Low Back Pain
Low back pain is a very common condition, and one that is very expensive for
our health care system. Experts estimate that chronic back pain costs the US
about $100 billion each year in direct and indirect costs. As the authors of
a new study write:
One factor explaining these enormous costs is the high rate of recurrence
and chronic disability related to low-back disorders. It has been suggested
that only 10% of LBP patients generate more than 80% of the total costs
related to LBP.
Because of the enormous costs of treating chronic back pain, prevention is
an important goal. This current study set out to examine the role of
chiropractic in treating chronic low back pain. The authors studied 30
patients who had back pain for at least six months. All patients were
subjected to a one-month control period that consisted of no treatment. This
was included so that the researchers could observe the natural course of the
back pain symptoms.
After this baseline period, half of the patients (Group 1) received
intensive chiropractic treatment consisting of 12 treatments in one month,
then no treatments for nine months. The other half of the patients (Group 2)
received the same intensive treatment, but also received maintenance
chiropractic treatments every 3 weeks for nine months. At the end of the
nine-month period, both groups were again examined.
After analyzing the results, the authors found the following:
- Pain levels were reduced in both groups of patients. The intensive
month of chiropractic adjustments reduced pain, even without follow-up care.
- Disability levels, however, showed a different response. For the
patients with no continuing treatment, the disability levels returned to
their pretreatment levels on the Oswestry. The Group 2 patients who
received maintenance care continued to see improvement in disability
scores over the whole nine months.
The following graph illustrates the differences between the two groups on
disability levels:
The authors conclude:
This study appears to confirm previous reports showing that LBP and
disability scores are reduced after spinal manipulation. It also shows the
positive effects of preventive chiropractic treatment in maintaining
functional capacities and reducing the number and intensity of pain episodes
after an acute phase of treatment. Maintenance chiropractic care involving
spinal manipulation combined with other treatment modalities (exercises,
pain management program) should be investigated. Such combined interventions
may have a critical influence on pain, disability, and return to work.
*Descarreaux M, Blouin JS, Drolet M, Papadimitriou S, Teasdale N. Efficacy
of preventive spinal manipulation for chronic low-back pain and related
disabilities: a preliminary study. Journal of Manipulative and Physiological
Therapeutics 2004;27:509-514.*
