Sociedade Brasileira de Coluna e Federação Mundial de Quiropraxia: uma nova parceria científica

Abstract

The recently published multinational Global Burden of Disease 2010 study listed low-back pain (LBP) and neck pain as the first and fourth leading causes of disability worldwide, and as a group musculoskeletal disorders are second only to mental and behavioral disorders as a cause of disability 1. Back and neck pain combined have a greater impact on global health than HIV/AIDs, malaria, lower respiratory infections, stroke, breast and lung cancer combined, Alzheimer's disease or diabetes. Spinal pain now is recognized as imposing an enormous and growing cost to individuals. It is increasing recognition that current models for the management of patients with spinal pain have not been very effective and there have been many calls for improved management. This has led to a 'revolution' in the management of spinal pain, to use the description of UK orthopedic surgeon and backpain specialist Gordon Waddell 2. This revolution began in the 1990s in the USA and the UK with new national evidence-based guidelines for the management of acute LBP, developed by multidisciplinary panels of experts. 3,4 On these panels physicians and surgeons were joined by other healthcare providers including chiropractors and occupational and physical therapists. The recommendations made have been strengthened by subsequent research and followed by a number of updated guidelines for acute and chronic back 5 and neck pain 6. These guidelines recognize that a significant number of patients have genetic, degenerative and traumatic disorders that require surgical intervention, but that the great majority of patients with spinal pain and disability have non-specific mechanical back and neck pain that can be successfully managed by non-surgical methods. Treatment modalities that are most commonly recommended in these guidelines include symptom control through oral medications (acetaminophen and NSAIDS) or spinal manipulative therapy, early return to activity, use of exercises after the acute phase, and patient education and encouragement and education to reduce risk factors that increase associated disability. For many types of back and neck pain where surgery is contemplated, outcomes for non-operative care can be comparable with those from surgery. 7 In 2013, from the perspectives of patients, healthcare professionals, and third parties who fund healthcare, there is clear value in orthopedists, chiropractors, physiotherapists and others working together in an interdisciplinary evidence-based team approach to the improved management of spinal disorders. Recent studies in Canada, the UK, and the USA report superior results for patients with back and neck pain when skilled spinal manipulation and exercise are added to or compared with usual medical care. 8-10 In these circumstances it is not only an honor for the World Federation of Chiropractic (WFC) to now become one of the sponsoring organizations of Coluna/COLUMNA but also, we believe, appropriate. The WFC, a non-governmental organization or NGO in official relations with the World Health Organiz...