According to current studies, "back symptoms are the most frequent reasons for visits to orthopaedic and neurosurgeons, and the second leading reason for all physician visits." (5) In addition, "The rate of low back pain disability during the period from 1960 to 1980 was 14 times that of the population growth." This is a staggering statistic, demonstrating that the cost of low back pain to the United States is increasing at incredible rates. "In the U.S., the total annual costs associated with low back pain, including direct health care costs and the indirect costs of work loss and disability payments, have been estimated to exceed $50 billion." (5) What is most difficult to accept is the small percentage of patients who account for the majority of the health care costs. Webster & Snook have found that, "25% of the low back pain cases account for 96% of the costs." (4) This is primarily due to the Health Care society's inability to control and prevent the acute low back pain patient from becoming a chronic recurrent (or chronic unrelenting) low back pain patient. Webster & Snook also go on to say that, "The primary goal of low back pain management should be the prevention or reduction of prolonged disability."
While low back pain has been plaguing us since the beginnings of recorded history, it has only been in recent years that it has become a burden on society. With the advent of disability, the problem of disabling low back pain is increasing in magnitude. We have all heard the statistics that 80% of the public will experience low back pain at some time in their lives and each year some 2-5% of adults will have experienced some degree of low back pain in the past year, although they will not necessarily have visited a doctor or lost time from work.
It has been shown that most episodes of low back pain are self limiting. In fact, Webster & Snook estimate that approximately 75 - 90% of people with low back pain, recover within 6 weeks, with or without medical treatment.
Gordon Waddell, M.D., however, feels that this is overly optimistic and it encourages a return to work instead of getting people to seek complete resolution of their problems. Waddell goes on to say that considering actual symptoms - "50% of attacks of low back pain settle more or less completely within 4 weeks but 15-20% continue to give some degree of symptoms for at least 1 year." In addition, "70% of all people who suffer low back pain attacks will have at least 3 or more recurrences."
It is clear that no matter what Health Care professional you speak with, or what study you draw from, we now know that the majority of back pain sufferers experience recurring pain over an extended period. With this in mind, Chiropractors, and other Health Care practitioners dealing with low back pain, need to focus on not just returning a patient to work as quickly as possible, but returning them to a pain-free functional state and preventing the problem from recurring or becoming chronic. When pain becomes chronic it not only damages a patient's ability to work & enjoy life, but puts further stress on the Health Care system & the work force.
We therefore must apply the most effective forms of treatment available in order to restore our patients to a fully functioning state. Fortunately, numerous studies have shown that spinal manipulation has produced great success in the treatment of acute low back pain. And this, combined with other modalities available to us, provides Chiropractors with a very effective means to treat chronic low back pain.
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