Chiropractic Care for Spine Conditions: Analysis of National Health Interview Survey

Abstract

Objective: To estimate the use of chiropractic care and perceived value for spinal conditions. Methods: National Health Interview Survey (NHIS) data from the Sample Adult for 1997, 2002, 2007 and 2012 and the Adult Alternative Medicine for 2002, 2007, and 2012 files were analyzed. National Population Estimates (NPE) was generated by applying the complete survey design structure. Odds ratios (OR) and 95% confidence intervals (CI) were generated to explore the likelihood that the respondents reporting spine-related problems would see Doctors of Chiropractic (DC) or other providers compared to those reporting no spine-related problems. Results: Reported use of chiropractic increased from 7.61% in 1997 to 10.11% in 2012 (p-value<0.001); the NPE increased by 8,023,162 adults. The OR of seeing a DC among those with the spine-related complaint was significantly higher (ranging over time from 4.31 to 3.09) than other providers, except in 2012 in which physical therapists were highest. For respondents reporting spine-related complaints, the OR was 2.40 (95%CI=1.28-4.50) for using chiropractic compared to osteopathic manipulation. Respondents with spine-related conditions were more likely to have a DC as their personal healthcare provider [OR(95%CI=3.48(2.60-4.65)]. Over 96% of those who did reported that it helped and were less likely to report using prescription medication [OR(95%CI) = 0.44(0.35-0.55)], over-the-counter medication [OR(95%CI) = 0.80(0.65-0.99)], surgery [OR(95%CI) = 0.35(0.23-0.52)], or physical therapy [OR(95%CI)=0.50(0.40-0.63)]. They were less likely to report receiving a recommendation from a medical doctor to seek chiropractic manipulation [n=224 (19.15%); OR(95%CI=0.49(0.39-0.62)]. Conclusion: The general use of chiropractic in the United States is slowly increasing but utilization is still low compared to that of primary care providers like MDs and NPs. A majority of NHIS 2012 respondents with spine-related problems used chiropractic manipulation for treatment and those who did were more likely to report that it helped and less likely to report using prescription and over-the-counter medications, surgery or physical therapy. Yet chiropractic care was hardly being recommended by medical doctors.