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Chiropractic Treatment of Chronic Pain


Chiropractic Treatment of Chronic Pain


Chiropractors have been around a long time

The chiropractic profession was founded in the United States in 1895. Chiropractors diagnose, treat, and prevent disorders of the musculoskeletal system. More than 90% of patients who seek care from chiropractors are seeking relief from pain, including back and neck pain and headaches.

Chiropractors have a lot of training

In the United States, it takes a minimum of six years of university-level education to become a chiropractor. This includes two years of university credits in qualifying subjects and four years of undergraduate study at a chiropractic college. After completing their studies, would-be chiropractors must pass a state licensing exam. Chiropractors are licensed health care providers in all 50 states. They provide drug-free treatment, with an emphasis on manual treatments, including spinal manipulation.

Studies of chiropractic indicate it’s safe and effective

Chiropractic treatment has been shown to be much safer than any conventional pain treatments. The estimated risk for serious complications for cervical (neck) manipulation is 6.39 per 10 million manipulations; for lumbar (low-back) manipulation, the estimate is 1 serious complication for every 100 million manipulations, according to a 1998 study sponsored by nonpartisan nonprofit research institute the RAND Corporation. Compare this to the 156,000 serious complications per 10 million cervical spine surgeries and 32,000 serious complications per 10 million patients using nonsteroidal anti-inflammatory drugs (NSAIDs). The same literature review found that spinal manipulation was more effective for both acute and subacute low-back pain without sciatica than comparison treatments, and that cervical manipulation was effective for neck pain and muscle tension-type headaches.

Governments around the world have endorsed chiropractic

In 1997, the Agency for Health Care Policy and Research reported that chiropractic spinal manipulation was one of the few evidence-based treatments recommended for the treatment of low-back pain. The World Health Organization (WHO) admitted the World Federation of Chiropractic, which represents national chiropractic associations from more than 70 countries, into official relations as a nongovernmental organization in 1997. This indicates that WHO considers chiropractic an accepted healing modality.

Between 1979 and 1999, treatment guidelines from governments around the world recognized chiropractic spinal manipulation as an effective treatment for low-back pain, including in the United States (1994); Great Britain (1994); Sweden (1987); Denmark (1999);Australia (1986); and New Zealand (1979).  Most studies have shown that chiropractic treatment saves money compared to conventional treatment for these conditions.

Why so many people distrust chiropractors

Since the founding of the chiropractic profession, the American Medical Association (AMA) has actively worked to contain and eliminate the profession. During the first half of the 20th century, with the active encouragement of the AMA, many chiropractors were prosecuted for practicing medicine without a license—and many went to jail.  Starting in 1905 with the state of Minnesota and ending with Louisiana in 1974, all U.S. States eventually licensed chiropractic.

In 1963 the American Medical Association established a Committee on Quackery with the avowed goal of eliminating the chiropractic profession.  Because chiropractic made little use of technology and no use of drugs, the profession had no strong financial allies. Meanwhile, the AMA had access to the deep pockets of the pharmaceutical industry to further its goals. AMA members faced expulsion from the association not only for referring to chiropractors but even for belonging to the same country club or church or synagogue—association was strictly prohibited. As a result, chiropractors faced discrimination in not only their professional life but also their personal life.

In 1976, five chiropractors sued the American Medical Association for libel. The suit claimed that the AMA had participated for years in an illegal conspiracy to destroy chiropractic. The lawsuit also included the American Hospital Association, the American College of Surgeons, the American College of Physicians, and the Joint Commission on Accreditation of Hospitals as co-defendants.

In 1987, after years of court battles, a. federal appellate court judge ruled that the AMA had engaged in a “lengthy, systematic, successful, and unlawful boycott” designed to restrict cooperation between MDs and chiropractors to eliminate the chiropractic profession as a competitor in the US health care system.

As part of the lawsuit settlement, the AMA was required to cease its efforts to restrict the professional association of chiropractors and AMA members. The AMA was also ordered to notify its 275,000 members of the court’s decision. In addition, the American Hospital Association (AHA) was required to send out 440,000 notices informing hospitals that the AHA had no objection to the provision of chiropractic care in hospitals. The judgment was upheld by the 7th US Circuit Court of Appeals.

In the end, despite winning many victories in both the courts and the court of public opinion, chiropractors have had their practices severely constrained by organized medicine through managed care. Patient access to chiropractic treatment is restricted by requirements for preapproval of care, limitations in length of care and “medical necessity” reviews. The paperwork burden on chiropractors consumes a substantial, and unpaid, portion of their professional days. In addition, over the last 35 years, chiropractic fees paid by insurance companies have for the most part stayed the same or even decreased. Consequently, the number of chiropractic jobs in the United States declined from 65,000 in the year 2000 to 44,400 in 2012.

The lingering effects of the almost 100 year campaign to discredit chiropractic and the economic war against chiropractic has not only deprived chiropractors of adequate income and discouraged many would be practitioners from entering the field, it has discouraged many pain patients who could benefit from seeking chiropractic treatment.

Help make chiropractic and other alternative pain treatments more affordable 

Although chiropractic treatment is not the answer to every pain problem, it can help many patients.  Please join me in advocating for adequate insurance coverage of alternative pain treatments and appropriate physician education.  Please sign my petition on change.org: Read and sign the petition here.

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