A Comparison Between Chiropractic Management and Pain Clinic Management for Chronic Low-Back Pain in a National Health Service Outpatient Clinic

Wilkey, Adam; Gregory, Michael; Byfield, David; McCarthy, Peter W.

doi:10.1089/acm.2007.0796

Cited by 46 publications

(35 citation statements)

References 33 publications

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“…The biggest concentration of full economic evaluations (19 in number) pertained to the use of NCCAM's definition of manipulative and body-based practices (eg, chiropractic, osteopathic manipulation, massage, etc) for the treatment of back pain. [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] However, even this subgroup is fairly heterogeneous in terms of the therapy (or therapies) tested and/or the type of back pain treated. Eight of these comparisons involved chiropractic care for back pain; one for chronic, 53 one for acute 57 and six for either type.…”

Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

et al. 2012

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ObjectiveA comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts.Data sourcesPubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted.Eligibility criteria for selecting studiesStudies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included.Study appraisal methodsAll recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported.ResultsA total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460).ConclusionsThis comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies.

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Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

et al. 2012

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“…3,49 Although there is evidence that chiropractic treatment can be effective in treating lower back pain in adults, 50,51 there are few data specifically pertaining to pediatric chiropracty despite its popularity for children.…”

Section: Clinical Responsementioning

confidence: 99%

Complementary and Alternative Medicine Practitioners' Standard of Care: Responsibilities to Patients and Parents

Gilmour

Harrison

Asadi³

et al. 2011

Pediatrics

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In this article we explain (1) the standard of care that health care providers must meet and (2) how these principles apply to complementary and alternative medicine practitioners. The scenario describes a 14-year-old boy who is experiencing back pain and whose chiropractor performed spinal manipulation but did not recognize or take steps to rule out serious underlying disease—in this case, testicular cancer—either initially or when the patient's condition continued to deteriorate despite treatment. We use chiropractic care for a patient with a sore back as an example, because back pain is such a common problem and chiropracty is a common treatment chosen by both adult and pediatric patients. The scenario illustrates the responsibilities that complementary and alternative medicine practitioners owe patients/parents, the potential for liability when deficient care harms patients, and the importance of ample formal pediatric training for practitioners who treat pediatric patients.

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“…Cognitive-behavioral pain treatment programs are usually combined with a functional rehabilitation approach and prove to be a successful treatment for many (Wheeler, 2007). There are few studies on the use of pain clinics in the management of LBP, however Adam-Wilkey et al (2008) controlled trial compared outcomes in perception of pain and disability for a group of patients suffering with chronic LBP when managed in a hospital by either a regional pain clinic or a chiropractor and reported that reduction in mean pain intensity at the end of the study was 1.8 points greater for the chiropractic group than for the pain-clinic group.…”

Section: Pain Clinics In the Management Of Lbpmentioning

confidence: 99%

Therapeutic Exercises in the Management of Non-Specific Low Back Pain

Esther¹

2012

Low Back Pain

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A Comparison Between Chiropractic Management and Pain Clinic Management for Chronic Low-Back Pain in a National Health Service Outpatient Clinic

Abstract: This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.

Cited by 46 publications

References 33 publications

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

Complementary and Alternative Medicine Practitioners' Standard of Care: Responsibilities to Patients and Parents

Therapeutic Exercises in the Management of Non-Specific Low Back Pain

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