When Back Pain Strikes - Who Should You See?

In a study entitled "The Manga Report", prominent health economists Pran Manga and Douglas Angus of the University of Ottawa, Canada, found chiropractic management to be the best choice of health care for patients with low back pain - in terms of safety, scientific evidence of effectiveness, evidence of cost effectiveness and patient satisfaction. Commissioned by the Ontario Ministry of Health in response to that province's staggering public deficit of the early 1990's, this landmark document represents the largest existing analysis of the scientific literature on low back pain to date.

The Report's primary focus was to determine the most cost-effective health care service available for the treatment of low back pain. In an attempt to address the Ontario government's cost saving concerns, the Report concentrated on comparing the value of chiropractic and medical management of this socially and economically crippling condition. The findings of the Report were based on a review of randomized controlled trials, case control/cohort studies, descriptive studies and meta-analysis/literature reviews - in total, over 400 references concerning both chiropractic and medical treatment methods.

The following are the key findings of this study:

1. On the evidence, particularly the most scientifically valid clinical studies,

spinal manipulation applied by chiropractors is shown to be more effective

than alternative treatments for low back pain (LBP).

2. There is no clinical or case-control study that demonstrates or even implies

chiropractic spinal manipulation is unsafe in the treatment of LBP. Their

interpretation of the literature suggests that chiropractic manipulation is

safer than medical management of LBP.

3. Indeed, several current medical therapies of LBP are generally contraindicated

on the basis of the existing clinical trials. There is also evidence in the literature

to suggest spinal manipulation is less safe and less effective when performed by

non-chiropractic professionals.

4. There is an over-whelming body of evidence indicating that chiropractic

management of LBP is more cost-effective than medical management.

5. There would be highly significant cost savings if more management of LBP

was transferred from physicians to chiropractic doctors. Evidence from Canada

and other countries suggests potential savings of many hundreds of millions of

dollars annually.

6. Workers' compensation studies report that injured workers with the same

specific diagnosis of LBP returned to work much sooner when treated by

chiropractors than by physicians.

7. There is good empirical evidence patients are very satisfied with chiropractic

management of LBP and considerably less satisfied with physician management.

8. The use of chiropractic has grown steadily over the years. Chiropractic is

now accepted as a legitimate healing profession by the public and an increasing

number of physicians.

Tips For a Pain Free Neck

Neck pain is a common reason people seek chiropractic care. Whether it is a stiffness, ache or sharp, debilitating pain, problems associated with the neck - which can include headache, arm/hand/shoulder symptoms and upper back disorders - present a significant burden to our health care system, to our productivity and to our lives.

The causes of neck pain are numerous. Two factors, however, are by far the most prevalent: posture and spinal alignment. Fortunately, both of these factors can be improved with knowledge, commitment and chiropractic treatment.

The following points may be useful in ensuring your neck remains pain-free:

POSTURE: Optimum posture is where, when viewed from the side, the centre of the ear lies directly over the midpoint of the shoulder. Viewed from the front, the head should not be tilted, shifted or rotated in relation to the rib cage. Optimum posture also involves having normal cervical, thoracic and lumbar curves. Your chiropractor can help to accurately assess your posture, and can give you specific exercises and suggestions to improve postural faults.

ERGONOMICS: Ergonomics involves such things as how one sits or stands at work, at a desk, computer or while watching TV or reading. It can also include driving or sleeping positions. To minimize neck, shoulder and upper back fatigue, avoid prolonged positions where the head is tilted or pushed forward. Change positions and tasks regularly and often, choosing a new task or position that works the body the opposite way. Strive for correct, balanced posture while working, traveling, playing and sleeping. This means do not prop your head up with pillows when sleeping on your back!

INJURY: Trauma to the neck must be treated appropriately, beginning with an accurate diagnosis. Accurate diagnosis of neck trauma, whether it was the result of a car accident, fall, sports or some other injury, should always include x-ray. X-ray is used to assess the structural condition of the spine, including the cervical curve. Abnormal curves in the cervical spine are major contributors to chronic neck pain, headache and other neck related problems. Chiropractic treatment has been shown to correct or improve abnormal spinal curves.

STRESS: We all must deal with stress in our lives. How we deal with it determines the level of tension we feel, and this can play a significant role in whether or not we experience neck related symptoms. To help us cope with stress more effectively, several behavior or attitude adjustments may be beneficial. Exercise moderately for about 45 minutes every day. Make adequate sleep and a healthy diet priorities. Maintain balance in your life between work and play, and in your relationships. Keep life in perspective. See the lighter side of situations. Seek and express humour.