Chiropractic Faq

 
Q.  What is Chiropractic?
A.  Chiropractic is a branch of the healing arts which is concerned with human health and disease processes. Doctors of Chiropractic are physicians who consider man as an integrated being and give special attention to the physiological and biochemical aspects including structural, spinal, musculoskeletal, neurological, vascular, nutritional, emotional and environmental relationships.
 The practice and procedures which may be employed by Doctors of Chiropractic are based on the academic and clinical training received in and through accredited chiropractic colleges and include, but are not limited to, the use of current diagnostic and therapeutic procedures. Such procedures specifically include the adjustment and manipulation of the articulations and adjacent tissues of the human body, particularly of the spinal column. Included is the treatment of intersegmental aberrations for alleviation of related functional disorders.

Chiropractic is a drug-free, non-surgical science and, as such, does not include pharmaceuticals or incisive surgery. Due regard shall be given to the fact that state laws, as well as the nation's antitrust laws, may allow Doctors of Chiropractic to utilize ancillary health care procedures commonly referred to as being in the common domain.


Q.  Can Chiropractic help my back pain?
A.  Although doctors of chiropractic (DCs) care for more than just back pain, many patients visit DCs looking for relief from this pervasive condition.

Thirty-one million Americans have low back pain at any given time (1). One half of all working Americans admit to having back symptoms each year (2). One third of all Americans over age 18 had a back problem in the past five years severe enough for them to seek professional help (3). And the cost of this care is estimated to be a staggering $50 Billion yearly--and that's just for the more easily identified costs! (4).
 These are just some of the astounding facts about Americans and their miserable backs! Is there any wonder why some experts estimate that as many as 80% of all of us will experience a back problem at some time in our lives? (5).

Because back problems are this common it's probably going to happen to you too! Shouldn't you find out what to do about it before it happens rather than after? Why wait until you're hurting to learn about your treatment options?

When you're hurting you may not give this important decision the time and attention it needs to make the best choice. Here are the facts about manipulation as a treatment for back problems:

Manipulation is one of several established forms of treatment used for back problems. Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today's growing emphasis on treatment and cost effectiveness, manipulation is receiving much more widespread attention. In fact, after an extensive study of all currently available care (Over 11,000 scientific studies) for low back problems, the Agency for Health Care Policy and Research--a federal government research organization--recommended that low back pain suffers choose the most conservative care first. And it recommended spinal manipulation as the ONLY safe and effective, DRUGLESS form of initial professional treatment for acute low back problems in adults! (6). Chiropractic manipulation, also frequently called the chiropractic adjustment, is the form of manipulation that has been most extensively used by Americans for the last one hundred years. (7). Satisfied chiropractic patients already know that DCs are uniquely trained and experienced in diagnosing back problems and are the doctors most skilled in using manipulation for the treatment of back pain and related disorders (8).  Though this report was released in December of 1994, a scientific review was done to determine if changes should be made.  The results of this scientific review found that the guideline is as current today as it was in 1994. To learn more about the federal government's recommendations and how chiropractic manipulation may help you, contact our office.

 

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References:

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. Finding from a national study conducted for the American Chiropractic Association. Risher P. Americans' Perception of Practitioners and Treatments for Back Problems. Louis Harris and Associates, Inc. New York: August, 1994.

4.This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD, Summer 1994.

5.In Vallfors B, previously cited.

6.Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.

7.The RAND Corporation reported from its analysis of spinal manipulation research literature that 94% of all spinal manipulation is performed by chiropractors, 4% by osteopaths, and the remainder by medical doctors.

8. In Risher P, previously cited.


Q.  Is Chiropractic Cost Effective?
A.  Synopsis of Cost Effectiveness Research
Manga, Pran. "Enhanced chiropractic coverage under OHIP (Ontario Health Insurance Plan) as a means for reducing health care costs, attaining better health outcomes and achieving equitable access to health services." Report to the Ontario Ministry of Health, 1998.

