Kaiser, Chiropractic, and Chronic Neck Pain
A Chiro.Org Editorial
I’m not enrolled in any of the Kaiser provider panels, so I have no vested interest in challenging their actions, but any time one Insurance Company explores a novel new way to reduce their costs, there’s always the chance that others will follow. Because Kaiser opened the conversation, asking whether chiropractic care actually provides benefits for those with neck pain, I draw your attention to the research we have gathered.
The Chiropractic and Chronic Neck Pain page contains numerous articles about the etiology of neck pain, as well as gathering many clinical trials, which have demonstrated the power of chiropractic management for neck pain.
The first study I’d like to draw your attention to is a paper published in the Archives of Physical Medicine & Rehabilitation (2005). Although this study is not specific to neck pain per-se, the results, published by several M.D.s and a Ph.D. from the Department of Rehabilitation Medicine at the University of Washington School of Medicine is still most interesting.
Questionnaires were given to several hundred recruited patients who experienced severe neuromusculoskeletal (NMS) pain. The researchers used a broad selection of assessment tools, including Pain presence or absence, pain severity, pain quality (Neuropathic Pain Scale), pain interference (Brief Pain Inventory), pain site, quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]), and the form of pain treatment used by the patient.
The following table tabulates the type of treatment each patient used, followed by the average pain relief they experienced from that treatment. It’s rated on a classical 1-10 scale, with 1 meaning little or no relief, and 10 suggesting complete pain relief. The results are quite staggering:
| Pain Treatment | |
| Chiropractic manipulation | |
| Nerve blocks | |
| Opioid analgesics | |
| Muscle relaxants | |
| Massage | |
| Acupuncture | |
| Ibuprofen | |
| Hypnosis | |
| Physical therapy | |
| Acetaminophen | |
| Magnets |
It may be uncomfortable for organized medicine to swallow, but this study revealed that chiropractic care was more effective for pain relief than nerve blocks, opioid analgesics , muscle relaxants, physical therapy, or acetaminophen (in that order). That’s pretty powerful, isn’t it?
I have tremendous respect for these authors because, even though the results were not very complementary to standard medical treatment (pain pills, muscle relaxants and physical therapy), they published the article anyway. Who can say how many similar studies were never published because they contained similar findings?
I hope you will spend some time reviewing the materials on the Chiropractic and Chronic Neck Pain page. If you know of other studies that we failed to include on this page, please e-mail me at Frankp@chiro.org so I can correct the oversight.
Nice followup Frank. One thing that burns me up is the double standard that exists regarding research findings. Unfortunately, cherry picking results and downright ignoring positive findings to claim no benefit is only too common. It emphasizes the need for all of us to get the truth out.
Thanks John. It’s a classic case of “King of the Castle”, the child’s game. If you’re on top of the hill, all you think about is holding your position…not the impact it will have when you shove the other kid back down the hill. Our website is about locating all this information conveniently in one place, without a struggle.
I’m in a business networking group, and one member suddenly experienced liver failure (cirrhosis) and is awaiting a liver transplant, with little hope of being granted one.
The cause? Thirty years of trusting his M.D.’s advice to take pain medication. (He does not drink more than the occasional glass of wine.) He was never told of the risks of the medication, even after experiencing liver failure.
So.. how does Kaiser feel about pain meds??? Talk about a double standard.
Thanks for posting this great study.
What get me is when they say the risks out weight the benefits. If you don’t want to cover some service that’s their prerogative, but to justify by a ignorant statement is ridiculous. How many people have died, been injured or done wrong by chiropractic in the last hundred years? Does that number equal even 1/10th of the number of people who have died, been injured or done wrong by medicine in the last 12 months?
http://www.medscape.com/viewarticle/728205?sssdmh=dm1.636271&src=nldne&uac=93650BZ
I encourage people to read this article that I recently received on Medscape. It’s a Danish Study that reveals the risk of stroke among healthy subjects that take NSAIDs. Remember often pts. that come into our office have been taking NSAIDS for their symptoms…….some of them have been taking NSAIDS routinely for years. Could this be the link regarding CV accidents. Please share this article.
Here is the double standard. They are trying to train PTs and osteopath/allopaths to do HVLA upper cervical spinal manipulation in just a weekend seminar:
http://www.ah.ouhsc.edu/rehab/documents/Spinal%20Manipulation%20OU-Tulsa%20March%202010%20brochure.pdf
Chiropractic doctors study this in intensive training during four years and 5000 hours on a full-time, post-graduate, doctoral level at a chiropractic university. Further skill enhancing is acquired at post-graduate seminars and scientific sypmosia.
Insurance companies like Kaiser are being made aware that this is endorsed by universities and the medical profession as evidenced by this seminar at the University of Oklahoma. So if they see fit to deny coverage based on the practitioner, well, this to me is blatant discrimination and a form of racism.
I am sure the Insurance Commissioners of the states that these companies do business in would be very perturbed to hear that and likely this would cause many headaches and potential uneeded and costly legal backlash.
Methinks that Kaiser has made their decision based on very unreliable and misguided, self-serving advice. It is just wrong and I am sure they are already hearing about this from various parties.
Has anyone on this blog contacted Kaiser yet to voice their concern about their spurious decision using the University of Oklahoma Health Sciences seminar as evidence that their decree is wrong and needs to be reversed?
Here is the link again for the Univ. of Oklahoma spinal manipulation seminar:
http://www.ah.ouhsc.edu/rehab/documents/Spinal%20Manipulation%20OU-Tulsa%20March%202010%20brochure.pdf
If it is OK with OK, why isn’t it OK with Kaiser? Well this is not OK and we should not stand for it. If enough people ask Kaiser these questions, I think they will get the point.
As long as rumors about the safety of chiropractic exist, we must work to educate the general public. The Foundation for Chiropractic Progress is doing a great job with campaigns by Jerry Rice and others. Every doctor DC needs to post articles proving efficacy of chiropractic and the fallacy of the stroke connection onto their website and work to educate the public, one patient at a time. In time, the public will come to know that chiropractic is the safest and most effective health care system available.