I came across a study that was in the December 2010 issue of JMPT (journal of manipulative therapeutics) that shows after adjusting for risk adjustment ( a fancy way of saying severity), the cost of chiropractic intervention was markedly less than going the traditional medical route (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55052)
One of the major cost drivers we experience in our office is when our patient decides to go to the emergency room for care. Typically, they are given pain killers or a shot of toradol for the pain which does nothing for the problem.
In many managed care plans, the medical doctor must give the referral. To their credit, many tell their patients that they can only offer medication and then refer them to someone like me for further intervention. Others, find themselves being sent from specialist (often orthopedics) to rehab, without having the problem that created the back issue ever resolved. I treat many patients who tell me they are fine as long as they do the exercises and then get ready in bed to be able to move. This tells me their problem is now subacute and have never been resolved. This causes periodic exacerbations, spinal, hip and knee degeneration and of course, they become less active and avoid painful activities.
In our office, we look for the cause and use tests that show the mechanical faults leading to back pain. Through active evaluation (a process of treat, test and treat), we get to the root of the back problem and other problems such as the hip, foot and knee improve as well, since these are merely symptoms of the gait issue that created them. Perhaps, the greater level of understanding chiropractors have avoids costly MRI and other tests that come with increasing severity.
Many studies really need to compare not just the episode, but with chiropractic care, do people have far fewer episodes of back pain. Also, foot orthotics are quite helpful as well as myofascial treatment to the region, which is becoming a larger part of many more progressive chiropractic practices as they move away from the less effective and more expensive model of heat, ultrasound and passive care and move toward the model of exercise, myofascial and active modes of care.
What do you think? As always, I value your opinion.