This study demonstrates the ways in which individuals in Ontario are deterred from the use of chiropractic care because it is not covered under OHIP. Greater chiropractic coverage under OHIP would result in a greater number of individuals visiting chiropractors and going more often. The study shows that despite increased visits to DCs, this would result in net savings in both direct and indirect costs. It is very costly to manage neuromusculoskeletal disorders using traditional medicine. If individuals were able to visit chiropractors under OHIP a great amount of money would be saved by the government. Direct savings for Ontario's healthcare system could be as much as $770 million and at the very least $380 million.

Manga, Pran; Angus, Doug; Papadopoulos, Costa; Swan, William. "The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain." Richmond Hill, Ontario: Kenilworth Publishing, 1993

This study demonstrates that an increase in use of chiropractic care to manage low back pain would save an enormous amount of money. The study reveals that if management of low back pain was taken from physicians and given to chiropractors there could be a potential savings of millions of dollars every year. The study also revealed that spinal manipulation is both safe and more effective than drugs, bed rest, analgesics, and general practice medical care for managing low back pain.

Mosley, Carrie; Cohen, Ilava; Arnold Roy. "Cost-effectiveness of chiropractic care in a managed care setting." The American Journal of Managed Care 1996; 2: 280-282.

In this study the cost of health care for back or neck pain for individuals belonging to an HMO who used chiropractic care or other methods of treatment were evaluated. In this study the cost of surgery, use of diagnostic imaging, and the satisfaction of patients were evaluated. Claims that were paid from October 1, 1994 through October 1, 1995 were evaluated and analyzed. The cost of healthcare for back and neck pain was much lower for patients using chiropractic care than those using other treatments. Surgical costs and the satisfaction of patients was nearly the same for those who used chiropractic care and those who did not. The conclusion of the study is that chiropractic care yields similar outcomes to other forms of care at a much lower cost.

Dean, David; Schmidt, Robert. "A comparison of the cost of chiropractors versus Alternative Medical Practitioners." Richmond, VA: Virginia Chiropractic Association, 1992.

This study is an assessment of the difference in cost of treatment between chiropractors and other practitioners in dealing with individuals who have similar back-related problems. This study analyzed individuals who had medical visits in 1980 and had a combination of eleven health problems including arthritis, disc disorders, bursitis, low back pain, spinal related sprains, strains, and dislocations. Chiropractic care had a lower cost option for many back ailments.

Wolk, Steve. "An Analysis of Florida Workers' Compensation Medical Claims for Back-Related Injuries." Journal of the American Chiropractic Association 1988; 27(7): 50-59.

This study is an analysis of worker's compensation claims in Florida from June through December of 1987. All of the claims analyzed were related to back injuries. The greater purpose of this study was to compare the cost of osteopathic, medical and chiropractic doctors. The cost of drugs were not included in the analysis. The results of the study lead to the finding that individuals who had compensable injuries and were treated by chiropractors often times were not forced to be hospitalized. It was also revealed that chiropractic care is a "relatively cost-effective approach to the management of work-related injuries."

Johnson, Marjorie. "A Comparison of Chiropractic, Medical and Osteopathic Care for Work-Related Sprains/Strains." Journal of Manipulative and Physiological Therapeutics 1989; 12(5): 335-344.

This study analyzed data on Iowa state record from individuals in Iowa who filed claims for back or neck injuries in 1984. The study compared benefits and the cost of care received by individuals from MDs, DCs and DOs. There was a focus on individuals who missed days of work and were compensated because of their injuries. Individuals who visited DCs missed on average at least 2.3 days less than individuals who visited MDs and 3.8 days less than individuals who saw DOs. Less money was dispersed as employment compensation on average for individuals who visited DCs. On average, the disability compensation paid to workers for those who visited DCs was $263.66, $617.85 for those who visited MDs, and was $1565.05 for those who visited DOs.

Nyiendo, Joanne, Lamm, Lester. "Disability Low Back Oregon Workers' Compensaion Claims. Part I: Methodology and Clinical Categorization of Chiropractic and Medical Cases." Journal of Manipulative and Physiological Therapeutics 1991 14(3): 177-184.

This study examined 201 randomly selected workers' compensation cases that involved low back injuries that were disabling. Study found individuals who visited DCs less often initially went to the hospital for their injuries than those visiting MDs. Those who visited DCs often had a history of chronic back pain.

