Chiropractic Treatment for Chronic Pain VS Other Professions

Back and neck pain are a chronic problem for many people. Work, computers, & stress are all major contributors to that fact. Chiropractic Care has been considered alternative care, almost like a voodoo science by the rest of the medical field due to a lack of understanding and a fear of competition from chiropractors who tend to produce better results with their treatment methods versus those of the MDs.

By the numbers:

6 in 10 adults experience chronic pain.

$80 Billion is spent each year in the US due to back and neck pain.

$64 Billion is lost due to decreased productivity at work.

What is chiropractic medicine?

To answer this question it is best to make a side-by-side comparison of the generalized approach of the major health professions out there.

Medical Doctor (MD)

These doctors are taught in two main fields; drugs & surgery. Their initial treatments usually involve anti-inflammatory meds and muscle relaxers that definitely have their place in acute, short-term pain. However, as the pain progresses their options tend to progress towards pain meds, steroid injections, and eventually surgery. Again, there are times when surgery is necessary to fix the problem, but many times the surgery causes more problems then it fixes. In my experience with patients, arthroscopic surgeries have a high success rate. Unfortunately, most back surgeries cannot utilize that technique and the results are 50-50 where there is a 50% chance that it will cure the pain for years and a 50% chance that it will make it worse. This makes the surgical option a very expensive coin flip. Medical Doctors are great for many things, but unfortunately, dealing with pain, especially from the spine, has never been a strong area for them.

Osteopathic Doctors (DO)

These doctors are trained as an MD – DC hybrid. They are trained similarly to MDs but with education and training in manual therapies and manipulative techniques. They could be the ultimate family doctor since they tend to have the most diverse knowledge base of all doctors. However, most do not utilize any of their training in the physical healing and therapeutic arts because it is simply much easier and efficient to treat patients with just meds and surgeries. It is a time issue. Most good chiropractors and good physical therapists spend a lot more time with the patients working hands on with them. Many medical doctors do not even see most of their patients anymore unless there is a complication as the can delegate the simpler cases to nurse practitioners and physicians assistants. A typical chiropractic or physical therapy visit is about 1hr unless the chiropractor is in a state that does not let them practice physical therapy even when they are trained in it, but that is another discussion entirely. So even though Osteopaths have the most potential of all doctors, pressure from insurance companies and lowered reimbursements most have essentially become MDs.

Chiropractic Doctors (DC)

Chiropractors are trained to be MDs who do not utilize medications or surgeries. I have always considered a mix between a medical doctor, physical therapist, and massage therapist. We are trained as primary care doctors and are able to diagnose any disorder an MD can. Our scope of practice, though, is limited to the musculoskeletal system. That is a good thing since it allows them to focus on the biggest problem area that is not well managed by the treatment methods of the other two doctors. They have a pure holistic approach and have a much larger education in nutrition. They are also trained as physical therapists and certified in physiotherapy (physiotherapist = certified physical therapist). The main difference is physical therapists are licensed in their craft because they have a bachelor’s degree in their field where chiropractors are trained within the doctoral program. The main difference between chiropractors and physical therapists is that chiropractors focus more on the spine, where as physical therapists focus more on extremities. Chiropractors can and do treat extremity issues, but the further away from the spine you get the better a physical therapist becomes for treating that problem.

Physical Therapists (PT)

Physical Therapists are what they sound like. They use physical and manual treatments to treat the body. They tend to be extremity specialists. Knees, elbows, wrists, ankles, major muscle rehab from permanent nerve damage are their forte. Unfortunately, the spine is not. All the physical therapists I know will treat every disorder by putting the patient on a bunch of weight resistance machines and treat the patient, as a trainer would do at a gym. They do this because it is easy, no one ever questions it, they are paid very well, and for extremities, it tends to work really well. The problem is, contrary to television commercials, the spine and core do not need strength training. They are perfectly strong enough for every day problems. Its endurance, coordination, and retraining the nervous system that’s the key and the only group of physical therapists that seem to get that are those that work for professional sports teams. PTs on professional sports teams would probably trump any other doctor or therapist because they are the elite of their profession and have a much better understanding of the interconnectedness of the whole body and how the kinetic chains of the body best respond to treatment.

PT vs. DC – special section

There has always been a rift between PTs and DCs, just like there has always been a rift between DCs and MDs. Chiropractors take a lot of work from them because the problems DCs focus on treating they treat better. PTs and MDs have joined together a bit against DCs in the past and PTs tend to have a much more favorable relationship with insurance companies. The main example is Medicare, which does not pay for any physical therapy if it is done by a chiropractor. I actually blame chiropractors for this because instead of fighting for equal treatment by the insurance companies and government for doing the same things that PTs are doing, many went the route of exploiting loopholes and trying to cheat the system. Therefore, it is their own fault.

The Studies

Time and again research has shown how spinal manipulation an manual therapies have succeeded by far over all other therapies and I wanted to share some of those articles here, all of which can be found in pubmed.gov, the #1 source of medical and health research articles.

1. January 2005: a long term study comparing chiropractic, acupuncture, and medication in treating chronic mechanical pain syndromes showed chiropractic as possibly the only treatment modality with significant long term benefits with medication coming in third

2. July 2011: Chiropractic management of postsurgical lumbar spine pain showed significant improvement, especially in surgeries involving a combination of discectomy, laminectomy, and/or fusion.

3. March 2012: Visceral responses to spinal manipulation in some individuals produce positive effects to function, although the reason is not yet understood.

There are many more studies there. Most are good, some negative. Most of the negative articles involve limited or biased data. The only articles I will warn against are the stroke articles, which have attempted to show that chiropractors cause stroke. This is not true. Chiropractors see more people who may have a stroke because neck pain and headaches can be a symptom of an upcoming stroke and thus they make up a higher percentage of their patients then other professions. In reality, the chance of getting a stroke at a chiropractic office is the same as going to a hair salon.

I wanted to make sure that people reading this know that it is not a pro chiropractic and bash everyone else. This is only focusing on spinal disorders. I have tried to make sure that I provided the pluses for the other professions and where they stand out over chiropractic. Chiropractors are trained in many areas, but their main expertise is in treating back and neck disorders. That is where they excel and if people want to avoid having to take lots of drugs or prevent surgeries, a chiropractor should be their first stop.