Whom to choose: Chiropractic care vs. medical care for musculoskeletal problems, like low back pain.

Evidence from many trials and many research projects clearly demonstrates the superiority of chiropractic services over standard medical care and even traditional physical therapy in the treatment of musculoskeletal conditions:

1972 – Rolland A. Martin, MD, director of Oregon’s Workmen’s Compensation Program, “A Retrospective Study of Comparable Workmen’s Industrial Injuries in Oregon”: “Examining the forms of conservative therapy the majority received, it is interesting to note the results of those treated by chiropractic physicians. … A total of twenty-nine claimants were treated by no other physician than a chiropractor. 82% of those workmen resumed work after one week of time loss. Their claims were closed without a disability award. … Examining claims treated by the M.D., in which the diagnosis seems comparable to the type of injury suffered by the workmen treated by the chiropractor, 41% of these workmen resumed work after one week of time loss.”

1975 – Richard C. Wolf, MD, “A Retrospective Study of 629 Workmen’s Compensation Cases in California”: The significant differences between the two groups appear to be as follows: Average lost time per employee – 32 days in the M.D.-treated group, 15.6 days in the chiropractor-treated group. Employees reporting no lost time – 21% in the M.D.-treated group, 47.9% in the chiropractor-treated group. Employees reporting lost time in excess of 60 days – 13.2% in the M.D.-treated group, 6.7% in the chiropractor-treated group. Employees reporting complete recovery – 34.8[%] in the M.D.-treated group, 51% in the chiropractor-treated group.”

1979 – Scott Haldeman, DC, MD, PhD, Royal Commission of Inquiry on Chiropractic in New Zealand: “The Commission accepts the evidence of Dr. Haldeman, and holds, that in order to acquire a degree of diagnostic and manual skill sufficient to match chiropractic standards, a medical graduate would require up to 12 months’ full-time training, while a physical therapist would require longer than that.”

1980 – John McMilan Mennell, MD, prominent medical educator and author: “Q: The musculoskeletal system comprises what portion of the body? A: As a system, about 60% of the body. I think my testimony was that if you ask a bunch of new residents who come into a hospital for the first time how long they spent in studying the problems of the musculoskeletal system, they would, for the most part reply, ‘Zero to about four hours,’ I think that was my testimony.”

1987 – Susan Getzendanner, United States District Court Judge: “Even the defendants’ [the AMA’s] expert witness, Mr. Lynk [a PhD economist], assumed that chiropractors outperformed medical physicians in the treatment of certain conditions and he believed that was a reasonable assumption.”

1998 – Annals of Internal Medicine, published jointly by the American College of Physicians and the American Society for Internal Medicine: “The Agency for Health Care Policy and Research (AHCPR) recently made history when it concluded that spinal manipulative therapy is the most effective and cost-effective treatment for acute low back pain … Perhaps most significantly, the guidelines state that unlike nonsurgical interventions, spinal manipulation offers both pain relief and functional improvement.” [Emphasis added]

1998 – Journal of Bone and Joint Surgery: “Second only to upper respiratory illness, musculoskeletal symptoms are the most common reason that patients seek medical attention, accounting for approximately 20 percent of both primary-care and emergency-room visits. Musculoskeletal problems were reported as the reason for 525 (23 percent) of 2285 visits by patients to a family physician, and musculoskeletal injuries accounted for 1539 (20 percent) of 7840 visits to the emergency room. … Nevertheless, seventy (82 percent) of eighty-five medical school graduates from thirty-seven different schools failed to demonstrate such competency on a validated examination of fundamental concepts.”

2012 – Journal of Bone and Joint Surgery: “In the United States, musculoskeletal disorders represent the most common health complaints, accounting for more than 130 million physician visits and 10% to 28% of all primary care visits each year and costing approximately $850 billion a year. These costs account for a substantial portion of the country’s health care expenditures. … Despite these facts, our own institution [the Johns Hopkins University Medical School] has had no required medical student musculoskeletal clerkship rotation or elective for several decades, and a landmark study in 2003 by DiCaprio et al. found that only 20% of allopathic medical schools in the United States had a dedicated musculoskeletal clerkship, making the quality of musculoskeletal training for medical school graduates inadequate. Clawson et al. surveyed 5487 second-year residents in the United States and found that most reported being ill-prepared in the area of musculoskeletal medicine, and another survey of pediatric residents identified orthopaedics as the main area in which they believed that their medical school education had been deficient. … This discrepancy appears to persist beyond the training years and into the realm of clinical practice. In a survey of family care physicians, 51% said that they had insufficient training to address musculoskeletal issues, which may be related to the fact that 56% of the respondents stated that medical school was their only source for formal musculoskeletal instruction.”