Nyiendo, Joanne. "Disability Low Back Oregon Workers' Compensation Claims. Part II: Time Loss." Journal of Manipulative and Physiological Therapeutics 1991 14(4): 231-239.

Report on loss of time for individuals who visited DCs and those who visited MDs for treatment of low back pain. Median missed days of work for individuals with similar severity of injury was 9.0 days for those visiting DCs and 11.5 for individuals visiting MDs. Individuals visiting chiropractors more often returned to work having missed one week or less of work days. There was no difference in time lost for individuals visiting DCs and MDs with no previous history of low back pain. The median of days missed of work for individuals who had chronic back pain and visited MDs was 34.5 days while the median of days missed of work for those visiting DCs was 9 days.

Branson, Richard. "Cost Comparison of Chiropractic and Medical Treatment of Common Musculoskeletal Disorders: A Review of the Literature after 1980." Topics in Clinical Chiropractic. 1999; 6(2): 57-68.

Comparison of costs of care provided by DCs and general and specialist MDs for individuals with musculoskeletal conditions. Study found that the majority of retrospective studies had positive results for chiropractic care.

Jarvis, Kelly; Phillips, Reed; Morris, Elliot. "Cost Per Case Comparison of Back Injury Claims of Chiropractic versus Medical Management for Conditions with Identical Diagnostic Codes." Journal of Occupational Medicine 1991; 33(8): 847-852.

Comparison of cost between MD and DC providers for injuries related to the back. The average number of treatments for medical claims was 4.93 as compared to 12.89 for chiropractic claims. Average days of care was 34.25 for medical claims and 54.49 for chiropractic claims. Average compensation cost for work time lost was $668.39 for medical claims and $68.38 for chiropractic claims. Average cost of care for medical claims was $684.15 and $526.84 for chiropractic claims. This study demonstrates that although individuals who receive chiropractic care usually have a greater number of visits to DCs than those who visit MDs the cost of care and the worker's compensation dispersed is lower for those visiting DCs.

Stano, Miron. "A Comparison of Health Care Costs for Chiropractic and Medical patients." Journal of Manipulative and Physiological Therapeutics 1993: 16(5): 291-299.

Comparison of cost for patients who received chiropractic care for neuromusculoskeletal problems versus those who received medical and osteopathic care. A fourth of patients analyzed were treated by chiropractors. These patients had lower health care costs. "Total cost differences on the order of $1000 over the two year period were found in the total sample of patients as well as in sub-samples of patients with specific disorders." Lower costs are attributed to lower inpatient utilization.

Stano, Miron. "The Economic Role of Chiropractic Further Analysis of Relative Insurance Costs for Low Back Care." Journal of the Neuromusculoskeletal System 1995; 3(3): 139-144.

Comparison of costs of care for common lumbar and low back conditions when a chiropractor is the first provider and when an MD is the first provider. Total payments for inpatient procedures were higher for MD episodes and especially episodes that lasted longer than a single day. Outpatient payments were much higher for MD initiated treatments as well.

Stano, Miron; Smith, Monica. "Chiropractic and Medical Costs of Low Back Care." Medical Care 34(3): 191-204.

Comparison of health insurance payments and patient utilization patterns for common lumbar and low back pain for patients who receive treatment from MDs and DCs. The results found that there were lower costs for episodes in which DCs were the first providers. The mean total payment when DC's were the first providers was $518 whereas the mean payment for cases in which a MD was the first provider was $1020.

Smith, Monica; Stano, Miron. "Costs and Recurrences of Chiropractic and Medical Episodes of Low Back Care." Journal of Manipulative and Physiological Therapeutics 1997: 20(1): 5-12.

Comparison of health insurance payments and patient utilization patterns for individuals suffering from recurring lumbar and low back pain visiting DCs vs. MDs. Insurance payments were higher for medically initiated episodes. Those who visited chiropractors paid a lower cost and were also satisfied with the care given. Because of this the study suggests that chiropractic care should be given careful attention by employers when using gate-keeper strategies.

