Low-back and neck pain (spinal pain disorders) are the No. 1 cause of global disability, and cost the U.S. health-care system nearly $150 billion each year. Much of this cost is associated with care that’s inconsistent with clinical-practice guidelines and provides little benefit with great cost.
A recently-completed study by the Palmer Center for Chiropractic Research (PCCR) showed that incorporating spinal manipulative therapy into the treatment protocol for neck pain helps patients avoid high-cost, low-value care, underscoring the value of chiropractic care.
This study examined insurance claims from nearly 60,000 individuals from 2012-2018 through a data-sharing agreement that provided claims from a privately-insured Fortune 500 company.
Individual cases were classified as either recipients or non-recipients of spinal-manipulative therapy based on specific procedure codes. PCCR researchers then identified cases of individuals who received imaging studies, injection procedures, emergency department visits or surgery based on specific procedure codes. The presence of any of these procedures defined treatment escalation. Statistical modeling determined the relative risk of treatment escalation based on whether or not an individual received spinal-manipulative therapy.
The results show that individuals with neck pain who didn’t receive spinal-manipulative therapy as part of their course of care were associated with 2.38-times higher risk of treatment escalation.
This data shows that spinal manipulative therapy provided a protective effect against treatment escalation, helping patients avoid high-cost, low-value care.
It should be noted that the relationship between spinal manipulative therapy and treatment escalation is not necessarily causal, as we can only prove association with this type of data.