Low back pain (LBP) is a global health problem that will affect most adults at least once in their lifetime. For many, LBP may become a chronic issue that can significantly affect their ability to work and carry out normal activities of daily living. While we often discuss how chiropractic care serves as an excellent front-line treatment for LBP, it’s seldom discussed how seeing a doctor of chiropractic first can save a patient and their insurer from future healthcare expenditures involving medications, advanced imaging, surgery, and adverse effects that can result from these services.
The High Costs of Advanced Imaging
Advanced imaging, such as MRI, is often used to confirm a diagnosis. While these tools can be life-saving, when it comes to low back pain, unnecessary imaging can lead to immediate costs and treatments that may not resolve the patient’s LBP and may place them at risk for harm.
Unnecessary Imaging: In 2018, researchers conducted a chart review of 313 patients referred for MRI and found that 130 imaging requests were unnecessary. This corresponds to a 2014 study that found 46.7% of MRI requests for LBP are inappropriate.
Cost Implications: A 2012 study that looked at data from the Washington State Worker’s Compensation system found that about 1 in 5 workers with LBP underwent an MRI within six weeks of their injury. Those who first went to a chiropractor were half as likely to be referred for an MRI, while those who first visited a surgeon were 78% more likely to receive advanced imaging.
The Opioid Epidemic and LBP
While typically not advised in treatment guidelines, patients with chronic low back pain are often prescribed opioids.
Long-Term Outcomes: In a 2022 study that looked at long-term outcomes for Medicare beneficiaries with new-onset low back pain, researchers observed that those who visited a chiropractor first were 2.2 times less likely to be prescribed opioids within the following four years.
Risks of Opioid Use: Prolonged opioid use is associated with an elevated risk for misuse, as well as abuse of more serious and illicit drugs.
Surgical Interventions: Risks and Costs
Treatment guidelines generally frown upon surgical intervention as a first step outside of emergency circumstances. However, many patients still undergo surgery without adequate non-pharmaceutical, non-operative treatment.
Pre-Surgical Treatment: A 2022 study found that 41.7% of patients who underwent back surgery in a sample of 2.5 million low back pain patients had minimal non-pharmaceutical, non-operative treatment in the six months before their operation.
Surgery Risks and Costs: Another study using the Washington State Workers Compensation dataset found that low back pain patients were 29 times less likely to end up in the operating room if they first consulted with a chiropractor. Surgery is costly and comes with a risk for complications and prolonged recovery, and a July 2022 study noted that the failure rate of spinal surgeries may be as high as 40%, with the majority of failures linked to misdiagnosis.
Chiropractic Care: A Cost-Effective Solution
A June 2023 study that looked at data from a large insurer regarding more than 30,000 patients with new-onset LBP found that seeing a chiropractor first led to an immediate and long-term reduction in healthcare costs. The data “…provides a compelling case for the influence of the first provider on an acute episode of LBP.”
Benefits of Chiropractic Care
Immediate Savings: Chiropractic care can reduce the need for unnecessary imaging, medications, and surgeries.
Long-Term Savings: By addressing LBP effectively early on, chiropractic care can prevent chronic issues that lead to higher healthcare costs over time.
Patient Outcomes: Patients often experience significant relief and improved quality of life with chiropractic care, reducing the need for ongoing medical interventions.
Conclusion
Low back pain is a significant health issue that impacts both individuals and healthcare systems financially. Chiropractic care offers a conservative and effective treatment option that can help reduce the economic burden associated with LBP. By prioritizing chiropractic care as a first-line treatment, patients can experience relief while saving on healthcare costs, ultimately freeing up resources for other critical healthcare needs.
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