"Utilization, Cost, and Effects of Chiropractic Care on Medicare Program Costs" Muse and Associates. American Chiropractic Association 2001.

Study examines cost, utilization and effects of chiropractic services on Medicare costs. The study compared program payments and service utilization for Medicare beneficiaries who visited DCs and those who visited other types of physicians. The results indicated that chiropractic care could reduce Medicare costs. Medicare beneficiaries who had chiropractic care had an average Medicare payment of $4426 for all Medicare services. Those who had other types of care had an average of $8103 Medicare payment for all Medicare services. The per claim average payment was also lower with chiropractic patients having an average of $133 per claim and individuals who did not have chiropractic care had an average of $210 per claim.

Prescription Drug Information
Using prescription drugs has become commonplace for many Americans. Because of the regular role prescription drugs play in daily life, few take the time to think of the seriousness of the problems that can arise from the use of such drugs. In 2000 reactions to drugs was the fourth leading cause of death in the United States. [1] This puts reactions to drugs in the ranks of lung cancer, heart disease and stroke. Lack of full knowledge of the effects of prescription drugs coupled with a somewhat lackadaisical approach to the use of prescription drugs is a volatile combination.

In their September newsletter, the Agency for Healthcare Research and Quality (AHRQ) released information regarding prescription drug costs. According to their newsletter, "prescription drug spending doubled from $60.8 billion in 1995 to $121.8 billion in 2000 and is expected to reach $160.9 billion in 2002." [2] AHRQ is launching research projects that will seek to find instances in which, "older, less expensive drugs or no drug treatment can work just as well as newer, more expensive drugs." Although prescription drugs are continuing to increase in price, AHRQ points out that, "very few studies have measured the cost benefits of new drugs." [2] Individuals are being forced to pay more for prescription drugs without truly knowing the benefits, and in regard to newer prescription drugs and older prescription drugs "little information is available to doctors to determine which therapy works best." [2] Billions of dollars are spent annually for treatments whose effects are not entirely clear.

The above is especially disturbing when one considers the May 1998 Journal of the American Medical Association study which stated that an estimated 106, 000 hospital patient deaths and 2.2 million injuries occur each year as a result of adverse reactions to prescription drugs. [3] With prescription drug costs dramatically escalating and the safety of these drugs being questioned the time seems especially right to demonstrate the benefits of drug-free treatments and interventions, such as chiropractic care.


1 Robert H. Shmerling, M.D. A perspective from Harvard Medical School. January 22, 2003.
2 Kass-Bartelmes BL, Bosco L, Rutherford MK. Prescription drug therapies: reducing costs and improving outcomes. Rockville (MD): Agency fro healthcare Research and Quality; 2002. Research in Action Issue 8. AHRQ Pub. No. 02-0045.
3 Thomas J. Moore; Bruce M. Psaty, MD, PhD; Curt D. Furberg, MD, PhD Time to Act on Drug Safety JAMA / volume:279 (page: 1571) May 20, 1998


Q.  Chiropractic Utilization Facts
A.  As evidence supporting the effectiveness of chiropractic continues to emerge, health care consumers are turning in record numbers to chiropractic care a form of health care aimed primarily at enhancing a patient's overall health and well-being without the use of drugs or surgery. More than 30 million people visited doctors of chiropractic last year for a variety of conditions, and more and more medical doctors are referring their patients to doctors of chiropractic.

Just a few interesting facts on this increasingly popular form of health care:

In 1970, there were an estimated 13,000 doctors of chiropractic licensed in the United States. This number had increased to 40,000 in 1990 and to approximately 50,000 in 1994. Thus, there is roughly one doctor of chiropractic for every 5,000 United States residents. (AHCPR Publication No. 98-N002, December 1997)

A recent study estimated that the number of doctors of chiropractic will double by the year 2010 (to over 100,000), far exceeding the 16 percent increase projected for medical doctors. Thus, it appears that doctors of chiropractic will represent a substantially larger proportion of health care professionals in the coming years. (AHCPR Publication No. 98-N002, December 1997)

The proportion of the United States population that uses chiropractic and the number of chiropractic visits per capita have approximately doubled in the past 15-20 years. (AHCPR Publication No. 98-N002, December 1997)

According to a study published in the November 11, 1998 issue of the Journal of the American Medical Association, approximately 11 percent of the population visited a doctor of chiropractic in 1997. According to the U.S. Census Bureau, today there are approximately 273 million people in the country. This translates into approximately 30 million patients who visited a doctor of chiropractic in 1997.

