmark Blue Cross and Blue Shield 2008 Physical Medicine Pilot on Quality, August, 2009.

"Conclusion: Spinal manipulation provided better short and long-term functional improvement, and more pain relief in the follow-up than either back school or individual physiotherapy." Clinical Rehabilitation, January, 2010.

"This study suggests chiropractic management as less expensive compared with medical management of back pain when care extends beyond primary care." Journal of Manipulative and Physiological Therapeutics, November, 2009.

A demonstration project was conducted relative to the usage of chiropractic care in Medicare. The Centers for Medicare & Medicaid Services (CMS) did a formal evaluation of the project which lasted 18 months ending in March , 2007. "Chiropractic recipients reported positive reactions to the chiropractic care they received in terms of relief of symptoms and satisfaction with care." Letter from Michael Leavitt, Secretary of Health and Human Services to the President of the Senate and the Speaker of the House of Representatives, October, 2008.

"The preponderance of the evidence for efficacy, including recent high-quality trials, and the estimated very low risk of serious adverse events support spinal manipulative therapy and mobilization as viable options for the treatment of chronic low back pain. Spinal manipulative therapy and mobilization are at least as effective as other efficacious and commonly used interventions." The Spine Journal, February, 2008.

"The interpretation of our preliminary data indicates that menstrual pain associated with primary dysmenorrhea was alleviated by treating motion segmental restrictions (spinal misalignments) of the lumbosacral spine with a drop table technique (chiropractic manipulation)." Journal of Manipulative and Physiological Therapeutics, 2008.

Listed under Mayo Clinic's Top 10 Complementary Therapies is spinal manipulation. One of the criteria used at the world-renowned Clinic is"...Does it meet a need that cannot be met by conventional medicine?" Listed under BEST TREATMENTS is "Spinal Manipulation. Practiced by chiropractors,...this hands-on technique adjusts the spine to properly align the vertebrae with muscles, joints and nerves. Standout scientific evidence. At the University of California, Los Angeles, School of Public Health, a study of 681 patients with low back pain showed that chiropractic care was as effective as medical care, including painkilling drugs, in relieving discomfort." Mayo Clinic's Top 10 Complementary Therapies, Mayo Clinic College of Medicine, Amit Sood, M.D., 2008.

“Good medicine is about putting the patient first and chiropractors are an important part of the total healthcare team. Chiropractic works. I know this because my partner is a chiropractor, and I’m proud of that fact.” Carlon Colker, M.D., Internal Medicine, Greenwich, CT, USA Today, 4/25/08

“I view chiropractic care as an essential component of our healthcare system. While conventional medicine does a good job of screening for the early detection of disease, I believe that the regular use of chiropractic actually prevents early stages of disease from evolving into crisis disease care management. I have referred many patients to chiropractic care and they have benefited from this wellness approach to maintaining health. I have avoided long-term pharmaceutical usage and/or acute surgery by using chiropractic as a non-pharmaceutical, non-surgical alternative. Remember, pharmaceutical and/or surgery should be utilized as a last resort – only when more natural, less invasive modalities are unavailable or ineffective.” Richard Sarnat, M.D., President of Alternative Medicine Integration, Highland Park, IL, USA Today, 4/25/08

“Chiropractors are increasingly becoming important members of the traditional healthcare team, providing valuable contributions to a patient’s health and well being. I can attest to this on a professional and a personal level. Following a car accident three years ago, I had the benefit of conservative chiropractic and orthopedic care and thus avoided surgery.” Sana Khan, Ph.D., M.D., Radiologist, Beverly Hills, CA, USA Today, 4/25/08

" evidence synthesis suggests that therapies involving manual therapy (manipulation) and exercise are more effective than alternative strategies for patients with neck pain..." Spine, 2008.

Chiropractic and hypertension
A pilot study was conducted to begin scientifically evaluating the observation that some patients experience a decrease in blood pressure following manipulation of the cervical spine (neck). For this study, 50 people were treated for eight weeks. The researchers concluded that “...restoration of the Atlas alignment (first cervical vertebra) is associated with marked and sustained reductions in blood pressure similar to the use of ...drug ... therapy.” Journal of Human Hypertension, G. Bakris et al, May, 2007

"Overall patients who have chronic mechanical spinal pain syndromes and received spinal manipulation gained significant broad based beneficial short-term and long-term outcomes. For patients receiving acupuncture, consistent improvements were also observed, although without reaching statistical significance. For patients receiving medication, the findings were less favorable." Chronic Mechanical Spinal Pain 2005

"For chronic spinal pain in general, when compared to acupuncture and traditional medical approaches, chiropractic has generally been shown to be more effective." Journal of Manipulative and Physiologic Therapeutics, 2005.

"Low back pain patients with chiropractic coverage in their insurance plan needed less surgery and fewer x-rays than patients on the same insurance plan without chiropractic coverage." Archives of Internal Medicine, 2004.

"Whiplash injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment." Journal of Orthopaedic Medicine, 1999.

"...93% of the 28 patients studied retrospectively were found to have a statistically significant improvement following chiropractic care. Chiropractic care in this study consisted of spinal manipulation, PNF (stretching) and cryotherapy." Injury, 1996.

chiropractic vs physical therapy
"At three years the results confirm the findings of an early report that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice, those treated by chiropractic derived more benefit and longer term satisfaction than those treated by the hospital." British Medical Journal, 1995.

"For patient with acute low back symptoms without ridiculopathy, the scientific evidence suggests spinal manipulation is effective in reducing pain…" United State Department of Health and Human Services, Agency for Healthcare Policy Research, 1994.

"On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors has shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate." The Ontario Ministry of Health, Canada, 1993.

"In Washington State in a study of 500 patients suffering from back pain, patients receiving care from a M.D. took an average of 39.7 days to return to normal activity, while the chiropractic patients were back to work in just 10.8 days." Journal of Family Practice, 1992.

"Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after twelve months." British Medical Journal, 1992.

"For the first time representatives of the medical community have gone on record stating that spinal manipulation is an appropriate treatment for certain low back pain conditions. " Rand Corporation, 1991.

"For patients with low back pain in whom manipulation is not contraindicated, chiropractic most certainly confers worthwhile long term benefit in comparison to standard hospital outpatient management." British Medical Journal, 1990.

"The only difference that I can see is that the patients at John F. Kennedy (hospital) get chiropractic manipulations. And in my experience, the patients at J.F.K. almost without fail get out of the hospital in a week. At Lutheran (hospital), it usually takes, oh, not uncommonly 14 days." Per Frietag, M.D. and Orthopedic Surgeon.


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