Results also show doctors of chiropractic (DCs) were most often associated with the lowest-cost, least-invasive care pathways.
The Foundation for Chiropractic Progress (F4CP), a not-for-profit organization educating the public about the benefits of chiropractic care, highlights a new study published in Spine showing a plurality of patients with new-onset neck pain first visited a DC.
The study, “Longitudinal Care Patterns and Utilization Among Patients with New-Onset Neck Pain by Initial Provider Specialty” is the first to examine which provider patients visit first specifically to manage new neck pain and how that influences the other care services accessed. Results show that DCs, who are commonly associated with back pain, are most often a patient’s first choice for neck pain, based on an analysis of health plan claims from 770,326 patients over three years.
Spine is an international peer-reviewed, bi-weekly periodical that publishes original articles focused on the treatment of spinal disorders.
“It is rewarding to see that so many Americans are first choosing drug-free, natural chiropractic care to manage their neck pain and avoid the potential health and safety risks of pharmaceutical drugs, injections and surgery,” said Sherry McAllister, DC, president, F4CP. “We celebrate comprehensive, peer-reviewed studies like this that contribute to the growing body of evidence demonstrating how chiropractic care helps patients manage musculoskeletal pain more easily and safely, but also at a lower cost to themselves and health insurers.”
Recent guidelines recommend nonpharmacologic interventions, such as spinal manipulation (commonly known as a chiropractic adjustment), heat, massage or acupuncture, as first-line treatment options for low back and neck pain. Specialty physician consultations and opioid prescriptions in the absence of red flags (e.g., fever, fracture, malignant neoplasms) are not recommended.
In adherence to those guidelines, DCs were chosen first by 45.2% of patients with neck pain, followed by allopathic or osteopathic primary care doctors (33.4%). Other physician specialties, including orthopedists, neurologists and emergency physicians were also sought first to manage neck pain although less often, according to the study.
When patients first visited a DC, 2% or less received costly imaging, specifically computed tomography (CT) and magnetic resonance imagery (MRI) scans compared to the more than 30% of patients who initially visited an emergency physician, orthopedist or neurologist. Similarly, 6.8% of patients received a therapeutic injection and 3.4% had major surgery after they visited an orthopedist first as compared to 0.4% and 0.1% of patients who first visited a chiropractor.
“Low back pain has been thoroughly researched, and this paper is the first in a series exploring neck pain to help healthcare providers, payers and patients understand the potential benefits of following guideline-concordant care to manage the condition,” said David Elton, DC, former Optum VP of Musculoskeletal R&D and co-author of the study. “As with the lower back, we are again finding that following guideline-concordant care for neck pain, which can include chiropractic care, tends to result in better patient outcomes and lower overall service utilization.”
Elton is co-authoring similar additional cohort studies to be published soon exploring the different types of providers chosen for neck pain and any associations with adverse events and pharmacological exposure.
About the Foundation for Chiropractic Progress
A not-for-profit organization with nearly 34,000 members, the Foundation for Chiropractic Progress (F4CP) informs and educates the general public about the value of chiropractic care delivered by doctors of chiropractic (DC) and its role in drug-free pain management. Visit f4cp.org/findadoc or call 866-901-F4CP (3427).