Chiropractic is the third largest doctoral-level health care profession after medicine and dentistry.
Click on the links at left to learn even more about chiropractic care - from important health tips you can use to prevent pain and injury to the latest information on research supporting chiropractic.


Q.  What is the research on chiropractic?
A.  Evidence for the Effectiveness of Chiropractic
Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective. Many other studies have shown that chiropractic care can contain costs and get workers back on the job in less time than other treatments. The following are excerpts from a few of the more recent studies:

 For Acute Low-Back Problems:
"For patients with acute low-back symptoms without radiculopathy, the scientific evidence suggests spinal manipulation is effective in reducing pain and perhaps speeding recovery within the first month of symptoms." - Clinical Practice Guidelines, AHCPR (1994)  This study was scientifically reaffirmed in 2002.

For Long-Term Low-Back Problems:
"There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than usual care by the general practitioner, bed rest, analgesics and massage." - Spine, Van Tulder and Bouter et al. (1997)

"...improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear." - British Medical Journal, Meade et al. (1995)

"Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months." - British Medical Journal, Koes et al. (1992)

For Pain:
"...patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain." - Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)

"...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system." - The Manga Report (1993)

For Headaches:
"Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache." - Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)

"The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values." - Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)

For the Elderly:
"[Elderly] chiropractic users were less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs." - Topics in Clinical Chiropractic, Coulter et al. (1996)

For Containing Costs and Getting Workers Back on the Job:
"The overwhelming body of evidence" shows that chiropractic management of low-back pain is more cost-effective than medical management, and that "many medical therapies are of questionable validity or are clearly inadequate." - The Manga Report (1993)

First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and "deserves careful consideration" by managed care executives concerned with controlling health care spending. - Medical Care, Stano and Smith (1996)


Q.  What is the history of Chiropractic?
A.  The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain. Hippocrates, the Greek physician, who lived from 460 to 357 B.C., also published texts detailing the importance of chiropractic care. In one of his writings he declares, "Get knowledge of the spine, for this is the requisite for many diseases".

In the United States, the practice of spinal manipulation began gaining momentum in the late nineteenth century. In 1895, Daniel David Palmer founded the Chiropractic profession in Davenport, Iowa. Palmer was well read in medical journals of his time and had great knowledge of the developments that were occurring throughout the world regarding anatomy and physiology. In 1897, Daniel David Palmer went on to begin the Palmer School of Chiropractic, which has continued to be one of the most prominent chiropractic colleges in the nation.

Throughout the twentieth century, doctors of chiropractic gained legal recognition in all fifty states. A continuing recognition and respect for the chiropractic profession in the United States has led to growing support for chiropractic care all over the world. The research that has emerged from " around the world" has yielded incredibly influential results, which have changed, shaped and molded perceptions of chiropractic care. The report, Chiropractic in New Zealand published in 1979 strongly supported the efficacy of chiropractic care and elicited medical cooperation in conjunction with chiropractic care. The 1993 Manga study published in Canada investigated the cost effectiveness of chiropractic care. The results of this study concluded that chiropractic care would save hundreds of millions of dollars annually with regard to work disability payments and direct health care costs.

Doctors of chiropractic have become pioneers in the field of non-invasive care promoting science-based approaches to a variety of ailments. A continuing dedication to chiropractic research could lead to even more discoveries in preventing and combating maladies in future years.

Education of Doctors of Chiropractic
Doctors of Chiropractic must complete four to five years at an accredited chiropractic college. The complete curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. Approximately 555 hours are devoted to learning about adjustive techniques and spinal analysis in colleges of chiropractic. In medical schools, training to become proficient in manipulation is generally not required of, or offered to, students. The Council on Chiropractic Education requires that students have 90 hours of undergraduate courses with science as the focus.

