A large study published on May 18, 2018, in the JAMA Network Open under Physical Medicine and Rehabilitation showed that adding chiropractic to standard medical care gave superior results for lower back pain than just standard medical care among active U.S. military personnel.
The study begins by noting the prevalence of lower back pain in the general population and the U.S. military population. Lower back pain (LBP) is the second leading cause of disability world-wide. In the U.S. it is estimated that 20% of the adult population suffers with this problem. LBP carries a hefty price tag with direct costs for this condition in the U.S. in 2010 being estimated at $34 billion, and additional indirect costs including lost workplace productivity losses estimated at $200 billion.
In the military, LBP is one of the most common reasons military personnel seek medical care as well as one of the most common conditions that cause a soldier to interrupt combat duty. Common medical care includes medications such as nonsteroidal anti-inflammatory drugs, or opioids, and surgical procedures such as spinal fusions, as well as procedures such as epidural steroid injections. Unfortunately, all these procedures carry significant risks and have been demonstrated to have a limited effectiveness.
This study involved a large number of active military personnel at three locations. The three locations were Walter Reed National Military Medical Center in Bethesda, Maryland; Naval Medical Center San Diego in San Diego, California; and the Naval Hospital Pensacola in Pensacola, Florida. Each of the three facilities had 250 participants in the study for a total of 750 active military personnel being involved. All participants were suffering from lower back pain not caused by disease or fracture.
This total was subdivided into two groups of 375 participants in each group. One of these groups received usual medical care (UMC) only, while the other group received UMC plus the addition of chiropractic care. The median age of the participants was 30.9 years. the breakdown showed that 175 participants (23.3%) were female, and 243 participants (32.4%) were nonwhite.
The outcomes were measured based on several factors and numbered scales. LBP was measured on a scale of 0 to 10 with 10 being the worst. Disability was measured on a 0-24 scale with 24 being the worst. Additionally, the study measures the participants perceived improvement from 0 (not at all satisfied) to 10 (extremely satisfied). Evaluations of the results were performed at weeks 2, 4, 6, and 12.
The results of the study showed that at each of the intervals, the groups that also received chiropractic in conjunction with UMC outperformed that group that only received medical care in all areas and timeframes tested. This study did not look at any outcomes of chiropractic care alone verses either medical care, or medical care combined with chiropractic. The only determination was that the addition of chiropractic to medical care was more beneficial then just medical care by itself.
In the authors’ conclusion, they wrote, “Chiropractic care, when added to usual medical care, resulted in moderate short-term improvements in low back pain intensity and disability in active-duty military personnel. This trial provides additional support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines.”
Dr. Michael McLean, a chiropractor and immediate past president of the International Chiropractors Association stated, “The men and woman of our armed services and their families deserve the best health care our nation can provide. This study adds to the growing body of science confirming that chiropractic care provides meaningful benefit and should become more easily available to those who serve and their families.”