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Embargoed Until: January 4, 2002

 Contact: Robin R. Merrifield

1304 Perry Ave., Bremerton WA 98310

Phone: 800-343-0549 or 360-471-7837

Fax: 360-478-0834 • E-mail: FCERedit@aol.com

Des Moines, Iowa—A descriptive study of patients with chronic low back pain (LBP) and sciatica found that chiropractic patients are taught to manage their pain—and do so more often than medical patients.

The study, published in the November/December 2001 issue of the Journal of Manipulative and Physiological Therapeutics,¹ involved 2945 consecutive patients in one of 14 general practice medical clinics or 51 chiropractic clinics. Patients were questioned about LBP history, duration and severity of the episode for which they were seeking treatment, and general health status. Demographic information was also collected. Patient were questioned at the first visit before the clinical encounter, and then at 2 weeks, 1 month, 3 months, 6 months, and 1 year.

Participating doctors (77 family practice physicians, 34 general internal physicians, and 60 chiropractic physicians) were also surveyed for information on practice activities, clinical impressions, use of diagnostic imaging, and referrals.

Among the study’s findings:

• At 10 days after treatment, nearly 80% of chiropractic patients expressed agreement with the statement "I knew what to do to take care of my back after the visit with my doctor/provider." At one year, that number was up to just under 90%. In contrast, at 10 days post-treatment, 56% of medical patients agreed with that statement; 55.5% agreed one year later.

• Over 90% of chiropractic patients received spinal manipulation; two-thirds received physiotherapy modalities.

• Eighty-one percent of medical patients received medication (nearly 42% were prescribed narcotics).

• Medical patients were more likely to change jobs or request changes to their work stations.

• Chiropractic patients were more likely to take dietary supplements.

• Chiropractic patients were more likely to exercise (aerobic, strengthening or stretching).

• Self-care education was "conspicuous" in chiropractic practice.

• Chiropractic patients had higher incomes, paid for care out-of-pocket, and reported slightly greater self-confidence in controlling their low back pain.

• Medical patients reported more severe pain and disability, had lower incomes, and had higher unemployment.

The authors concluded, "The chiropractic encounter may have enhanced patients’ self-efficacy motivation, leading to better coping abilities and better pain and disability outcomes." The researchers note, however, that several possible factors—such as the differences in socioeconomic status and pain severity—may have influenced the outcomes.

The study was conducted by researchers from the Western States Chiropractic College and the Departments of Family Medicine and Public Health and Preventive Medicine at Oregon Health Sciences University. The project was funded through two grants from the Health Resources and Services Administration, DHHS. Additional funding was provided by the Foundation for Chiropractic Education and Research through a grant from the NCMIC Insurance Company.

Reference:

¹Nyiendo J, Haas M, Goldberg B, Lloyd C. "A Descriptive Study of Medical and Chiropractic Patients With Chronic Low Back Pain and Sciatica: Management by Physicians (Practice Activities) and Patients (Self-Management)." Journal of Manipulative and Physiological Therapeutics. November/December 2001; Vol. 24, No. 9.

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