When Forbes magazine online published an inflammatory article disparaging the practice of chiropractic as “waste,” the chiropractic community responded, including a strongly worded response from the International Chiropractors Association. PHS Chiropractic consultants Dr. Christian Reichart, DC, CCSP; Dr. Curtis Turchin, MA, DC; and Dr. Mark Mandell, DC, MBA also weigh in on the controversy, offering a series of responses that you and your office can use to answer patient questions.
Over the past two decades, chiropractic has become one of the largest, most regulated and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys have even shown that chiropractors are used more often than any other alternative provider group, with patient use of chiropractic in the U.S. tripling over the last 20 years. [i]
Why? The data is clear: Chiropractic has proven benefits for acute and chronic pain, and has demonstrated a higher success rate in comparison to other treatment alternatives. It is also highly cost effective and results in higher patient satisfaction.
Chiropractic Compared to Other Treatment Alternatives for Acute and Chronic Pain
Studies have demonstrated that patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse. In addition, satisfaction scores were higher for chiropractic patients. [ii]
In a randomized, controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care. [iii]
In another randomized, controlled trial, researchers compared the effectiveness of manual therapy, physical therapy and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care. [iv]
Chiropractic patients have been found to be more satisfied with their back care providers after four weeks of treatment than medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks. [v]
Chiropractic care appears relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy, and manipulation-based therapy is at least as good as and, in some cases, better than other therapeutics. [vi]
Finally, one of the major flaws in the Forbes article is that the author fails to note that the largest profession performing manipulation and manual therapies is physical therapists, and there is no criticism of their use of the same procedures. Chiropractic does have a checkered and colorful past, with many incorrect viewpoints in its history. However, medicine at one time used blood letting and mercury as accepted treatment procedures, even though we now know those procedures killed many patients. If the author were to visit a chiropractic college today, he would see that the majority of the education is very scientifically based, much like medicine, dentistry, podiatry and physical therapy.
The proof for chiropractic’s effectiveness is widely available in published, peer reviewed, medically indexed scientific journals, powered by decades of research by institutions, government agencies and the tens of millions of people who are helped each year by chiropractors. The failure of Forbes to look at the mountain of material validating chiropractic’s effectiveness speaks to shoddy, biased journalism and has no place in the professional media world.
This article also does a disservice to many patients who have found success in managing their pain through chiropractic treatments. As with any treatment, we recommend that patients do their own research on their back pain or neck pain treatment options; in addition, patients should also research the practitioner to ensure that they’re doing the right thing for their body and their pain. However, articles like this only serve to limit patients’ choices.
Shame on Forbes for willfully disseminating misinformation that, at a minimum, frustrates hard-working chiropractors and, at worst, discourages and prevents patients from seeking the care they need.
[i] Meeker, Haldeman (2002), Annals of Internal Medicine
[ii] Nyiendo et al (2000), Journal of Manipulative and Physiological Therapeutics
[iii] Korthals-de Bos et al (2003), British Medical Journal
[iv] Hoving et al (2002), Annals of Internal Medicine
[v] Hertzman-Miller et al (2002), American Journal of Public Health
[vi] Haas et al (2005), Journal of Manipulative and Physiological Therapeutics