SIB # 416-Chiropractic Manipulation compared to Physical Therapy for Low Back Pain Care

The Study: Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation                      

The Facts:

a. “The purpose of this study was to investigate the cost-effectiveness of chiropractic versus PT in the U.S.”

b. The authors note that low back pain is one of the chief causes of years lost to disability.

c. They also note that low back pain (LBP) is the second most common reason for a person to consult with a physician.

d. Usually LBP resolves in 8 to 12 weeks but pain persists for over 3 months in 15% of cases..

e. After 3 months it is considered chronic low back pain and it is important to promote early intervention when the LBP is in the acute phase.

f. The care needs to be cost effective.

g. The authors state that, “…both chiropractic therapy and PT, compared with other non-pharmacologic interventions, are shown to have better, yet similar benefits, and at lower costs.”

h. Data collection for this study. “For data collection, Medline and PubMed databases were searched from 2000 to September 2018.”

i. There are shortcomings to both chiropractic and PT care.

j. Both treatments are quite similar in cost outcomes although chiropractic held a very slight advantage in the short term.

k. Chiropractic showed only a $48.56 dollar lower cost than “PT over a one-month treatment time period and five months follow-up.”  

Take Home:

Chiropractic care in the short term is less expensive, but only marginally.

Reviewer's Comments:

When we look back chiropractic has often come out quite well in costs when compared to other medical interventions for low back pain. Also these studies are often in relation to acute low back pain. This article therefore reinforces my thoughts. I once heard Dana Lawrence, who was the editor of JMPT at that time, indicate that he had enough articles on effectiveness of chiropractic on low back pain and I tend to think that is correct. But as long as we have researchers, we will continue to see the words, “More research is needed.”

Reviewer:  Roger Coleman DC 

Editor’s Comments: Personally, I’ve seen enough studies on LBP to last me a lifetime but as long as they keep publishing them, I guess we will have to keep reviewing them to some degree.

Editor: Mark R. Payne DC

 Reference: Nina Khodakarami. Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation. Healthcare (Basel). 2020 Feb 24;8(1):44.doi: 10.3390/healthcare8010044. 

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/32102417/

Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151187/pdf/healthcare-08-00044.pdf