The latest CDC statistics show that , in 2012, 54 out of 100 people had self-reported musculoskeletal conditions. That is six times more than self-reported cases of cancer, double that of respiratory disease, and one-third more than circulatory disorders. If we extrapolate that to a more current population in the United States of 321 million, that equates to 173 million people reporting musculoskeletal problems in 2012.
Many of these are spine patients who suffer long term without any type of bio-mechanical assessment or functional case management. Why does health care fall short with spinal conditions despite the compelling literature that states the opposite in treatment outcomes?
The front line of medical care for spine-related pain is typically the prescription of pain medication, particularly at the emergency care level, and then if that doesn’t work, a referral is made to physical therapy. If physical therapy is unsuccessful, the final referral is to a surgeon. If the surgeon does not intervene with surgery, then the diagnosis becomes ” nonspecific back pain,” and the patient is given stronger medication since there is nothing the surgeon can do. FOr surgical interventions that result in persistent pain, a commonly reported problem, there is an ICD-10 diagnosis for failed spine surgery.
According to Mulholland (2008), “[Surgery] Spinal fusion became what has been termed the ‘gold standard’ for the treatment of mechanical low back pain, yet there was no scientific basis for this.” Simply put, surgery does not correct the underlying biomechanical failure or the cause of the pain.
Opioid pain medication use presents serious risks, including overdose and opioid use disorder. From 1999 to 2014, more than 165,000 persons died from overdose related to opioid pain medication in the United States.
Clearly, there needs to be a nationwide standard for the process by which patients with spine pain are handled, including academic and clinical leadership on spinal biomechanics. The only profession that is poised to accomplish such a task is Chiropractic.
MDs tend to use medication, including analgesics, muscle relaxants, and anti-flammatory agents, for the treatment for acute nonspecific spinal pain, whereas DCs favor spinal manipulation therapy as the primary treatment for this condition.