Chiropractic: Good Option? Reasonable Option? Simply Quackery?
In April of 2017 The American College of Physicians (ACP) released updated guidelines on the care of acute, subacute and chronic back pain. Shortly thereafter a meta-analysis was published in the Journal of the American Medical Association (JAMA). Both publications build on an ever-growing body of evidence demonstrating that spinal manipulation is a good treatment option.
The Joint Commission, an independent, not-for-profit organization, accredits and certifies more than 20,500 health care organizations and programs in the United States, including every major hospital. Joint Commission accreditation and certification are recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. In 2015 the Joint Commission included chiropractic care in their Standard for Pain Management.
As early as 2000, chiropractic care (PL107-135 and PL108-170) was included in the military and VA healthcare systems. More recently because of the overwhelming success and patient satisfaction of chiropractic in the VA system, Congress has expanded access to chiropractic care. At the time of this writing, the U.S. Senate introduced bill S-609, mandating that all major VA facilities have a chiropractor on staff.
Because of the current state of science, Blue Cross Blue Shield of Alabama now requires up to 6 weeks of conservative management before considering advanced imaging or aggressive treatment options and specifically lists spinal manipulation as one of the conservative care options.
So is chiropractic care THE answer to back pain, neck pain, headaches and maybe other NMS conditions? Of course not. But the profession does offer an effective treatment option for these patients. According to the ACP spinal manipulation is at least as effective as any other treatment currently available. Chiropractors provide over 90% of all the spinal manipulative services provided in the U.S. and are unequivocally the most highly trained and skillful providers to do so. If one considers the safety record, patient satisfaction rates and cost associated with SMT, as well as some of the side effects of traditional treatment strategies, i.e., opioid dependency, and the societal costs associated with it, it seems almost unreasonable not to consider specifically chiropractic care.
Yet today the primary care community still has not widely utilized chiropractic as an option in their care pathways. Why not? Perhaps for some a bias was ingrained during their training (see Wilk v. American Medical Association, 895 F.2d 352 (7th Cir. 1990)). Or perhaps the opinons of Stephen Barrett, M.D., and the website www.quackwatch.com have influenced them negatively. For others perhaps they see the wide variation in chiropractic practice and therefore have questions or even concerns about what "brand" of chiropractic care is best. Perhaps there are more frivolous reasons such as simple course of habit or sociative norms. Whatever the case may be the Hug Chiropractic Clinic staff has been working diligently to build bridges with the primary care community in Birmingham, Alabama. As the science continues to shed light on this extremely safe, cost and clinically effective treatment paradigm, we encourage primary care and other physicians who treat spine pain and headaches to take a serious look at chiropractic as an option for their patients.
We welcome opportunities to present current data and discuss how we may be able to work together for the mutual benefit of NMS pain patients. Please contact us at firstname.lastname@example.org or call us at 205.967.0280 for details and lunch schedules.
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Brad Russell, D.C., Proprietor & Clinic Director
Hug Chiropractic Clinic
3153 Cahaba Heights Road
Birmingham AL 35243