As we delve into the intricacies of the topic at hand, it becomes apparent that there are numerous layers to unpack and explore. The article that serves as our guiding source sheds light on a wide array of perspectives and insights that contribute to a comprehensive understanding of the subject matter.

This post is based on a couple of published articles:

https://medpix.nlm.nih.gov/case?id=302fa559-7313-44de-8eb4-786045c03c0f

The Outcome Assessment of Physical Therapy and Chiropractic Spinal Adjustments on Low Back Pain, Opioid Use, and Health Care Utilization – Lowering Opioids by 55% vs. Raising Opioids by 90%

The short answer is that current medical protocol typically involves the referral of injured and pain patients to physical therapy. Chiropractic largely functions outside of the medical healthcare referral network.

While physical therapy continues to be a cornerstone in treating low back pain, research shows that chiropractic care may be a more effective and cost-efficient option. The evidence presented in the article “The Outcome Assessment of Physical Therapy and Chiropractic Spinal Adjustments on Low Back Pain, Opioid Use, and Health Care Utilization” highlights the benefits of chiropractic care in reducing opioid use by 55% and decreasing disability by 313% compared to physical therapy.

Here’s what they found:

“Opioid use is an indicator of the efficacy of care for low back pain. All physical therapy modalities realize no lowering of opiate use, while the addition of active and passive care increases use by 90%. Longer physical therapy care increases the use of opiates, spinal injections, MD specialty care, and hospitalizations. Chiropractic care reduces the use of opioids by 55%, with patient satisfaction of 96%, while decreasing disability by 313% compared to physical therapy.”

WHY DOES CHIROPRACTIC WORK SO WELL?

Physical therapy typically involves a lot of passive therapies that often feel good while they are being applied but actually do little to change the underlying source of pain. Examples of these include: ice, heat, electrical stimulation, ultrasound, therapist stretching. 

Chiropractic adjustments on the other hand stimulate changes in the nervous system where pain is experienced and expressed. These changes are called neuroplastic changes and they help change a nervous system from being stuck in a recurrent pain to reduced or eliminated pain. 

This is a great example of something that we assume is effective is actually being destructive. Too often the procedures and treatments used in medicine actually lack research support for their effectiveness. By questioning assumptions, challenging conventional wisdom, and examining evidence with a discerning eye, we are able to cultivate a deeper understanding and appreciation for the intricacies of the topic at hand.  

LOW BACK PAIN

Let’s focus on perhaps the most common debilitating chronic pain, lower back pain. Here’s what this article has to say:

“Low Back pain affects 33.9% or 2.66 billion adults worldwide, costing more than $365 billion annually (Lo et al.2021). Low back pain remains the leading cause of years lived with disability in the world since 1990, with the number of incidents increasing since 2019. The ages peak at 45-54 years for both sexes and finalize at 80-84.The highest incidence globally is in North America.”

ACTIVE VS. PASSIVE CARE

Above I noted how much of Physical Therapy is passive in nature, like lying on a table with ice or hot packs or electrical stimulation or ultrasound or mechanical traction on you. 

The findings indicate that when passive therapy is added to the treatment protocol opiate use increases. With one passive therapy spinal injections increased by 32%. You might be wondering how the results changed with the combination of active and passive therapy. 

Here’s the quote directly from the paper:

“If any combination of passive and active care is performed, spinal injections increase by 53%, and M.D. specialty care increases by 50%. If 2 or more passive interventions were used, there was a 50% to 80% greater likelihood of the escalation of care events.”

SPINAL ADJUSTMENT OR SPINAL MANIPULATION

Here’s a great reason to stay away from physical therapists and chiropractors who describe what they do as spinal mobilization or manipulation. This article found that the application of a chiropractic spinal adjustment has been shown to reduce opioid use by 55%. 

Manipulation and mobilization do not achieve the same results. Why? The chiropractic adjustment helps stimulate changes within the central nervous system that changes the experience of pain. 

IF YOU HAVE LOW BACK PAIN THEN CONSIDER CHIROPRACTIC

The chiropractic adjustment is the single most effective treatment for both acute and chronic lower back pain. It is so effective that it has been demonstrated to dramatically reduce opioid use for pain, while physical therapy actually increases opiate use. 

About Dr. Berkowitz  

Bringing more than 3 decades of practice experience, Dr. Bill Berkowitz focuses on balancing and corrective care, applying his expertise to provide patients with predictable, repeatable and measurable results.

Dr. Bill consistently strives to enhance the well-being of his patients by addressing the root imbalances of their problems and promoting optimal balance, alignment, and function of the spine and nervous system.  

Bill’s wealth of knowledge and experience has allowed him to develop a nuanced understanding of the human body and its intricate connections. With each adjustment, he supports the body in returning to a state of balance that goes beyond mere symptom relief, focusing instead on long-term correction for his patients’ well-being. 

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