In February 2017, the Annals of Internal Medicine reported that back pain treatment should not include drugs as an initial treatment according to the best available evidence. They advised using a number of treatments that included exercise, manipulation of the spine, massage, and other modes of care that were movement-based. They told doctors to avoid using a medication, tests, and invasive procedures.
Chiropractors are the only group that uses a number of the treatments on the Annals of Internal Medicine list. Consumer Reports and Men’s Health has praised the profession citing that for back pain, chiropractic has the best satisfaction ratings for back pain treatment.
The evidence has been ignored by many healthcare providers who continue to recommend muscle relaxants and pain killers, even though there is no evidence supporting their usage. The segmentation of care model medical providers uses often leads to chronicity, higher costs, and riskier procedures.
Most patients have heard this, so why are so few doctors understanding they need to recommend chiropractors, physical therapists, first?
On the other hand, United Healthcare’s Optum health division said openly that people should be seeing chiropractors and therapists first because they save them money.
A recent paper published in the BMJ (British Medical Journal) confirmed that there is no evidence for their continued usage.
Why are insurance companies making copayments so high to get the most appropriate care for an acute episode? I have often heard medical providers complain that their poor habits are often reinforced by insurance carrier policies of high deductibles and high copayments which make appropriate care less affordable.
It is well known that delaying care which happens with medication first approaches to care is likely to result in chronic lower back pain, a more difficult problem to manage and treat.
The public should follow the evidence even if their doctor doesn’t. Since chiropractic visits rarely require a referral, for lower back pain, see a chiropractor first. If your problem requires medical attention, a chiropractic physician will refer you to the appropriate medical physician. The good news is that is rarely necessary for most lower back pain.
What should you expect on your initial chiropractic visit?
- A thorough holistic history
- An evaluation of your feet, legs, lower back, and upper body.
- As long as there are no medical conditions preventing it, treatment is usually rendered on the initial visit.
- Many patients have foot problems related to their lower back pain and the doctor may recommend foot orthotics if needed.
What is chiropractic treatment like?
- Chiropractors will utilize manipulation of the spine and extremity to improve the way you move and function.
- Exercises to retrain and strengthen dysfunctional areas of the body.
- Soft tissue techniques such as myofascial release treatment or instrument-assisted soft tissue methods such as Graston to improve how you move.
- Active evaluation and treat- test – treat protocols to make sure the treatment had the desired effect on that visit.
Who should you see first for lower back pain? Think Chiropractic first. You can book online using this link.