Posted by: Wagner IT | April 20, 2011

LBP: What Works?

What will you do?

Chiropractic vs. Medication

What works best for Acute Low Back Pain?

Studies show there is no contest.

Usually when we experience acute low back pain, we first reach for the medicine cabinet, and second, call our primary care physician. Before you make an appointment with your PCP, consider what is routinely done all over the world, visit your chiropractor. Hopefully, the findings in this article will convince you to give your body a faster, safer, more effective chance for recovery.

J. Adam Wagner, D.C.

Read the results made available in the December 2010 edition of The Spine Journal:

A recent Study[i] conducted by the Chiropractic Hospital-based Interventions Research Outcomes or (CHIRO), which was published in the most frequently cited spine research journal in the world[ii], The Spine Journal, the facts are clear; “Patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little to no improvement with the usual care they receive from a family physician.”

What’s more, after 16 weeks of care, patients who were treated by medical doctors “saw almost no improvement in their disability scores, were likely to still be taking pain drugs…and were unlikely to be referred to a doctor of chiropractic.”

The study was a randomized controlled trial which compared clinical practice guidelines including spinal manipulation administered by chiropractors, to “family physician-directed usual care” involving prescription or over-the-counter medications, and other treatments. Researchers found overwhelmingly that chiropractic spinal manipulation therapy, or CSMT, is “associated with significantly greater improvement in condition-specific functioning” than the family physician directed “usual care”.

Study Details:

The study incorporated two groups;

The SC, or “study care” group, receiving acetaminophen, a “progressive walking program” and up to four weeks of lumbar chiropractic spinal manipulative therapy.

The UC, or usual care group, receiving the primary physician’s discretionary recommendations for a variety of treatments, and referrals for studies to massage therapists, kinesiologists, and/or physiotherapists.

The participants were first seen by a spine physician and randomly assigned to either of the study groups. All care was provided at a hospital-based clinic. A Roland-Morris Disability Questionnaire (RDQ) was used at the beginning of care and again at 16 weeks, but also at 8 and 24 weeks.

The Findings:

Both groups showed improvement in 2 areas; physical functioning and bodily pain, but, the UC group “uniquely showed no improvement whatsoever in back-specific functioning (RDQ scores) throughout the entire study period.”

The study also found:

“The addition of NSAIDs and a form of spinal manipulative therapy or mobilization administered by a physiotherapist to the lumbar spine, thoracic spine, sacroiliac joint, pelvis, and hip (compared with a detuned ultrasound as placebo manipulative therapy), to family physician ‘advice’ and acetaminophen were shown to have no clinically worthwhile benefit when compared with advice and acetaminophen alone.”

More Findings:

After 16 weeks, “78% of patients in the UC group were still taking narcotic analgesic medications on either a daily or as needed basis.” (Only 6 percent of this group received chiropractic care.)

Condition-specific improvement after 16 weeks “clearly favored the SC group, with mean RDQ improvement scores of 2.7 in the SC group compared with only 0.1 in the UC group.”

While the difference in improvement “was not quite as significant at 8 weeks,” it was found to be “clearly significant at 24 weeks of follow-up.”

Get your life back!

The Conclusion:

“Evidence-based clinical practice guidelines have been established for acute mechanical low back pain in many countries around the world, but sadly, most primary care medical doctors don’t follow these guidelines.”

In my practice, I am pleased to report that, my efforts to develop relationships with area family practice and internal medicine physicians have enjoyed some measure of success. Many of my patients are referred directly to me by leading area medical doctors. Unfortunately, I still see too many patients who have been referred to too many specialists and have been exposed to far too many laboratory studies before they get to my office. My goal is to affirm the efficacy of the care my patients receive to every physician in the area, and to honor and respect the benefits of our complimentary relationship to ensure our patient’s optimum relief of their pain and discomfort.

Enjoy every phase of YOUR life!

If you have a primary care physician or specialist that you would like me to contact with more information about what I do at Vital Link Chiropractic, please email me at I would be pleased to contact them personally.

[i] Bishop PB, Quon JA, Fisher CG, Dvorak MFS. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) 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;10:1055-1064.
[ii] Brunarski D. “Impact of the Chiropractic Literature.” Dynamic Chiropractic, Dec. 2, 2010;28(25).

To read the entire article:

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