Research

The following information comes from www.chiro.org and is used by permission. Please visit their web site to learn more about chiropractic research.

Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association: An Additional 3-year Update

J Manipulative Physiol Ther 2007 (May); 30 (4): 263–269

A new retrospective analysis of 70,274 member-months in a 7-year period within an IPA, comparing medical management to chiropractic management, demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 83% pharmaceutical costs when compared with conventional medicine IPA performance. This clearly demonstrates that chiropractic nonsurgical nonpharmaceutical approaches generates reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone.

Effects of a Managed Chiropractic Benefit on the Use of Specific Diagnostic and Therapeutic Procedures in the Treatment of Low Back and Neck Pain

J Manipulative Physiol Ther 2005 (Oct); 28 (8): 564–569

For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs . This effect was greater on a per-episode basis than on a per-patient basis.

Cost-effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain

J Manipulative Physiol Ther 2005 (Oct); 28 (8): 555–563

Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction. Chiropractic care appeared relatively cost-effective for the treatment of chronic LBP. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulation efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis. This evidence can guide physicians, payers, and policy makers in evaluating chiropractic as a treatment option for low back pain.

Comparative Analysis of Individuals With and Without Chiropractic Coverage: Patient Characteristics, Utilization, and Costs

Archives of Internal Medicine 2004 (Oct 11); 164 (18): 1985–1892 ~ FULL TEXT  

A 4-year retrospective claims data analysis comparing more than 700,000 health plan members within a managed care environment found thatmembers had lower annual total health care expenditures, utilized x-rays and MRIs less, had less back surgeries, and for patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode-related costs ($289 vs $399).

The authors concluded: “Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care.”

Cost Effectiveness of Physiotherapy, Manual Therapy, and General Practitioner Care for Neck Pain: Economic Evaluation Alongside a Randomised Controlled Trial

British Medical Journal 2003 (Apr 26); 326 (7395): 911 ~ FULL TEXT

A hands-on approach to treating neck pain by manual therapy may help people get better faster and at a lower cost than more traditional treatments, according to this study. After seven and 26 weeks, they found significant improvements in recovery rates in the manual therapy group compared to the other 2 groups. For example, at week seven, 68% of the manual therapy group had recovered from their neck pain vs. 51% in the physical therapy group and 36% in the medical care group.

A Comparison of Chiropractic Student Knowledge Versus Medical Residents

Proceedings of the World Federation of Chiropractic Congress 2001 Pgs. 255

A previously published knowledge questionnaire designed by chief orthopedic residents was given to a Chiropractic student group for comparison to the results of the medical resident group. Based on the marking scale determined by the chief residents, the Chiropractic group (n = 51) showed statistically significant higher average grade than the orthopedic residents. Expressed in other terms, 70% of chiropractic students passed the knowledge questionnaire, compared to an 80% failure rate for the orthopedic residents.

Lower back pain

The medical “debate” has been going on for years…is spinal adjusting (a.k.a manipulation) effective for Low Back Pain? The original Meade study (British Medical Journal 1990) demonstrated that chiropractic was much more effective for LBP than conventional medical care.

In 1993 the province of Ontario, Canada hired the esteemed health care economist Pran Manga, PhD to examine the benefits of chiropractic care for low back pain (LBP) and to make a set of recommendations on how to contain and reduce health care costs. His report A Study to Examine the Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain cited research demonstrating that: (1) chiropractic manipulation is safer than medical management for LBP; (2) that spinal manipulation is less safe and effective when performed by non-chiropractic professionals; (3) that there is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management; (4) and that there would be highly significant cost savings if more management of LBP was transferred from medical physicians to chiropractors. He also stated that “A very good case can be made for making chiropractors the gatekeepers for management of low-back pain in the Workers’ Compensation System in Ontario.”

In 1994 Medicine was horrified when the Agency for Health Care Policy and Research (AHCPR) confirmed the untested, questionable or harmful nature of many current medical therapies for LBP , and also stated that, of all forms of management they reviewed, only chiropractic care could both reduce pain AND improve function.

Meade did a 1995 follow-up study in British Medical Journal, that once again demonstrated that those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals, especially for chronic (long-term) LBP!

A recent study in SPINE Journal revealed that health care expenditures for back pain sufferers were a staggering $90.7 billion in 1998 and that prescription drugs accounted for more than 13% of that figure. Considering that muscle relaxants are associated with slower recovery, and that steroid injections offer minimal relief, one has to ask why drug use costs continue to climb? Even care by physical therapists has been shown to prolong low back pain.

A chronic pain study at the University of Washington School of Medicine recently compared which treatments were most effective at reducing pain for neuromuscular diseases and found that chiropractic scored the highest pain relief rating (7.33 out of 10), scoring higher than the relief provided by either nerve blocks (6.75) or opioid analgesics (6.37).

In December 2004, the British Medical Research Council published 2 papers in the British Medical Journal demonstrating both the efficacy and cost-effectiveness of chiropractic compared with medical management. These two papers found:

  • Manipulation, with or without exercise, improved symptoms more than medical care did after both 3 and 12 months
  • The authors concluded: “We believe that this is the first study of physical therapy for low back pain to show convincingly that both manipulation alone and manipulation followed by exercise provide cost effective additions to care in general practice.”