Those intending to become doctors of chiropractic must also pass the national board exam and all exams required by the state in which the individual wishes to practice. The individual must also meet all individual state licensing requirements in order to become a doctor of chiropractic.

An individual studying to become a doctor of chiropractic receives an education in both the basic and clinical sciences and in related health subjects. The intention of the basic chiropractic curriculum is to provide an in-depth understanding of the structure and function of the human body in health and disease. The educational program includes training in the basic medical sciences, including anatomy with human dissection, physiology, and biochemistry. Thorough training is also obtained in differential diagnosis, radiology and therapeutic techniques. This means, a doctor of chiropractic can both diagnose and treat patients, which separates them from non-physician status providers, like physical therapists. According to the Council on Chiropractic Education DCs are trained as Primary care Providers.

What is a Doctor of Chiropractic?
The proper title for a doctor of chiropractic is "doctor" as they are considered physicians under Medicare and in the overwhelming majority of states. The professional credentials abbreviation " D.C." means doctor of chiropractic. ACA also advocates in its Policies on Public Health that DCs may be referred to as (chiropractic) physicians as well.

Chiropractic Philosophy
As a profession, the primary belief is in natural and conservative methods of health care. Doctors of chiropractic have a deep respect for the human body's ability to heal itself without the use of surgery or medication. These doctors devote careful attention to the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health. A Doctor of Chiropractic is one who is involved in the treatment and prevention of disease, as well as the promotion of public health, and a wellness approach to patient healthcare.

Scope of Practice
Doctors of Chiropractic frequently treat individuals with neuromusculoskeletal complaints, such as headaches, joint pain, neck pain, low back pain and sciatica. Chiropractors also treat patients with osteoarthritis, spinal disk conditions, carpal tunnel syndrome, tendonitis, sprains, and strains. However, the scope of conditions that Doctors of Chiropractic manage or provide care for is not limited to neuromusculoskeletal disorders. Chiropractors have the training to treat a variety of non-neuromusculoskeletal conditions such as: allergies, asthma, digestive disorders, otitis media (non-suppurative) and other disorders as new research is developed.

A variety of techniques, treatment and procedure are used to restore healing which will be the topic of future education releases.


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Works Cited
Chapman-Smith, David: The Chiropractic Profession. West Des Moines, Iowa, NCMIC Group Inc., 2000: 11-17, 70-71.
Chiropractic: State of Art. Arlington, Virginia, American Chiropractic Association, 1998: 2-3, 12-14.
Spinal Manipulation Policy Statement. Arlington, Virginia: American Chiropractic Association, 1999: 6.


Q.  Does Medicare cover Chiropractic Care?
A.  Medicare does cover Chiropractic care for manipulation of the spine.  Medicare does not cover chiropractic care for any other services. 

Health News You Need: Warning to Medicare Beneficiaries
Recent government reports indicate that most Medicare HMOs do not provide chiropractic services. That is Illegal. Before signing up with a Medicare HMO or a Medicare+Choice plan, be sure to ask the following:

Does the HMO or plan actually use chiropractors to deliver these services? Many plans claim to have chiropractic services "available" but actually never or rarely provide them-or claim to provide them through the services of non-chiropractors.

Does the HMO (or its panel or staff) actually employ any chiropractors? If so, are they permitted to refer plan members for chiropractic care? Government studies indicate that most Medicare HMOs do not employ chiropractors or have them on staff, and that non-chiropractors make decisions concerning the appropriateness of referral for chiropractic care.

What are the actual HMO or plan statistics concerning the numbers of participants receiving chiropractic care from chiropractors? What is the average length of treatment? Many conditions require chiropractic treatment over a length of time--one or a few allowed services may have no or minimal effect. And, of course, to have any effect at all, chiropractic care must be provided by a chiropractor.
Remember, Medicare Part B beneficiaries already have the right to receive chiropractic care as provided by a chiropractor. That right should not be surrendered merely by walking through an HMO door. Consider the preceding material carefully before signing on for any Medicare+Choice HMO plans.


