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Research is an important part of what we do as providers. However, it is to be used as a tool to guide us rather than a hard and fast rule to follow. That is simply because it evolves. Chiropractic has enjoyed high patient satisfaction rates and clinical success and frankly that is why we are the third largest health profession in the United States. A portion of that success comes from us being able to “manage” difficult cases and help patients return to normal or near normal function. I was in the middle of writing another consultation when I saw this new research article that was published just last week. It is titled “Spinal manipulation epidemiology: Systemic review of cost effectiveness studies”(Michaleff, Lin, Maher and Tulder, 2012). This is important information because it combines the clinical effectiveness with the economic effectiveness of spinal manipulative therapy(SMT).   This would naturally bring us toa discussion on the difference between SMT and the chiropractic adjustment, which must be saved for a different time. For now, let us look at what the authors found. I should note that all of these studies arefor “non-specific” spinal pain. 

The authors stated “Studies that recruited adults with non-specific spinal (neck or back) pain (i.e. pain is not the result of an accident, trauma or specific spinal pathology) of any duration, reported costs and effects of the interventions and included SMT in at least on intervention group were eligible for this review.” (Michaleff et al., 2012, p. 2) Most of the research is based on this “type” of spinal pain.

The authors reviewed papers that compared SMT to care by a general practitioner, SMT to exercise, SMT plus general practitioner care and SMT and any other treatment compared to any other treatment alone. The authors stated “Regardless of the perspective employed or the region of pain, SMT appears to be a cost-effective treatment when used alone or in combination with GP [general practitioner] or advice and exercise compared to GP care alone, exercise or any combination of these.” ((Michaleff et al., 2012,p. 7) 

They further state “Based on the available literature, this review supports the use of SMT in clinical practice as a cost-effective treatment when used alone or in combination with other treatment approaches.” (Michaleff et al., 2012, p. 7) This is a VERY important concept to provide to the medical community. Finally they stated “This systemic review found SMT to be a cost-effective treatment tomanage spinal pain when used alone or in combination with GP care or advice and exercise compared to GP care alone, exercise or any combination of these.” (Michaleff et al., 2012, p. 7)

We now not only have SMT proven in the clinical setting, we also have it shown to be effective in the economic setting. Call me if you don’t know how to use this to GET REFERRALS!

1: Michaleff ZA, Lin CW, Maher CG, van Tulder MW. Spinal manipulation epidemiology: Systematic review of cost effectiveness studies. J ElectromyogrKinesiol. 2012 Mar 17.


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