A new study finds that chiropractic and medical care
have comparable costs for treating chronic low-back pain,
with chiropractic care producing significantly better
outcomes. A group of chronic low-back patients who underwent
chiropractic treatment showed higher pain relief and satisfaction
with the care and lower disability scores than a group
that underwent medical care, according to an October 2005
study in the Journal of Manipulative and Physiological
Therapeutics (JMPT).
Although several cost-effectiveness studies outside
the United States have favorably compared chiropractic
to medical care, this new study is one of the first to
compare low-back treatment costs and outcomes within the
structure of the American health care system. In the United
States alone, back pain associated costs are estimated
to reach $48 billion this year, and, at any given time,
80 percent of the U.S. population suffers from back pain
– statistics that make this study especially pertinent,
according to the authors.
Specifics of the study:
The study involved 2780 patients with mechanical low-back
pain who referred themselves to 60 doctors of chiropractic
and 111 medical doctors in 64 general practice community
clinics in Oregon and one in Vancouver, Wa. Chiropractic
care included spinal manipulation, physical therapies,
an exercise plan, and self-care patient education. Medical
care consisted of prescription drugs, an exercise plan,
self-care advice, and a referral to a physical therapist
(in approximately 25 percent of cases). The costs of treatment
and patients' pain, disability, and satisfaction with
their health care were assessed at 3 and 12 months after
the initial visit to the doctor.
The office costs alone for chiropractic treatment of
low-back pain were higher than for medical care. However,
when costs of advanced imaging and referral to physical
therapists and other providers were added, chiropractic
care costs for chronic patients were 16 percent lower
than medical care costs. The differences between medical
and chiropractic total costs were not statistically significant
for acute or chronic patients. The study did not include
over-the-counter drug, hospitalization, or surgical costs.
Both acute and chronic patients showed better outcomes
in pain and disability reduction and higher satisfaction
with their care after undergoing chiropractic treatment.
The advantage of chiropractic care was clinically significant
in the chronic patient group at 3 months' follow-up, but
smaller in the acute group. Improvements in patients'
physical and mental health were comparable in both the
chiropractic and the medical group, with the exception
of physical health scores in the acute patients in the
chiropractic group, which showed an advantage over the
medical group.
"With their mission to increase value and respond to
patient preferences, health care organizations and policy
makers need to reevaluate the appropriateness of chiropractic
as a treatment option for low-back pain," concluded the
study authors.
- More articles
on Chiropractic
Reference
Source 125
November
16, 2005
