Chiropractic Department of Defense Gains Interest

Chiropractic management of patients experiencing spine pain is becoming more and more mainstream in both the national and international healthcare systems. The chiropractor playing a central role in care coordination has received heighted attention within the Department of Defense. In a recent study by Hays et al (2022) in cooperation with UCLA, RAND Corporation, Parker University, Duke University, and Palmer University, the authors stated, “More than half of US adults have received care from a chiropractor. The chiropractic therapeutic approach for LBP includes evaluation, management, and treatment with conservative care options like spinal manipulation, exercise, and lifestyle advice. Meta-analyses have shown that spinal manipulation is effective for acute and chronic LBP” (pg. 2).

The paper continues by explaining outcome measures, stating, “The Patient-Reported Outcome Measurement Information System (PROMIS) includes measures of physical, mental, and social health” (pg. 2). Patient satisfaction with chiropractic care has been a hallmark of the profession’s growth and continued use. The authors outlined, “PROMIS measures remain unreported in clinical trials assessing chiropractic care.... a recent pragmatic, clinical trial of 750 active-duty military personnel designed to compare usual medical care (UMC) to UMC plus chiropractic care (UMC+CC) [13, 14] administered 2 “legacy” measures: the Roland Morris Disability Questionnaire (RMDQ) [23] and a numeric worse pain intensity item” (pg. 2).

Hays et al asserted, “Pre-planned secondary outcomes from this rigorous, pragmatic RCT demonstrate that chiropractic care can positively impact HRQOL [Health Related Quality of Life] beyond pain and pain-related disability. This along with prior research suggests positive effects of chiropractic care on patient-reported outcomes up to 3 months” (pg. 9).

Interestingly, the paper concludes, “The use of PROMIS measures encompassing physical, mental, and social health provided a richer, more holistic picture of response to chiropractic care, with less time commitment for trial participants demonstrating benefit for outcomes assessment in research and clinical practice” (pg. 9).” It is now a critical part of the discussion relating to the diagnosis and management of spine pain to include both the objective AND subjective reporting of outcomes. Chiropractic management of spinal disorders is an important part of this process, and working with a chiropractor trained to coordinate care is now more important than ever.

Dr. William Owens Jr is currently in private practice in Buffalo, NY. His practice employees 4 Doctors of Chiropractic and 2 Doctors of Physical Therapy. He is President and CEO of the National Spine Management Group, LLC and Clinical Director of the Fellowship in Spinal Biomechanics and Trauma. Additionally, Dr. Owens is Adjunct Faculty in Family Medicine at the State University of New York at Buffalo Jacobs School of Medicine and Cleveland University Kansas City, College of Chiropractic. He can be reached at 716.228.3847.

Reference

1. Hays, R D., Shannon, Z. K., Long, C. R, Spritzer, K. L., Fining, R. I)., Coulter, I.,... & Goertz, C. M. (2022). Health-related quality of life among United States service members with low back pain receiving usual care plus chiropractic care plus usual care vs usual care alone: Secondary outcomes of a pragmatic clinical trial. Pain Medicine.