Q.  Are back packs a problem for children?
A.  Back pain is pervasive among American adults, but a new and disturbing trend is emerging. Young children are suffering from back pain much earlier than previous generations, and the use of overweight backpacks is a contributing factor, according to the American Chiropractic Association (ACA). In fact, the U.S. Consumer Product Safety Commission reports that backpack-related injuries sent more than 7,000 people to the emergency room in 2001 alone.

"In my own practice, I have noticed a marked increase in the number of young children who are complaining about back, neck and shoulder pain," said Dr. Scott Bautch, immediate past president of the ACA's Council on Occupational Health. "The first question I ask these patients is, 'Do you carry a backpack to school?' Almost always, the answer is 'yes.'"

This new back pain trend among youngsters isn't surprising when you consider the disproportionate amounts of weight they carry in their backpacks - often slung over just one shoulder. According to Dr. Bautch, a recent study conducted in Italy found that the average child carries a backpack that would be the equivalent of a 39-pound burden for a 176-pound man, or a 29-pound load for a 132-pound woman. Of those children carrying heavy backpacks to school, 60 percent had experienced back pain as a result.

According to Dr. Bautch, preliminary results of studies being conducted in France show that the longer a child wears a backpack, the longer it takes for a curvature or deformity of the spine to correct itself. "The question that needs to be addressed next is, 'Does it ever return to normal?'" Dr. Bautch added.

The results of these types of studies are especially important as more and more school districts - many of them in urban areas - remove lockers from the premises, forcing students to carry their books with them all day long.

The problem has become so widespread, in fact, that the California State Assembly recently passed legislation that would force school districts to develop ways of reducing the weight of students' backpacks. Similar legislation is being considered in New Jersey as well. The ACA believes that limiting the backpack's weight to no more than 10 percent of the child's body weight and urging the use of ergonomically correct backpacks are possible solutions.

What Can You Do?
The ACA offers the following tips to help prevent the needless pain that backpack misuse could cause the students in your household.
Make sure your child's backpack weighs no more than 5 to 10 percent of his or her body weight. A heavier backpack will cause your child to bend forward in an attempt to support the weight on his or her back, rather than on the shoulders, by the straps.


The backpack should never hang more than four inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.


A backpack with individualized compartments helps in positioning the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child's back.


Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry-and the heavier the backpack will be.


Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause the disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.


Wide, padded straps are very important. Non-padded straps are uncomfortable, and can dig into your child's shoulders.


The shoulder straps should be adjustable so the backpack can be fitted to your child's body. Straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.


If the backpack is still too heavy, talk to your child's teacher. Ask if your child could leave the heaviest books at school, and bring home only lighter hand-out materials or workbooks.


Although the use of rollerpacks - or backpacks on wheels - has become popular in recent years, the ACA is now recommending that they be used cautiously and on a limited basis by only those students who are not physically able to carry a backpack. Some school districts have begun banning the use of rollerpacks because they clutter hallways, resulting in dangerous trips and falls.


Dr. Hayes was involved in two separate studies of back packs.  The first was published in Ergonomics, a very prestegious Journal.  The abstract from the study can be found in the Scientific Articles section.  The best back pack identified to date is a back pack made by a company called RakGear.  This pack has individual shelves that fold up in the pack.  This will cause the weight to be distributed much more evenly.  This pack will be available to the public in 2004.  It is designed with the young person in mind, and has had much influence by the people who will actually use it.  It is very stylish, with a separate compart for a CD player.  It has wide, padded straps, and is uniquely designed to evenly distribute a load and prevent it from tending to all load up in one place.


If you or your child experiences any pain or discomfort resulting from backpack use, call our office. We are trained to diagnose and treat patients of all ages and will use a gentler type of treatment for children. In addition, we can also prescribe exercises designed to help children develop strong muscles, along with instruction in good nutrition, posture and sleeping habits.

Q.  Can Chiropractic help ear problems in children?
A.  Ear problems can be excruciatingly painful, especially in children; in other cases, a disorder related to the ear can render a patient so dizzy that simply standing up is a challenge. For some conditions of the ear, chiropractic adjustment/spinal manipulation and adjunctive therapies offer relief when traditional therapies have failed.


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