Guidelines and recommendations for so many
things from how to properly replace a light bulb
to when to do back surgery fill
our daily lives. Guidelines are appreciated by people facing
a new task or a new health condition for the first
time. Guidelines for the care of back pain have been circulated
through the years, many citing non-surgical
care including spinal manipulation as first line treatment. Just how well are
those guidelines followed by involved healthcare practitioners,
by back pain patients? Apple Country Chiropractic found these newly
published reports attention-getting and thought
our Williamson chiropractic patients would, too. We can all
use them to design and follow a guideline-based
treatment plan.
BACK PAIN TREATMENT GUIDELINES
Your Williamson chiropractor keeps
abreast of the current guidelines to best help you, our Williamson
back pain patient. Back in 2009, the American College of Physicians listed spinal
manipulation in its guidelines’
recommendations of appropriate spinal pain care choices.
(1) Apple Country Chiropractic uses the well-documented Cox® Technic
System of Spinal Pain Management which has a published algorithm of
decision-making for patients suffering pain below the knee
and patients who experience pain that does not
go below the knee with a goal of 50% improvement in 30 days or
so of care. These guidelines were released in 1996
and have been tested in clinic-based data collections in the years since. (2) Such guidelines with research support and
proper clinical application build confidence that there is hope to
our Williamson chiropractic patients!
ARE GUIDELINES BEING FOLLOWED?
We hope so! Nearly 64% of chiropractors say they use (Cox®)
flexion distraction with their spine pain patients and have the algorithm/guideline
available to them. Apple Country Chiropractic is one of those
chiropractors. Beyond chiropractic, general guidelines for back
pain care are also accessible. Are they followed? A newly
completed review of chiropractic and OT/PT use among 146,087 adults
with low back pain in the past 3 months found that
chiropractic care or OT/PT care for low back pain rose after
clinical guidelines recommending their care were introduced in
2016. Between 2002 and 2018, a bit less than a third of those
adults with low back pain reported undergoing chiropractic and/or PT/OT with an increase
to a third after the 2016 clinical guidelines were released.
(3) This does show that guidelines assist
with treatment direction but are not always followed. In Denmark
where guidelines for low back pain care are outlined
for primary care before being referred found that 33% of
patients had not undergone an adequate course of treatment
in primary care before referral. The patients were on
average 53 years old with nearly 50% of them saying
that they had pain for more than a
year, and 75% reporting
pain below the knee. (4) Struggles in the healthcare system to follow guidelines are seemingly global.
CHIROPRACTIC’S ROLE
A group of chiropractic leaders gathered
their ideas on the role of the chiropractor in his/her own
practice, with his/her own patients, within the healthcare community, and
within society for healthcare. Quite interesting! Individually,
chiropractors reported themselves as capable
and well-educated spine and musculoskeletal care experts who offered
evidence-based care founded on the current research,
clinical expertise, and patient values. They delivered
patient-centered care that spreads to cooperating with other
healthcare providers with the best interest of the patient in mind. (5) Using guidelines, chiropractors are
confident that they can assist their back pain patients with
those patient’s best interests in mind.
CONTACT Apple Country Chiropractic
Listen to this PODCAST
with Dr. Ted Siciliano on The Back Doctors Podcast with
Dr. Michael Johnson as he describes his use
of The Cox® Technic System of Spinal Pain Management to help
a patient dealing with back pain and foot drop.
Schedule your Williamson chiropractic
appointment soon. Facing a serious bout of back
pain is certainly not comparable to changing a light bulb for
the first time, but it’s comforting to know that there are available to best manage
each task!