With the exception of upper respiratory infections, back pain is the most common reason people give for visiting a doctor's office. It has been estimated that four out of every five American adults will suffer an incident of back pain at some point in their lives; some researchers believe that the total costs of treating back pain in the U.S. exceed $90 billion per year in office visits, medications and related expenditures - roughly one percent of the country's entire annual gross domestic product.1
While some incidences of back pain resolve within six weeks, many people suffer from chronic back pain, which can last from several months to, in many cases, years. It is considered the most expensive benign condition in the industrialized world, and the most common cause of disability in people younger than age 45. Left untreated, it can create conditions that dramatically alter a person's productivity and severely reduce quality of life. Many popular treatments for chronic back pain, however, merely attempt to provide some measure of pain relief, without treating the underlying causes of the condition.2
In a report conducted for the American Chiropractic Association (ACA), the I/H/R Research Group, an independent market research firm, surveyed 800 American adults, all suffering from chronic back pain of various durations.3,4 The purpose of the survey was to determine what treatments people use to help fight chronic back pain, and their opinions about seeing a doctor of chiropractic for care.
In the survey, participants were asked a variety of questions, including how long they suffered from back pain; the type of provider they first sought out for care; the types of treatments used to relieve back pain; the cause of and severity of pain; how well the pain was being managed; whether they would consider visiting a chiropractor to treat back pain; and whether they would prefer not to use medications for their back pain. Responses were then stratified based on respondents' age, geography, gender, income and marital status.
Among the survey's findings:
- Most of the respondents had experienced back pain for an exceeding length of time. Over 71 percent had suffered chronic back pain for five or more years; 84.6 percent had suffered back pain for a minimum of three years.
- The most common diagnosis as to the cause of chronic back pain was an injury or accident (18.3 percent), followed by degenerative disc disorder (12.5 percent), herniated disc (10.3 percent) and arthritis (10 percent). Interestingly, 2.6 percent of the surveyants said they were diagnosed with "nothing" as the cause of their back pain.
- General practitioners and family doctors were the first choice for most people with back pain; 55.1 percent of the respondents saw one of those providers when their back pain began. Another 18.8 percent chose to see a chiropractor first. Family doctors and GPs were also the providers most likely to set up a treatment regimen for back pain (35.3 percent), followed by chiropractors (13.8 percent).
- The most common remedy for back pain? Drugs. More than 27 percent of those taking the survey reported taking analgesics or narcotics to relieve their chronic back pain; 25 percent used over-the counter medications, such as Tylenol and Advil; 19.6 percent used muscle relaxants; and 18 percent used nonsteroidal anti-inflammatories (NSAIDs). Many respondents used a combination of drugs for pain relief. Only 10.8 percent of the respondents reported current use of chiropractic care to treat their back pain.
- Despite the widespread use of drugs to treat back pain, they appeared to be largely ineffective for a plurality of the respondents. Almost 40 percent of the people surveyed reported their back pain as being either "severe" or "very severe" at the present time; less than 31 percent reported that their back pain was "under control" or "completely under control" at the time they answered the survey; and 41 percent said their back pain was either "not under control" or "not under control at all."
- When the respondents were asked if they would consider seeing a chiropractor for their back pain, a clear majority - 64.4 percent - said "yes." Younger respondents, and those living in the southern and western regions of the country, were more apt to consider seeing a chiropractor than older respondents and those living in the northeast or Midwest.
- When asked if they would prefer to avoid the use of medications during back treatment, an even higher number of respondents (80.3 percent) answered that they would. Interestingly, people with the highest annual income (and thus presumably more able to afford drugs than people on lower incomes) were the group least likely to prefer using medications for pain relief.
Given the overwhelming ineffectiveness of drugs in relieving chronic back pain, and that most people would prefer more natural methods of pain relief if such an option were available, why did so few people in the survey seek out and use a chiropractor for care? ACA President Donald J. Krippendorf, DC, hinted that the profession must do more to educate the public about chiropractic's vast array of benefits:
"The survey results reiterate that chiropractic offers the treatment options desired by patients - compassionate health care that works safely, without drugs or surgery," remarked Dr. Krippendorf. "However, the information provided also shows that more needs to be done to educate patients, physicians and the health community about the benefits of chiropractic care and its ability to manage pain effectively."3
The results of the I/H/R survey should serve as an important point of discussion for chiropractors nationwide. On the one hand, the survey shows that people with chronic back pain would be more than happy to see a DC for treatment, and would prefer a drugless form of back pain care. On the other hand, it shows that the chiropractic profession must do a better job of promoting itself as a provider of safe, natural, drug-free methods of pain relief - and not just for back pain, but other elements crucial to maintaining overall health and well-being. Only then will the general public realize all of the benefits doctors of chiropractic can offer.
References
- Economic impact of back pain substantial. Science Daily, Jan. 1, 2004.
- Wheeler AH, Stubbart JR. Pathophysiology of chronic back pain. eMedicine.com specialty article: www.emedicine.com/neuro/topic516.htm.
- Survey: chronic back pain sufferers prefer drug-free pain management. ACA press release, Aug. 20, 2004.
- 2004 Chronic Back Pain Omnibus Survey. Conducted by I/H/R Research Group.
