In a research paper published in the June, 1992 issue of the Chiropractic Journal of Australia, Dr. Phillip S. Ebrall demonstrated the cost effectiveness of chiropractic care in the Victoria, Australia WorkCare program. "Mechanical Low Back Pain: A Comparison of Medical and Chiropractic Management within the Victorian WorkCare Scheme" is a retrospective study of "all work-related mechanical low back pain (MLBP) claimants within a 12-month period in Victoria, Australia."
Dr. Ebrall compared two matched samples of 998 patients each where "management was solely by either a chiropractor or a medical practitioner." Excerpts from the study are printed below:
While in summation these results seem quite impressive, the detail behind each outcome is even more so:
Chiropractor Medical Practitioner n % n %Claimants where
comp. days = 0 606 30.4 224 11.3Claimants where
comp. days > 0 392 19.6 774 38.7 Total 998 50.0 998 50.0 X2 obs = 301, p 0.001, % shown is of total sample, n=1996. 2. For the outcome "the number of 'compensation days' taken by claimants within each sample," the average number of compensation days for all claims is lower among claimants with chiropractic management. 3. For the outcome "the occurrence of chronicity" among claimants requiring compensation days, there was a greater progression to chronicity among claimants receiving medical management. 4. For the outcome "the costing of claims within each sample," the average payment per claim was greater with medical management ($2,308) than with chiropractic management ($963). (Table 4)
Chiropractic Medical Practitioner $ $ All payments 963.47 2,308.10Compensation
payment 392.02 1,569.93Non-compensation
payment 571.45 738.17Provider
payment 369.01 209.60 Other payments 202.44 528.57(provider + other) = non-compensation payments
5. Other findings: A notable consideration for all claims is the higher average practitioner payment with chiropractic management. It is 1.75 times that of medicine ($369 chiropractic, $209 medical). The meaning of this finding will be discussed.
If this study is recording outcomes of palliative care by medical practitioners, then the social impact of such an approach is high. With respect to these 1,996 identified claims alone, medical management costs the community an additional $1,344 per claimant, which is an additional $1.3 million across the sample. If the Victorian chiropractors managed a similar portion (40%) of these injuries as do Oregon chiropractors,14 then the direct savings within the Victorian WorkCare scheme for this period would have been $10 million over 7,482 claims.
The real costs of the medical sample, however, must also include the cost to the employer of the greater number of compensation days (time off work). Claimants within the chiropractic sample required only one-quarter of the number of days off work, which would roughly translate to only one-quarter of the cost to the employer. The medical sample required an additional 19,270 days of compensation (total compensation days equal 6,243 d chiropractic, 25,513 d medical). The chiropractic management of MLBP clearly produces wide-ranging savings.25,27
"The financial and social savings inherent in the chiropractic approach could be maximized by:
(i) an increased participation rate by chiropractors in the WorkCare system, and
(ii) increased early referral of claimants with MLBP by medical practitioners to chiropractors.
"There is a higher average practitioner payment with chiropractic management, but this can be understood as reflecting a management process that is practitioner-intense, and is more than offset by other savings.
"The findings from this study firmly shift the onus onto chiropractors to report and critically analyze the components of their management for MLBP. Nachemson has identified the criteria to be met by research into work-related (occupational) MLBP.29 There is a need to determine what it is within the chiropractic management package that achieves such significant effectiveness. The RAND Corporation, in conjunction with the Consortium for Chiropractic Research and the Foundation for Chiropractic Education and Research are actively addressing these issues.30 Finally, close assessment of the medical package is indicated with a view to reducing the community's reliance on what has been indicated by this study to be a more expensive and less effective management of work-related MLBP."
25. Patijn J, Durinck JR. Effects of manual medicine on absenteeism. J Manual Med 1991; 6:49-53.
27. Johnson MR, Schultz MK, Ferguson AC. A comparison of chiropractic, medical and osteopathic care for work-related sprains and strains. J Manipulative Physiol Ther 1989; 12:335-44.
29. Nachemson A. Research methods in occupational low back pain. Spine 1991; 16:666-7.
30. Shekelle PG, Adams AH, Chassin MR, Hurwitz EL, Phillips RB, Brok RH. The appropriateness of spinal manipulation for low-back pain. Santa Monica: RAND, 1991.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
