Tuesday, May 24, 2005

Back It Up

Back pain is one of the most common reasons why people seek medical care, accounting for more than $100 billion in annual health-care costs. It is the second-leading cause of doctor visits and hospitalizations. But, before you go under the knife or fill a prescription for painkillers, consider this: A new study shows that chiropractic care can significantly reduce the health-care costs, hospitalizations and surgery associated with back pain. The research was sponsored by American Specialty Health Plans, Inc., a health insurance company that provides coverage for complementary medicine. Results were published in the October 11, 2004, issue of Archives of Internal Medicine. In a retrospective claims-data analysis, researchers looked at the records of 700,000 members of a health plan that had chiropractic coverage and one million members of the same plan that had no chiropractic benefits. The difference in costs and treatments for those with access to chiropractic care was staggering. Versus the group without chiropractic benefits, those with chiropractic benefits were found to have...
*37% fewer imaging tests, such as X-rays and magnetic resonance imaging (MRIs).
*41% fewer hospitalizations.
*32% fewer back surgeries.
*28% overall reduction in cost of treatment.
Nearly everyone can expect to experience back pain at some point in their lives, says Jerome F. McAndrews, DC, a chiropractor in Claremore, Oklahoma, and a spokesperson for the American Chiropractic Association. Yet even though back pain is so common, conventionally trained medical doctors typically have a hard time figuring out what causes it. Frustrated by the absence of standardized physical examinations and diagnoses, physicians often end up ordering MRIs to get to the bottom of the problem. Unfortunately, this strategy can backfire, because most MRIs are "abnormal." Spinal abnormalities are actually quite common, and they usually have nothing to do with back pain... but a bulging disk on an MRI can lead to a recommendation for surgery even though the real problem may be weakness, stiffness or muscle spasms in the areas surrounding the joints. The fact is that most primary care practitioners have little training in the management of musculoskeletal conditions, says Dr. McAndrews. As a result, costs quickly add up as physicians order expensive tests and treatments. He worries that many conventional doctors are inclined to think that they can mechanically fix the problem with surgery. In contrast, chiropractors practice spinal manipulation, an approach that has been approved for low back pain by the US Department of Health and Human Services' Agency for Healthcare Research and Quality. Chiropractic's hands-on treatment utilizes leverage and exercises to adjust spinal structures back to their proper positions rather than modifying them with surgery and hoping that this will address the pain. If you have an acute injury -- say you threw out your back because you lifted a heavy box without bending your knees -- a chiropractor may be able to get you properly realigned in as little as one visit. Long-standing misalignments in the musculoskeletal system -- for example, if you have a crick in your neck or a pain in your hip and have been adjusting other body parts to favor it for months or years -- usually require multiple visits to the chiropractor. With either type of injury, surgery is generally not the answer for most people. Not only does the cost run into the tens of thousands of dollars, but other important factors to be considered are pain and discomfort, follow-up therapy, uncertain outcome, the possibility of long-term disability and last but certainly not least, the risks associated with any operation. Though not all chiropractic care is gentle (some can be dramatic and decidedly not gentle), surgery should only be used after therapies like chiropractic have been tried and exhausted. Dr. McAndrews notes that while chiropractic can certainly be helpful in emergency situations, its best use may actually be preventive maintenance -- just as it is better to take care of minor mechanical problems with your car before they develop into major ones, you should address minor aches, pains and maladjustments in your body before they deteriorate into major, debilitating conditions. To that end, Dr. McAndrews recommends yearly chiropractor visits. I always say, "Nothing is a panacea" -- not even chiropractic. However, adding chiropractic to your health-care coverage can result in a win-win situation, saving you time and pain, and saving your insurance company money. And who knows? Someday you may even see some of those savings passed back to you in the form of lower premiums. To find a licensed chiropractor in your area, go to the American Chiropractic Association's Web site at http://www.amerchiro.org/ or to the American Association of Naturopathic Physicians' Web site at http://www.naturopathic.org/.
A study in the journal Neurology warned of an association between neck cracking and stroke. If you are considering spinal manipulation, ask your chiropractor about the risk for stroke.

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