Back Pain

I.Q. -- Interesting Quotes

Editorial Staff

Strictly Medical Approach is Disadvantageous

In the April, 1993 issue of the British Medical Journal, Dr. Andrew Frank, rheumatologist at Northwick Park Hospital in Harrow, makes some interesting comments in his article, "Low Back Pain." Dr. Frank was one of the authors of the Meade et al., study that showed chiropractic care more effective compared to hospital outpatient care for low back pain of mechanical origin.

Consider these statements:

"Modern management emphasizes self care, and bed rest should usually not be longer than 48 hours.

"Medical training may hinder a satisfactory therapeutic approach by concentrating on the exclusion of serious (although usually uncommon) disease: patients may feel that what they need is understanding of their problems and alleviation of their symptoms. This may explain why so many people seek help from heterodox (non-allopathic) practitioners1 and their apparent success.2

"A strictly medical approach to management is disadvantageous.

"The beneficial effects on the economy of 'a few days' saved for work by more effective means of treatment are potentially enormous.

"There is now published evidence that back pain and disability can be ameliorated and that further episodes can often be minimized by professional intervention at the start of the first attack. Absence from work can be shortened through physiotherapeutic and chiropractic (and probably osteopathic) manipulation, physical training, a variety of exercise programmes, and multiprofessional rehabilitation."

According to Dr. Frank, back pain costs the United Kingdom:
  • 56.2 million certified working days

     

  • estimated loss output of 2 billion pounds (approximately $3 billion U.S. dollars)

     

  • physician costs estimated at 2 million pounds

     

  • hospital (inpatient and outpatient) costs of 400,000 pounds ($600,000 U.S.)

Considering the fact that this review was published in the British Medical Journal, it should cause the medical community to reconsider their opinion of back care and chiropractic. It appears that the driving force of economics may be more powerful than the old time prejudices still held by many in medicine.

References

  1. Aldridge D. Europe looks at complementary medicine. BMJ 1989;299: 1121-2.

     

  2. Meade TW, Dyer S, Browne W, Townsend J, Frank AO. Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment. BMJ 1990;300: 1431-7.
November 1993
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