McKinney Chiropractor Practices Research Commentary; Comparing Chiropractic Care Vs. Medical Care for Low Back Pain

McKinney Chiropractor Practices Research Commentary

by Dr. Anthony Vasile

Chiropractic for Low Back Pain!

Chiropractic for Low Back Pain!

Comparing Chiropractic Care Vs. Medical Care for Low Back Pain

a UCLA Low-Back Pain Study

A review of

Hertzman-Miller RP, Morgenstern H, Hurwitz EL, Yu F, Adams AH, Harber P, Kominski GF. Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care. Results from the UCLA low-back pain study. Am J Public Health. 2002 Oct;92(10):1628-33. doi: 10.2105/ajph.92.10.1628. PMID: 12356612; PMCID: PMC1447298.

Research Reviewed by Dr. Anthony Vasile

 

Summarized Review of Conclusion

 

What this research proved is chiropractic care for low back pain (LBP) is the most effective type of treatment available. Chiropractic care showed increased satisfaction due to a reduction of pain and increased function compared to receiving treatment from medical providers. In addition to the positive results from the Spinal Manipulative Therapy (chiropractic adjustment), provider communication with the patient about treatment plans and self-care advice increased patient satisfaction. Appropriate communication showed more concern and gave more encouragement to the patient to take an active role in their own care. It is imperative that patients understand the 3 factors of health and take responsibility of their life to truly get to a state of homeostasis and wellness. And remember to go with Chiropractic for Low Back Pain!

Below I have referenced key quotes from this randomized controlled trial of research to help summarize the results.

 

Quotes from the Article:

 

“In this randomized trial, chiropractic patients were more satisfied with their back care providers after 4 weeks of treatment than were medical patients.”

 

Hertzman-Miller RP, Morgenstern H, Hurwitz EL, Yu F, Adams AH, Harber P, Kominski GF. Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: results from the UCLA low-back pain study. Am J Public Health. 2002 Oct;92(10):1628-33. doi: 10.2105/ajph.92.10.1628. PMID: 12356612; PMCID: PMC1447298.

 

“We found that receipt of self-care advice and explanation of treatment had strong estimated effects on patient satisfaction. These findings are consistent with previous studies that demonstrate associations between the amount of information patients receive and their degree of satisfaction.”

 

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995; 152:1423–1433.

 

“We conclude that providers in managed care organizations may be able to increase the satisfaction of their low back pain patients by communicating advice and information to patients about their condition and treatment.”

 

Hertzman-Miller RP, Morgenstern H, Hurwitz EL, Yu F, Adams AH, Harber P, Kominski GF. Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: results from the UCLA low-back pain study. Am J Public Health. 2002 Oct;92(10):1628-33. doi: 10.2105/ajph.92.10.1628. PMID: 12356612; PMCID: PMC1447298.

 

Introduction to the Research

 

The purpose of this research was to examine the satisfaction of patients when visiting a chiropractor for treatment of LBP or a medical doctor for the treatment of low back pain in a managed care organization. To achieve patient satisfaction patients must have a reduction of pain, increased function, increased understanding why they are in pain and increased knowledge about the treatment plans to get them to a state of wellness. This study was looking at the difference in treatment between chiropractors vs. medical doctors. Currently one third of back pain patients seek out chiropractic and the other two thirds seek medical doctors. As a doctor when I look at the current opioid epidemic, it is imperative that we take a closer look to the methods of care. Chiropractic spinal manipulative therapy has been shown to be the safest, most effective, most cost-efficient treatment for low back pain compared to any other treatment. A patient’s understanding of care, treatment time and education on healthy lifestyle choices to prevent recurrence are also key components to not only satisfaction but to successful outcomes.

 

Research Methodology

 

A field coordinator and office staff identified patients presenting with back pain to a chiropractor, physician, nurse practitioner, or physician assistant at any study site. Each patient who agreed to participate in the study received a screening history, physical exam and signed an informed consent to care. The subjects were randomized into 4 groups. Medical care with physical therapy (MDPt), medical care alone (MD), chiropractic care with physical modalities (DCPm), and chiropractic care alone (DC). Treatment was at the provider’s discretion, except for the limitations placed on the DC group because subjects could not be blinded to their treatment assignment. During the first 4 weeks of follow-up, patients assigned to the chiropractic groups were treated by 1 of 3 primary providers and those assigned to the medical groups were treated by 1 of 33 primary providers. Subjects completed written questionnaires at baseline and after 2 weeks of treatment and were then interviewed by telephone at 4 weeks.

Satisfaction with the medical and chiropractic provider was measured at 4 weeks with a 10-item index. The index included 3 items on general health practices, stress reduction and other physical activity. 7 items on the management of back pain.

Baseline low back pain disability and changes in disability from baseline to 2 weeks were measured with the Roland-Morris Disability Questionnaire, a 24-item scale with possible scores ranging from 0 (minimal disability) to 24 (severe disability).

 

Research Findings

 

This study showed the mean satisfaction score was 30.6 for medical patients and 36.1 for chiropractic patients. Chiropractic patients reported

  1. A greater reduction of low back pain
  2. Receiving more self-care advice and an explanation of their treatment than did medical patients.
  3. Visiting their primary providers more often.

The study proved that chiropractic care is not only the best at reducing low back pain but showed how important it is to educate patients about what it takes to be and stay healthy.

 

Research References

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety.  The references used in this article by the authors of this article are listed in the attached PDF.