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Chiropractic & Research

In 1993, for the first time in history, Congress authorized $1.8 million in Chiropractic research. $750,000 was allocated for research studies at chiropractic colleges involving the collaboration of doctors of chiropractic and medical doctors. The other section of the bill allocates an additional $1 million in funding to increase the chiropractic profession’s ability to assist in medically underserved rural areas. (Pub. Law 103-112)

*Acute Low Back Problems in Adults- U.S. Department of Health and Human Services
Chiropractic manipulation was recommended as a treatment of choice for acute low back pain by the Agency For Health Care Policy and Research, a division of the Department of Health and Human Services. These guidelines were published in December, 1994.

* Independent research authorities such as RAND Corporation, which reported in 1991 that spinal manipulation was now proven to be an appropriate treatment for most back pain patients. Shekelle, PG, Adams, A, et al. The Appropriateness of Spinal Manipulation for Low-Back Pain. RAND Corporation, Santa Monica, CA, 1992.

* Worker’s Compensation studies suggest a minimum 50% saving in overall costs when treatment is chiropractic rather than medical.

California, 1972: Half the work days were lost by chiropractic patients as compared to medical patients. Wolf, CR, (1974), Industrial Back Injury. Internation Review of Chiropractic, 26:6-7.

Wisconsin, 1978: Half the work days were lost by chiropractic patients as compared to medical patients. Chiropractic care about half the cost of medical care. Duffy, DJ, (1978), A Study of Wisconsin Industrial Back Injury Cases, University of Wisconsin, unpublished monograph.

Florida, 1986: The duration of disability was 51.3% shorter for chiropractic patients. The cost of chiropractic care was 58.8% less than medical care. Wolk,S (1988), An Analysis of Florida Workers’ Compensation Medical Claims for Back Related injuries, Foundation for Chiropractic Education and Research, Arlington, VA.

Utah, 1991: Chiropractic care outperformed medical care by a 10:1 margin in compensation costs. The number of work days lost under medical care was nearly 10 times higher than those receiving chiropractic care. Jarvis KB, Phillips RD et al (1991), Cost Per Case Comparison of Back Injury Claims of Chiropractic versus Medical Management for Conditions with Identical Diagnostic Codes, Journal of Occupational Medicine, 33(8): 847-852.

*The Meade Study A ten year government study in Great Britain showed that among all patients with severe and chronic pain, chiropractic patients improved more than medical patients. “If all the patients were referred for chiropractic instead of hospital treatments…there might be a reduction of some 290,000 days in sickness absence during two years saving about $21,580,000 in output and $4,814,000 in social security payments.” “…for patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly offers worthwhile, long term benefit in comparison with hospital outpatient management.”

Meade, TW, Dyer, S, et al. Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and hospital Outpatient Treatment, British Medical Journal, 2 June 1990, Vol.300, No.67137, pp. 1431-1437.

*The Meade Study- Follow-up The author did a three-year follow-up to the study which concluded that, “When chiropractic or hospital therapists treat patients with low-back pain as they would in day-to- day practice,those threated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals.” There was a 29% hreater improvement in patients treated with chiropractic compared with hospital care.

Meade, TW Randomized Comparison of Chiropractic and Hospital Outpatient Management for Low Back Pain: Results from an Extended Follow-up, British Medical Journal, 5 August 1995, Vol.311.

*The Duke Study Based on a literature review of several headache treatment options, a panel of 19 multidisciplinary experts concluded that spinal manipulations resulted in almost immediate improvement for cervicogenic headaches and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly-prescribed medication. Researchers concluded the following: Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic haedache when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity.”

McCrory DC, it al. Evidence Report: Behavioral and Physical treatments for Tension-type and Cervicogenic Headache. Duke University Evidence-Based Practice Center, Durham, North Carolina, January, 2001.

* In 1991, a Gallop Poll revealed that 90% of chiropractic patients felt their treatment was effective. A report in the Western Journal of Medicine in 1989 stated that patients of chiropractors were 3 times more satisfied with their care than patients of family practice medical doctors. Demographic Characteristics of Users of Chiropractic Services. The Gallup Organization, Princeton, N.J., 1991. Back Pain Care from Family Physicians and Chiropractors, Western Journal of Medicine, March 1989, Vol.150, pp. 351-355.

* The Manga Report, commissioned by the government of Ontario, Canada, in 1993, stated that chiropractic management is superior to medical management for patients with low-back pain – in terms of safety, scientific evidence of effectiveness, evidence of cost-effectiveness and patient satisfaction.

“There is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management.”

“Chiropractic services should be fully integrated into the health care system.” “There should be a shift in policy to encourage and prefer chiropractic services for most patients with low back pain.”

“Finally, the government should take all reasonable steps to actively encourage cooperation between providers, particularly the chiropractic, medical and physiotherapy professions. Lack of cooperation has been a major factor in the current inefficient management of low back pain. Better cooperation is important if the government is to capture the large potential savings in question and, it should be noted, is desired by an increasing number of individuals within each of the professions.

Manga P, Angus, D it al (1993) “The Effective and Cost-Effectiveness of Chiropractic Management of Low-Back Pain,” Pran Manga and Associates, University of Ottawa, Canada.

* The Virginia Assessment “The researchers conducted a through investigation between chiropractic and traditional medical treatment. The evidence shows that chiropractic care provides substantial benefits at a relatively low cost. They concluded that adding chiropractic benefits would have a very small impact on health insurance expenditures and might actually lower overall health care costs.” Schifrin, Leonard G. (1992), Chancellor Professor of Economics and Preventive Medicine, The College of William and Mary, Williamsburg, Va.

* University of Richmond Research “Researchers compared chiropractic care with treatment rendered by general practitioners, internists, surgeons, physicians, and non-physicians. When the treatment costs were compared, chiropractic care was the lowest. Total treatment costs were lower for those receiving chiropractic care, than for those receiving care from other types of practitioners. Researchers concluded that if chiropractic care was covered by insurance to the degree of other types of care, it would be the first choice by many patients.” Dean, David H., Ph.D., Schmidt, Robert M., Ph.D., A Comparison of the Costs of Chiropractors Versus Alternative Medical Practitioners, Bureau of Disability Economics Research, Robins School of Business, University of Richmond, January 13, 1992, Page 25.

* The New Zealand Report “In 1979, the government of New Zealand published an objective study of chiropractic. The commission concluded that spinal adjustments given by registered chiropractic doctors are safe, and that their education helps them assess and manage spinal problems at a very high level. Based upon the commission’s objective findings, chiropractic care was recommended to be a covered service under its Social Security and Accident Compensation Acts.” Chiropractic in New Zealand, Report of the Commission of Inquiry, 1979, Page 78.s

* The Colic Study When researchers compared spinal manipulation for the treatment of infantile colic to dimethicone (a medication for colic), they came to a simple conclusion: “Spinal manipulation is effective in relieving infantile colic.” Wilberg JMM, et al. Journal of Manipulative and Physiologic Therapeutics. October 1999; Vol.22, No.8, pp.517-522.

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