Study finds chiropractic saves 40% on care

A new study finds that low back pain care initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), the American Chiropractic Association (ACA) announced today. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.

The study, “Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer,” which is available online and will also be published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics, looked at Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population over a two-year span. The insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays.
Results show that paid costs for episodes of care initiated by a DC were almost 40 percent less than care initiated through an MD. After risk-adjusting each patient’s costs, researchers still found significant savings in the chiropractic group. They estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.

“As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day,” said ACA President Rick McMichael, DC. “It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs.”

                                           http://www.acatoday.org/press_css.cfm?CID=4178

This study reinforces a concept that many resolute chiropractic patients have known for years.  

As a chiropractor, I treat back pain all day long, every day.  I do most of my continuing education in spinal related issues, learning the newest concepts in this specific field.  I have built relationships with specialists in the medical arena to confer with in situations where chiropractic alone may not be the answer.   Since the vast majority of spinal pain does not require surgery or expensive testing, this means more "one stop" access to care for the patient versus the traditional medical system in which you visit the family practitioner who then may autonatically refer you for expensive testing, physical therapy and a specialist consultation.

A visit to the chiropractor should be your first choice when confronted with back pain.   This small step can save time and money.

If you have any questions, please feel free to call the office and we will be happy to help you.

Why does it keep “going out”? I wasnt doing anything.

If this is more than the third time that you have had a similar problem, you need to realize this condition is not stable and may always be weak. 

When the first injury occurred, if you did not treat it immediately and follow through to full recovery, the tiny muscles in your spine called the multifidus shrank on the side of the injury.  These multifidus muscles are the stabilizers of your spine.   They allow you to do complex motions like bending over and picking up a Kleenex or dancing or a thousand other things we do every day. 

If the muscle shrank on only one side, then that side will always be weaker and the vertebra will “go out” much easier and more frequently.   The solution is to do specific home exercises to stabilize your spine.  For more information on these exercises, you can consult our website at www.advancedchirocareplus.com, look under Chiropractic and then Home Exercises and Stretching.

Ice or Heat--I am so confused!

This is probably the most frequent question that I answer and why I feel it should be the first post on my new blog.

With nearly any injury, like a sprained ankle or if you bend over and feel your back pop, use ice to reduce inflammation.  The way to remember this is to think about the Super Bowl.    Along the side lines, do you see huge ice containers or large heating pads.  Well, of course, we all know it is ice buckets.  If it is good enough for the NFL players, then it is what you should use.

The rule of thumb recommendation is twenty minutes on and twenty minutes off until the pain or swelling subsides.   As an alternative, you may want to use this method to determine how long to keep the ice on.   The ice application will initially feel cold, then hot or you will experience a burning type sensation, after that you feel an achiness and finally numbness.    Once you get to numbness, you can remove the ice pack because you have acheived your treatment goal.   You then let the skin warm up to room temperature and you can repeat the process.

For small areas or very swollen areas, an ice massage is recommended.  Ice massage is using an ice cube to massage the area.  Remember to apply warm water to the area so the ice cube can glide.  Also use a paper towel to hold the ice cube.  You should go through the same stages to get to numbness. 

Ice is the preferred treatment for almost every situation a layperson runs into and should be your "go to" choice.

Yes, heat feels better.  But it is not nearly as effective and will often cause a delay in healing time if applied improperly.   Heat should NEVER be applied to a brand new injury.  Heat is only for specific problems. Even then has to be applied and monitored carefully.   I always tell patients that if you are not a turkey do not cook yourself.   Application of heat for long periods of time will "cook" the tissue and cause damage that may double or triple healing times.

Heat brings blood and fluid to the injured area.   You would use heat on old problems that are aching, like an old footbal knee, or you could use it to relax large muscles.    Heat should not be used by the layperson without professional advice if there is numbness, tingling or "nerve pain".

A good rule of thumb is to use moist heat for no more than 10 minutes on an area.   Warm moist towels, hot tub, bath or a hot water bottle will all do the trick.   If the area turns pinkish-red then you are doing it right.  If it turns bright red, that is too hot or applied for too long.

Finally, alternating ice and heat applications is a great solution for that painful area which has started to heal.  Most authorities state that you can start alternating ice and heat after 48-72 hours.   I usually recommend starting with an ice/heat/ice regimen if you are starting alternating therapies that early.

Another great solution for temporary  pain relief is a topical analgesic like BioFreeze or those analgesic pads sold by various companies such as Icy Hot. 

If these simple home care solutions do not help in just a few applications, it's best to call the office and get the situation checked out. 

Hope this answered your questions.   Til the next time, Dr. Hovi