In 1993, Dr. David Eisenberg made national headlines when a study he co-authored, "Unconventional Medicine in the United States," was published in The New England Journal of Medicine.1 The study found that one out of every three adults in the U.S. had used some type of alternative treatment, and that chiropractic was the second most popular form of "unconventional therapy." Subsequent studies by Eisenberg and fellow researchers have found the use of alternative therapies has remained relatively stable, and that chiropractic care is being used to treat conditions ranging from back pain and arthritis to headaches and neck pain.
As the reports by Eisenberg and others show, "alternative medicine" is no longer really alternative. Just as the scientific world has explored the use of alternative medicine by the American public, so have more mainstream media outlets. Case in point: Consumer Reports, a monthly magazine with a subscription base estimated at more than 4 million. In late 2004, the magazine sent an annual questionnaire to its readers regarding their use of both alternative and conventional therapies. The results of that survey, published in the August 2005 issue of the magazine,2 reveal some surprising statistics - and opinions - about chiropractic care.
More than 34,000 readers participated in the survey, which asked them to rate the effectiveness of both conventional and alternative forms of care for their two most problematic health conditions experienced during the past two years. Readers were asked to rate each treatment depending on whether it helped "a lot," "somewhat," "a little," or "not at all." The respondents based their opinions of the effectiveness of care on personal experience, rather than scientific measurements.
Forty-seven percent of the respondents reported trying at least one alternative remedy in the past two years, a figure slightly higher than reported in the Eisenberg studies, yet in keeping with other national surveys on alternative medicine use. In addition, women were more likely than men to have tried, and liked, "hands-on" treatments such as chiropractic, massage and acupuncture.
Readers also seemed willing to share their experiences with alternative medicine with their medical doctor. Of readers who had used an alternative therapy, approximately 75 percent told their doctors about it. Most of the doctors approved the use of such treatments; in fact, 25 percent of those readers told Consumer Reports their doctor had suggested the alternative treatment in the first place.
In terms of individual conditions, chiropractic ranked first out of 11 treatments, including massage, acupuncture, and exercise, in its ability to treat back pain. More readers said that chiropractic "helped me feel much better" than any of the other therapies. Prescription drugs and over-the-counter drugs ranked eighth and 10th, respectively.
Chiropractic also ranked first (out of eight treatments) in the treatment of neck pain, with prescription drugs and over-the-counter drugs ranking sixth and seventh, respectively. In fact, for only one condition - osteoarthritis - in which chiropractic, prescription drugs and OTC drugs were compared did either class of drugs rank higher.
Even with the favorable impression given chiropractic by its readers, however, the editors of Consumer Reports stated several times that manipulation of the neck "can be risky." In a related story, the editors stated that "we can't recommend its use on the neck," citing a 2003 study of stroke victims that alleged that manipulation could damage the lining of the arteries of the neck. Consumer Reports then went one step further, stating that "the clinical trial evidence for chiropractic is mixed," and that "objective scientific studies have found that chiropractic manipulation helps back pain only a little," without citing any studies to reinforce their assertions. The reason chiropractic care seems to be more effective, they surmised, stemmed from the extra time and attention chiropractors give their patients.
The article also featured commentary from a medical doctor from New Hampshire, who recommended against chiropractic care if a person's back pain was caused by spinal stenosis or a herniated disc. "Excessive motion might make things worse rather than better," said Dr. William Abdu, medical director of the Spine Center at Dartmouth-Hitchcock Medical Center.
It has been 12 years since Dr. Eisenberg's landmark study on "unconventional medicine" was published. While the Consumer Reports survey can't be considered in the same scientific vein as that study, several important points from the survey's results are evident, and in some ways, just as relevant. First, alternative medicine is continuing to increase in popularity: Nearly half of those taking the survey reported using at least one form of alternative treatment in the previous 24 months. Second, the American public is relying more and more on alternative forms of care such as chiropractic to help them. And third, as they have demonstrated in the past, Consumer Reports3 and other publications still have a certain reluctance to give chiropractic its due, despite what their readers tell them.
References
- Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. The New England Journal of Medicine 1993;328:246-52.
- Which alternative treatments work? Consumer Reports August 2005;70:39-43.
- Sportelli L. Consumer Reports cannot con the consumer. Dynamic Chiropractic, May 29, 2000: www.chiroweb.com/archives/18/12/17.html.
