March 2004

Low back pain study to include chiropractic

The Center for Complementary and Integrative Medicine was awarded $878,000 by the Health Alliance Plan (HAP) for a chronic low back pain study, including a chiropractic component. The center, located in Novi, Mich., is part of Henry Ford Health System.

The study, led by Robert A. Levine, Ph.D., co-director of the center, aims to improve the quality of care for chronic low back pain sufferers while reducing health care costs.

More than 100 million people in the United States suffer from chronic low back pain. The disease is a significant, multi-billion dollar cost to American society, taking into account health care costs, time off of work and lost productivity.

Low back pain is traditionally treated with physical therapy to rehabilitate the patient and pharmaceuticals, such as pain killers and anti-inflammatory drugs, to manage pain. In severe cases, surgery or injections are employed.

"HAP is providing a great service to the medical community by providing funding for a back pain program that will be easily reproduced throughout the health care system," said Levine. "We expect the study to show that novel, integrative approaches are valid and produce positive results with patients. Once the approaches are validated on a large scale, providers will be placed in parts of Henry Ford Health System to administer the treatments."

Patients will initially be evaluated by Shlomo Mandel, M.D., a Henry Ford Hospital orthopedic specialist. Participants will then receive conventional care or one of two innovative approaches to treating back pain:

• Comprehensive Integrative Care — includes chiropractic manipulation, neuromuscular therapy, movement reeducation (breaks dysfunctional movement patterns), acupuncture and hypnotherapy.

• Streamlined Integrative Care — includes therapy that restores neuromuscular balance, non-needling acupuncture, a joint mobilization technique and hypnotherapy.

"This is an innovative program because it is a multi-modal approach that comprehensively addresses the whole person," said Levine. "There is significant evidence that indicates using a single mode of therapy to treat chronic disease is often ineffective. Our integrative program maximizes the synergy between different treatments and offers the patient the best chance of recovery."

The initial research to validate the approaches will be complete in approximately 18 months. Following the initial research, the study will demonstrate that the treatments can be disseminated in other areas of Henry Ford Health System and produce similar positive results.

Henry Ford Health System, one of the country's largest health care systems, integrates primary and specialty care with research and education. It includes six owned or affiliated hospitals, a 540,000 member health maintenance organization, 22 ambulatory centers, home health care and other health-related entities located throughout southeastern Michigan. Last year, the system recorded 2.5 million ambulatory visits.

Source: Health Alliance Plan, www.hap.org; Henry Ford Health System, www.hfhs.org

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