Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain
SOURCE: J Manipulative Physiol Ther. 2018 (Aug 15) [Epub]
Scott Haldeman, Claire D. Johnson, Roger Chou, Margareta Nordin, Pierre Côté, Eric L. Hurwitz, Bart N. Green, Christine Cedraschi et. al.
RAND Corporation,
Santa Monica, California.
OBJECTIVES: Chronic low back pain (CLBP) and chronic neck pain (CNP) are the most common types of chronic pain, and chiropractic spinal manipulation is a common nonpharmacologic treatment. This study presents the characteristics of a large United States sample of chiropractic patients with CLBP and CNP.
METHODS: Data were collected from chiropractic patients using multistage systematic stratified sampling with 4 sampling levels: regions and states, sites (ie, metropolitan areas), providers and clinics, and patients. The sites and regions were San Diego, California; Tampa, Florida; Minneapolis, Minnesota; Seneca Falls and Upstate New York; Portland, Oregon; and Dallas, Texas. Data were collected from patients through an iPad-based prescreening questionnaire in the clinic and emailed links to full screening and baseline online questionnaires. The goal was 20 providers or clinics and 7 patients with CLBP and 7 with CNP from each clinic.
RESULTS: We had 6342 patients at 125 clinics complete the prescreening questionnaire, 3333 patients start the full screening questionnaire, and 2024 eligible patients completed the baseline questionnaire: 518 with CLBP only, 347 with CNP only, and 1159 with both. In general, most of this sample were highly-educated, non-Hispanic, white females with at least partial insurance coverage for chiropractic care who have been in pain and using chiropractic care for years. Over 90% reported high satisfaction with their care, few used narcotics, and avoiding surgery was the most important reason they chose chiropractic care.
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CONCLUSIONS: Given the prevalence of CLBP and CNP, the need to find effective nonpharmacologic alternatives for chronic pain, and the satisfaction these patients found with their care, further study of these patients is worthwhile.
Key Indexing Terms: Manipulation, Spinal, Chronic Pain, Low Back Pain, Neck Pain, Chiropractic, Manipulation, Chiropractic
From the FULL TEXT Article:
Introduction
Chronic low back pain (CLBP) and chronic neck pain (CNP) are the most common types of chronic pain. [1, 2] Their combined prevalence is estimated to be about 10% to 20% of the adult population. [1, 3–10] Although there are many treatments for chronic pain, [2, 11] because of the dangers of opioid abuse, recent efforts have focused on finding effective nonpharmacologic therapies. [12] Chiropractors, osteopaths, and physical therapists are the provider types most likely to deliver spinal manipulation, [13] which is 1 of the nonpharmacologic treatments recommended for these conditions. [14–18] In the US, about 30% of those with spinal pain have used chiropractic. [19]
However, what is unknown is how those with CLBP and CNP are using chiropractic. Are they using short courses of chiropractic care or are they using this care long term? What are their motivations for using chiropractic care, and are they satisfied with this care? Several studies have described the characteristics of typical chiropractic patients, [13, 20–24] and others have described the characteristics of patients with back or neck pain, [6–10, 25] including some that focus on chronic forms of these conditions. [5, 26, 27] However, no study provides a detailed look at the demographics; attitudes; motivations; pain and functioning; and the utilization of chiropractic, self-care, and other health care among those using chiropractic care for their CLBP and CNP. Given the prevalence and long-term nature of chronic pain, understanding the issues of this population are essential to developing successful policies for the treatment of CLBP and CNP.
This study describes the characteristics of a large sample of CLBP and CNP patients in the United States who use chiropractic care for their CLBP and CNP. These data were collected in support of a larger project to advance methods to determine the appropriateness of manipulation and mobilization for CLBP and CNP.
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