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HAVE BACK PAIN Are you OVERPAYING for relief Are you getting the BEST care

By Dr. Scott E. Rosenthal

Ever see the majestic figure of a Humpback whale off the bow of a boat? Ever feel the rush of hitting the lottery? Ever experience the accomplishment of pushing to the end of a marathon? Ever shout with joy from winning a reality game show? Ever gaze down at the earth from Mount Everest? I certainly hope that you polish off many of the items that fill your bucket list. Unfortunately, another bucket list exists with items that most Americans will experience, but wish they wouldn't! This list contains events that embarrass, terrify and hurt. I may not be able to help you avoid producing an unexpected bodily sound at a board meeting, or keep bad luck or poisonous spiders out of your way, but I can provide you with valuable insights for the best and most cost-effective ways for handling an event that happens to nearly all Americans - lower back pain!

It is estimated that up to 85% of people will experience back pain at some point in their lives.1 As one of the most common reasons for seeking a doctor's care, the treatment of back pain costs all of us over 50 billion per year.2 Additional indirect costs, such as lost time from work and the resulting drop in productivity, are estimated to cost up to an additional 19.8 billion each year.3,4 With such costs, one must examine treatment options where value for the dollar is brought into play. This is especially important in today's environment where health care spending is spiraling out of control.

Treatment of low back pain is frequently conducted by one of three types of physicians- medical, osteopathic or chiropractic. The cause of lower back pain is the result of one or a combination of factors ranging from intervertebral disk disorders, spinal misalignments to muscular issues. The medical and osteopathic treatment toolbox primarily contains use of narcotic, analgesic, nonsteroidal, and muscle relaxant drugs. The chiropractic approach focuses on gentle corrective adjustments of the spine, tailbone and pelvis.

When insurance companies provide equal access thus allowing doctors to do what they are trained to do without hurdles or restrictions, what is the outcome? Which would you choose? Which doctor would provide you with the best result at the best price? The question of cost was answered by a 2010 study that evaluated lower back pain care for Blue Cross Blue Shield of Tennessee’s fully insured members over a two-year period. The 85,000 BCBS subscribers had open access to medical/osteopathic or chiropractic physicians without the need of a referral. The study's conclusion brings good news, not only to your aching back, but to your wallet:

“This study provides a unique opportunity to evaluate an insured population with open access (including identical copays and deductibles) and an unlimited number of visits to providers via self-referral. Our results support a growing body of evidence that chiropractic treatment of low back pain is less expensive than traditional medical care. We found that episode cost of care for low back pain initiated with a chiropractic physician is less expensive than care initiated through an MD or osteopath. Paid costs for episodes of care initiated with a doctor of chiropractic were almost 40% less than episodes initiated with an MD... Our results suggest that insurance companies that restrict access to chiropractic care for low back pain may, inadvertently, be paying more for care than they would if they removed these restrictions.”

The researchers estimated that allowing chiropractic-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.5 This significant savings is not only important to insurance carriers, but for the uninsured patient faced with a sea of decisions regarding how to spend precious healthcare dollars.

You now know that chiropractic care provides a more economical solution to back pain, but is it more effective? A 2010 study at the University of British Columbia found that care for lower back pain by chiropractic physicians is significantly more effective than “usual care” provided by medical physicians.6

What if your back condition is more serious than expected and you are told you need surgery? For years, patient's have put off surgical recommendations and found relief through the hands of a chiropractor. At times, this took a degree of bravery and defiance to go against the medical recommendation and concern of family and friends. For most, the payoff was tremendous and surgery, with it's potential adverse reactions, was avoided. New research has found that initially seeing the doctor of chiropractic is a must prior to getting the most common form of surgical intervention for herniated (“slipped”) lower back disk problems. The 2010 study published in the Journal of Manipulative and Physiological Therapeutics compared chiropractic care to lumbar microdiskectomy surgery. The following was revealed:

60% of the patients who were considered surgical candidates improved EQUALLY with chiropractic care as to those who received surgery!

The research also found that the patients who eventually needed surgery had equal results, even when the surgery was delayed by undergoing chiropractic care first. The study's authors concluded that chiropractic care should be considered as a first line of care for herniated lumbar disks that cause sciatica.7

When examining the expense of this common back surgery it was found that if chiropractic is utilized first, it will save $2.75 billion dollars each year.8 Surgery is roughly 12 times the cost of a full-course of chiropractic care.

If (it may be more realistic to say “when”) you have lower back pain, the following list will provide you with the best plan of action:

  • Act promptly!
  • Make the doctor of chiropractic your first contact.
  • If you have already received other care, it's never too late to get a second opinion from a chiropractor.
  • If you are facing lumbar surgery, consult with a doctor of chiropractic to see if you are a candidate for care.
  • Insist that your insurance plan offers unrestricted access to chiropractic care.

The doctor of chiropractic is trained to find the cause of you pain, order appropriate tests when needed, and work with other healthcare professionals. His or her care is comfortable, cost-effective, evidence-based and highly effective. It provides patients with the best opportunity to avoid the risks, complications and expenses of drugs and surgery and provides the opportunity to naturally regain a more comfortable and functional life. If back pain is within your bucket of undesirables, empty it with chiropractic and start achieving the important items within your bucket of dreams and ambitions!

Dr. Scott Rosenthal provides quality chiropractic care to patients in Wilmington, Delaware. He also writes a monthly column in Living Well Magazine. Whether you're searching for effective pain relief or a way to boost whole body wellness, Rosenthal Chiropractic can help.

Call our office at (302) 999-0633 for an appointment today!

1. Furlan AD, Brosseau L, Imamura M, et al. Massage for lowback pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2002;27:1896-910.

2. AMA 2003;290:2443-54 and Spine 2006;31:3052-60

3. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003;290:2443-54.

4. Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC. Back pain exacerbations and lost productive time costs in United States workers. Spine 2006;31:3052-60.

5. J Manipulative Physiol Ther. 2010 Nov-Dec;33(9):640-3. Epub 2010 Oct 18. Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer.

6. Bishop PB, Quon JA, Fisher CG, Dvorak MF. The Chiropractic Hospital-based Interventions Research Outcomes study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine Journal, 2010

7. J Manip Physiol Ther 33:576 (2010)