What Do Consumers Say Works Best?


We know that many people, about 80% of the population, will hurt their back at some point in life. In a survey conducted by Consumer Reports (CR) (see the May 2009 issue), over 14,000 subscribers had low back pain (LBP) but no surgery to treat it in 2008. More than half reported severe daily activity limitations for at least one week and 88% reported their LBP recurred throughout the year.


Many indicated their sleep, sex life, and weight management all suffered as a result of LBP. What is important about these findings is that once you have LBP, you’re probably going to have repeat episodes. It’s the chronic, recurrent nature of LBP that makes it one of the most costly conditions to the injured employee, employers, fellow workers, insurance companies, and the healthcare system in general. Of interest, most of the 14,000 LBP sufferers indicated they had tried 5 or 6 different treatment approaches. When rating the degree of helpfulness of each type of care and their overall satisfaction with the various healthcare professionals, the hands-on therapies were the highest rated, with chiropractic leading the list at 59%. Physical therapists (PT) were next at 55% though later in the article a “very helpful” rating for PT was reported at 46% vs. massage therapy at 48%. Acupuncture was listed at third with 53%, specialty physicians at 44%, and primary care physicians were rated the lowest at 34%. Medications by prescription “helped a lot” in 44% and about 22% were helped by over-the-counter medication. It is ironic that other reports have indicated that only about 15% of people with LBP go to chiropractors when research, consumer satisfaction—as indicated here, and all of the international guidelines have recommended that chiropractic be considered as one of the first approaches in the management of non-surgical LBP. What is the hesitation?


Other interesting points in the article include that most of the LBP sufferers who elected not to seek treatment (about 35%) did so because of cost concerns or the belief that professional care would not help. Both research and the majority of the 14,000 who tried chiropractic said it helped and a the Consumer Reports article reviewed a LBP case to emphasize this point. The case example focused on the value of periodic chiropractic treatment for a worker in a heavy physically demanding job and the benefits he received from a treatment every few weeks, indicating this approach, “…is able to keep his back pain to a minimum.” Another important point was that 44% of the 14,000 consumers reported exercise was helpful, and this represented the top placed self-help measure. Moreover, 58% indicated they wished they had included more exercises to strengthen their back in the past year. Chiropractic management of back pain and other musculoskeletal conditions includes exercise training during the care rendered for LBP.


The article concludes with caution about back surgery, and references a separate CR survey completed in 2006. That survey reported 60% satisfaction among about 1,000 LBP consumers who had surgery in the prior 5 years compared with hip or knee replacement satisfaction at 82%. Additionally, more than 50% reported at least one problem during recovery, 16% had no improvement at all, while 8% were worse. The recommendation of obtaining at least two opinions was suggested prior to undergoing surgery, preferably one from a non-surgeon.


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