Soft tissue musculoskeletal injuries and pain are an epidemic. They include back and neck pain, and headache from neck injury, and are the largest and most costly type of claim for employees, workers’ compensation insurers and automobile insurers in the western world. They also account for the lion’s share of chiropractic care center in Merrifield. Despite the fact that Merrifield VA chiropractic doctors believe chiropractic care has far-reaching beneficial effects throughout the body and that it promotes wellness in addition to providing pain relief, the fact is that most patients seek chiropractic care for musculoskeletal injuries. This is not all that surprising however over the last few decades; a huge body of research has provided overwhelming evidence that chiropractic care is ideal for these injuries.
As a result the U.S. Department of Health and Human Services and numerous government agencies abroad have issued guidelines that recommend chiropractic care for both acute and chronic back pain. In addition, recent legislation in the United States has provided coverage of chiropractic care for all active duty military personnel and will add chiropractic doctors within and throughout the military health care system. Even more recently, Congress mandated that chiropractic care be available for our veterans, and is slowly being implemented by the Department of Veterans Affairs.
Along the same path, the worker’s compensation system in Ontario, Canada some years ago adopted guidelines for care of back pain that support all major chiropractic methods of care including spinal manipulation (also called adjustments), exercise, and return to normal activities as opposed to bed rest. In Ontario, chiropractic care has been paid for not only by the government’s general health care plan, but also under car insurance benefits under their workers’ compensation plan since the 1970’s.
Ontario has the largest industrial base in Canada. Their Workplace Safety and Insurance Board (WSIB) covers all workers’ compensation claims there and is one of the largest workers’ compensation authorities in the world. While they already covered chiropractic care, they wanted to know what type of care was best for back injuries. They established a multidisciplinary panel of experts from various health professions to review all the literature and produce an evidenced-based program of care for acute back injuries. Then they tested the plans for six months and developed a final plan of care for both acute and sub-acute phases. They defined acute as within four weeks of injury and sub-acute as weeks 5-12. Then they did a separate but similar undertaking for chronic low back pain that persists more than 12 weeks.
For the acute phase they recommended care consistent with the scientific evidence and chiropractic management. TO heal the injury they recommended spinal manipulation or mobilization, instruction in and supervision of exercises, encouraging the activities of daily living, and patient reassurance. For pain relief they suggest non-prescription pain medications like aspirin, but only as a temporary measure in conjunction with other pain relief methods like heat/ice and manipulation/mobilization.
For the sub-acute phase the recommendations are similar with a greater emphasis on a program of exercise focusing on strength, flexibility, and return to job function. For either the acute or sub-acute phase a host of treatments were not recommended, including prolonged or total bed-rest, biofeedback, magnet therapy, and others.
For the chronic phase the report on the literature review found manipulation and exercise effective, but not pain medications. In addition, because by the time pain gets chronic, there are often social or psychological issues with it, they found psychologically based techniques (cognitive-behavioral, or relaxation) typically combined with exercise to be effective.
The chiropractic approach to back pain is clearly supported by the scientific literature and by government panels. Yet an amazing number of people still suffer with back pain, taking pain pills daily or even resorting to surgery without trying chiropractic.