Care-Seeking Among Individuals With Chronic Low Back Pain

Carey, Timothy S.; Evans, Arthur T.; Hadler, Nortin M.; Kalsbeek, William D.; McLaughlin, Curtis P.; Fryer, J. G.

doi:10.1097/00007632-199502000-00009

Cited by 177 publications

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“…20,28 After physicians, chiropractors are the next major provider group, accounting for a substantial proportion of care. 7,8,21 In chiropractic, 40% to 68% of all patients report LBP as the primary reason for seeking care and NP as the second most common reason. 17,30,40 Among these 3 major types of care providers for LBP and NP, physicians and chiropractors are similar because both provide primary care, while physical therapists and chiropractors are similar because both provide manipulative and corrective care.…”

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confidence: 99%

“…34,35 Despite providing this apparently high proportion of care, physical therapists rank third behind physicians and chiropractors in patient care-seeking rates among the major clinician types who provide care for patients with LBP, 7,8 with the majority of persons seeking care for LBP from a physician. 7,21,28 Deyo and Tsui Wu 21 found that 59% of all persons with LBP seek care from a physician. In ambulatory care medical settings, LBP ranks fifth among all diagnoses as a reason for a physician visit and second among symptomatic complaints for a physician visit, accounting for 2.3% to 2.8% of all visits to physicians.…”

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Factors Associated With Care Seeking From Physicians, Physical Therapists, or Chiropractors by Persons With Spinal Pain: A Population-Based Study

Chevan¹,

Riddle²

2011

J Orthop Sports Phys Ther

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Low back pain (LBP) and neck pain (NP) account for as much as a third of all visits to outpatient physical therapy practices. 34,35 Despite providing this apparently high proportion of care, physical therapists rank third behind physicians and chiropractors in patient care-seeking rates among the major clinician types who provide care for patients with LBP, 7,8 with the majority of persons seeking care for LBP from a physician. 7,21,28 Deyo and Tsui Wu 21 found that 59% of all persons with LBP seek care from a physician. In ambulatory care medical settings, LBP ranks fifth among all diagnoses as a reason for a physician visit and second among symptomatic complaints for a physician visit, accounting for 2.3% to 2.8% of all visits to physicians. 20,28 After physicians, chiropractors are the next major provider group, accounting for a substantial proportion of care. 7,8,21 In chiropractic, 40% to 68% of all patients report LBP as the primary reason for seeking care and NP as the second most common reason. 17,30,40 Among these 3 major types of care providers for LBP and NP, physicians and chiropractors are similar because both provide primary care, while physical therapists and chiropractors are similar because both provide manipulative and corrective care. The conceptual and philosophical basis of care for physical therapists and chiropractors does differ, and 2 older studies conducted in the UK and Sweden indicate that chiropractors use more manipulation and physical therapists provide both manipulation and mobilization, as well as exercise, modality-based treatment, and education. 36,43 Variation in the attributes that determine care seeking for LBP has been docu-T T STUDY DESIGN: Secondary analysis of longitudinal population-based survey data. T T OBJECTIVES:To investigate factors associated with care seeking for physician-referred physical therapy (MD/PT), as compared to physician-only (MD) or chiropractic-only (DC) care for spinal pain. T T BACKGROUND:Although a large proportion of ambulatory physical therapy visits are related to spinal pain, physical therapists are not the most commonly seen provider. The majority of visits are to physicians, followed by chiropractors. We attempted to understand more about this disparity by examining social and demographic factors that differentiate between persons who see these providers. T T METHODS:Episodes of care were constructed from participants in 2 panels from the Medical Expenditure Panel Survey who had spinal pain. The provider of care was identified for each episode, and logistic regression was used to determine factors associated with MD/PT use compared to MD use, and MD/PT use compared to DC use. T T RESULTS:The majority of patients (61%) received MD care for spinal pain, followed by those who received DC (28%) and MD/PT (11%) care. Female sex, higher levels of education, and higher income were significantly associated with MD/ PT care over MD care. Increased age, female sex, lower self-health rating, and presence of at least 1 disability day were all significa...

