Who Should You See For Back Pain, a Chiropractor or an MD?
This will be the most important article you have ever read about back pain, musculoskeletal pain, and treatment.
Please take the time to read it.
It will radically transform ideas about musculoskeletal treatment.
- What treatment is more effective for getting people out of pain?
- How does the person do over time?
- Does the pain return?
Researchers set out to determine what is most effective in people who have started having Back Pain.
The results were published in the prestigious journal, Spine.
The Study, “A Comparison Of Spinal Manipulation Methods And Usual Medical Care For Acute And Sub-Acute Low Back Pain: A Randomized Clinical Trial.”
The back pain study was a randomized controlled trial with 6 month follow up.
- The results were that 94% of the Chiropractic group had at least a 30% reduction in low back pain at week 4.
- In the medical care group, 56% had at least a 30% reduction in low back pain at week 4.
- This means that seeing a doctor of chiropractic was 38% more effective that seeing a medical doctor.
- The study also found that people are best served when informed of non-medication treatment for low back pain before electing riskier, less effective treatments.
The chiropractic adjustment performed by doctors of chiropractic, achieves a greater reduction in low back pain compared with common medical treatments.
Low back pain is one of the top reasons someone seeks healthcare.
- About 50% of US adults experience low back pain each year.
- About 25% adults have back pain in the last 3 months.
- Back pain is the most common cause of disability for people under 45 .
In other words, how we commonly deal with back pain isn’t working.
It’s leading to ongoing suffering for those suffering from it… and there are huge numbers of people in this group unfortunately.
What’s most commonly done for back pain?
Generally people try taking over the counter pain relievers.
When this doesn’t help, then people usually go see their family doctor or maybe an Urgent Care facility.
Other research has looked at basic musculoskeletal competency that would allow the healthcare practitioner (an MD, a doctor of physical therapy, or a doctor of chiropractic) to properly evaluate a musculoskeletal problem.
A quick look at the article…
A 2007, article by Humphreys, Sulkowski, et al reported, that Medical School might not devote enough time to the musculoskeletal system saying,
“It has been estimated that less than 5% of the undergraduate and graduate medical curriculum in the United States is devoted to musculoskeletal medicine.”
This is very disproportionate to the number of patients seen for these conditions.
“A study by Childs (et al) on the physical therapists’ knowledge in managing musculoskeletal conditions found that only 21% of students working on their master’s degree in physical therapy and 25% of students working on their doctorate degree in physical therapy achieved a passing mark on the Basic Competency Evaluation (in musculoskeletal system).”
Researchers looked at what chiropractors learn while receiving the doctorate of chiropractic…
“The typical chiropractic curriculum consists of 4800 hours of education composed of courses in the biological sciences (ie, anatomy, embryology, histology, microbiology, pathology, laboratory diagnosis, biochemistry, nutrition, and psychology), chiropractic sciences, and clinical sciences (clinical diagnosis, neurodiagnosis, orthopedics, rheumatology, radiology, and psychology).”
“As the diagnosis, treatment, and management of musculoskeletal disorders are the primary focus of the undergraduate curriculum as well as future clinical practice, it seems logical that chiropractic graduates should possess competence in basic musculoskeletal medicine.”
The authors looked at competency in understanding the musculoskeletal by profession.
The results were published in this paper for the Basic Competency Examination of the musculoskeletal system.
The following numbers indicate the percentage of each profession that was able to achieve a 73% or higher…
- Recent medical graduates (18%),
- Medical students, residents, and staff physicians (20.7%),
- Osteopathic students (29.6%),
- physical therapy (Masters level PT, 21%),
- physical therapy (doctorate level PT, 26%),
- Chiropractic students (51.5%).
These numbers are dramatic.
Chiropractic students were on average more than twice as likely to have competency in musculoskeletal disorders.
Interestingly, once a chiropractor graduates and develops experience seeing patients with musculoskeletal disorders it’s likely the gap would be much greater.
These numbers tell a real story about who a person suffering from musculoskeletal problems should see… clearly it’s a chiropractor.
Getting back to the most common treatment, going to see a family doctor for back pain…
Commonly, treatment here would be some combination of prescription pain relievers, muscle relaxers, and often steroids.
If the pain continues, as the research above shows that it very often does then people are generally sent to specialists like an orthopedic surgeon.
At this point, they may end up having surgery or may get other more aggressive treatments ranging from other medications to injections, etc.
This is not to say that these other treatments don’t have a place. Of course, all treatments may be able to help someone depending on the situation.
Many people end up experiencing chronic back pain and unfortunately far too many end up being disabled.
The vast majority never see a chiropractor, even though chiropractic is a proven safe and more effective treatment for their back pain.
It just doesn’t make sense.
This is why so many people end up having ongoing pain and suffering that for many could’ve been taken care of simply by seeing a chiropractor.
Many people end up experiencing significant side effects from the medications as we’ve seen with the COX 2 inhibitors like Vioxx that killed so many innocent people before it was finally pulled from the market…
And the opiate epidemic is from people experiencing ongoing pain being put on opiates because often other medical treatments weren’t working leading to massive amounts of additional suffering and unfortunately death…
And the steroids causing problems in people like gaining a lot of bodyfat or destroying their blood sugar…
And even the over the counter medications causing problems ranging from stomach and kidney damage to heart attacks.
Each person is different and those with particular problems may not be able to use certain treatments.
Many people also have surgery for their back problem without ever seeing a chiropractor, even though the AMA itself recommends seeing a chiropractor first.
We’ve seen research showing that if a person sees a surgeon instead of seeing a chiropractor first that they are more than 28X more likely to have surgery.
Other research has shown chiropractic care was safe and as effective as surgery for disc herniations causing sciatica radiating leg pain.
It should be noted that in some cases, it works best to see both an MD and a DC (chiropractor).
In fact, in many cases seeing both is the best option.
The problem is you probably have to do it on your own because the massive number of people that would benefit from chiropractors that see their MD are never referred to one.
It’s generally because MDs really don’t know anything about Chiropractic which is why the FDA recently recommended that MDs learn more about Chiropractic’s important role in treating pain.
As mentioned earlier in this post, you do not need a medical referral to go to a chiropractor.
Reference:
Spine (Phila Pa 1976). 2015 Feb 15; 40(4): 209–217.
A comparison of spinal manipulation methods and usual medical care for acute and sub-acute low back pain: a randomized clinical trial
Michael Schneider, DC, PhD, Mitchell Haas, DC, MA, Ronald Glick, MD, Joel Stevans, DC, and Doug Landsittel, PhD
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326596/
Other medical references are listed on the linked articles.
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