What if research could prove doctors of chiropractic are best-suited to lead a multidisciplinary approach to managing low back pain from an effectiveness and cost perspective? The Duke University School of Medicine's Duke Clinical Research Institute (DCRI) is spearheading an exciting new study that puts primary spine practitioners including DCs at the head of a collaborative team approach to improving LBP outcomes.
Christine Goertz, DC, PhD, will serve as DCRI co-principle investigator with Adam Goode, DPT, PhD, joining Jon Lurie, MD, MS, of Dartmouth-Hitchcock Medical Center, to lead the lead the clinical coordinating center for the trial. DCRI's Hrishikesh Chakraborty, DrPH, will lead the data coordinating center.
The patient population will be drawn from 22 family medicine, primary care and general internal medicine clinics in three health care systems – Duke, Dartmouth and the University of Iowa; with plans to enroll 1,800 patients with a primary complaint of LBP. Doctors of chiropractic and physical therapists are considered primary spine practitioners for trial purposes.
A DCRI press release announcing the pragmatic IMPACt-LBP trial noted three primary goals investigators hope to achieve in the course of their research: "To compare the effectiveness of the multidisciplinary/Primary Spine Practitioner (PSP) model compared to usual care; to estimate the cost of implementation of the intervention; and to evaluate barriers and facilitators to implementing a multidisciplinary/PSP care model."
In the DCRI release, Dr. Goertz noted: "Current guidelines call for patients with lower back pain to be treated with non-pharmacological care options first. This study seeks to evaluate guideline-based care by placing patients at the forefront and having a collaborative, multidisciplinary structure in place to support their care."
The National Center for Complementary and Integrative Health is funding the study, with support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute of Child Health and Human Development.
A historic meeting between chiropractic and Make America Healthy Again (MAHA) leadership took place on March 10th, 2026, in Washington, D.C., featuring representatives from chiropractic national organizations, professional associations and policy principals. The collective goal: advancing the role of chiropractic in improving the health of Americans. Meeting participants focused on long-standing issues that have affected the chiropractic profession for decades, including access to care, reimbursement parity, and ensuring DCs have an appropriate role in national health policy discussions.
Radicular-like pain of the upper and lower extremities is among the most common presentations in musculoskeletal and spine-related practice. Traditionally, these symptoms are interpreted through a disc-centric and dermatomal framework, often leading clinicians to attribute limb pain, paresthesia or perceived weakness to spinal nerve-root pathology. While this approach is appropriate in cases of true radiculopathy, it frequently falls short when symptoms fail to follow consistent dermatomal patterns or correlate poorly with imaging findings.
A 46-year-old male presented to our clinic with a seven-year history of recurrent low back pain with sciatica. He reported stiffness and discomfort that worsened with prolonged sitting both at his desk job and during evening television time. The patient had seen multiple chiropractors over the years. In every case, spinal manipulation and other passive treatments would bring gradual symptom relief over 2-3 months. However, within another 3-6 months, the symptoms would return. Frustrated – and now considering a spinal injection and possibly surgery if that failed, he came to our office seeking a different approach.