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confidence: 99%

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confidence: 99%

Factors Associated With Care Seeking From Physicians, Physical Therapists, or Chiropractors by Persons With Spinal Pain: A Population-Based Study

Chevan¹,

Riddle²

2011

J Orthop Sports Phys Ther

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“…1 Over $25 billion is spent annually to treat LBP, not including the additional societal costs associated with time away from work and disability. 7 Identifying factors associated with LBP is important to aid in the development and implementation of effective treatments at lower financial cost.…”

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confidence: 99%

Changes in Pain and Disability Secondary to Shoe Lift Intervention in Subjects With Limb Length Inequality and Chronic Low Back Pain: A Preliminary Report

Golightly¹,

Tate²,

Burns³

et al. 2007

J Orthop Sports Phys Ther

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l ow back pain (LBP) is a considerable health and socioeconomic problem affecting 70% to 80% of adults at some time in their lives.12 LBP is the most frequent cause of activity limitation in individuals younger than 45 years and is the second most common reason for doctor visits in the United States.1 Over $25 billion is spent annually to treat LBP, not including the additional societal costs associated with time away from work and disability. t results: Subjects experienced relief of general pain symptoms (P = .0006) and pain associated with standing (P = .002) following lift intervention, with minimally clinically important (MCID) reductions in general pain for 9 of 12 subjects and MCID reductions in standing pain for 8 of 10 subjects. Subjects also had less disability on the disability questionnaire (P = .001) following the intervention, with 9 of 12 subjects experiencing MCID reductions in disability.t ConClusion: Shoe lifts may reduce LBP and improve function for patients who have chronic LBP and an LLI. Randomized controlled trials are needed to assess the efficacy of this intervention.

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“…23 Despite surgical intervention, up to 61% of patients continue to experience spinal pain after surgery. [3][4][5] These patients may continue to seek treatment and are faced with numerous options for pain management and functional restoration, including chiropractic care.…”

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confidence: 99%

Chiropractic management of postoperative spine pain: a report of 3 cases

Coulis

Lisi

2013

Journal of Chiropractic Medicine

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Objective: The purpose of this case series is to describe chiropractic care including spinal manipulation for 3 patients with postsurgical spine pain. Clinical features: Three patients with postsurgical spine pain (1 cervical fusion, 1 lumbar discectomy, and 1 lumbar laminectomy) presented for chiropractic treatment at a major US medical center. Treatment included spinal manipulation and/or flexion-distraction mobilization based on patient response to joint loading strategies. Intervention and outcomes: Two patients were treated with high-velocity, low-amplitude spinal manipulation; and 1 patient was treated with flexion-distraction mobilization. Treatment frequency and duration were 4 treatments over 4 weeks for case 1, 17 treatments over 7 years for case 2, and 5 treatments over 5 weeks for case 3. Subjective improvement was noted using numeric pain scores and functional changes; and upon completion, the patients reported being "satisfied" with their overall outcome. One episode of transient benign soreness was noted by 1 patient. No additional adverse events or effects were noted. Conclusion: In these 3 cases, patients with postsurgical spine pain responded positively to chiropractic care. Spinal manipulation/mobilization was tolerated without significant adverse effects.

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Care-Seeking Among Individuals With Chronic Low Back Pain

Cited by 177 publications

References 0 publications

Factors Associated With Care Seeking From Physicians, Physical Therapists, or Chiropractors by Persons With Spinal Pain: A Population-Based Study

Factors Associated With Care Seeking From Physicians, Physical Therapists, or Chiropractors by Persons With Spinal Pain: A Population-Based Study

Changes in Pain and Disability Secondary to Shoe Lift Intervention in Subjects With Limb Length Inequality and Chronic Low Back Pain: A Preliminary Report

Chiropractic management of postoperative spine pain: a report of 3 cases

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