“Get Off Our Backs”

by

JC Smith, MA, DC

Americans love the underdog, whether it’s the hapless sports team beating the overwhelming favorite like the 1980 US hockey team consisting of college boys winning the gold medal against the pros from the USSR at Lake Placid Olympics, or any of the typical David versus Goliath situations. People seem very sympathetic to those who swim upstream against the current and prevail in their fight despite the heavy odds against success. It’s the stuff that movies are made of, such as the popular movies like “Rocky” and “Rudy.”

Who Are They?

One such group of underdogs has been virtually ignored by the press and public although their story is just as compelling. This group could be called the first libertarians fighting for freedom of choice in the health field long before civil rights, women’s rights or gay rights ever existed. For over one hundred years now, this tireless minority has stayed their course despite being thrown in jail without just cause, ostracized by the medical profession without good reason, and vilified by some in the press. Despite these huge problems, they have increased their ranks to 60,000 as they serve 30 million Americans each year as well as citizens in 88 countries around the world, and they now constitute the third-largest health care profession in the US. But do you know who they are?

Their crime was simply helping sick folks get well without drugs or surgery. With just their hands, a strong back and a thick skin, these underdogs not only fought against disease, pain and suffering, they were forced to fight against an unsympathetic medical profession that resented their economic competition and ideological difference as the AMA smeared their competitors’ image with a propaganda campaign never seen in any other American industry. This medical nemesis used the legal system to jail over 15,000 of these underdogs before state legislators stopped it with protective scope laws. As mentioned, their only crime was to help sick folks get well naturally, and for doing so, they were persecuted like “rabid dogs,” as the AMA called them. Even ethical MDs who referred patients to these providers were threatened with the loss of their licenses by their own vindictive medical society that attempted to have these competitors “wither on the vine.” Do you know who they are yet?

Bigotry in Health Care

The medical society not only caused these underdogs great difficulty to practice their healing art, they also made it personal with their bigoted attitudes, overt discrimination, and name-calling, much of which still lingers on today. While it may not be politically correct to discriminate against minorities, women or homosexuals, in the medical world it is still okay to discriminate against their rivals. In reality, it was simply a ruse to monopolize a market by eliminating any and all competition done under the guise of “protecting the public good.”

Indeed, “Jim Crow,” MD, is very much alive in the medical world today, and don’t think for a moment that all medical professionals atop their pedestals are above reproach. Bigotry is a hard attitude to change even when the facts disprove it, society frowns upon it, or the courts condemn it. Most people are unaware of the fact that in 1989 a federal court ruled against the AMA’s blackballing and antitrust activity since little has actually changed among many MDs and in most hospitals that still discriminate.

Just as minorities still suffer from racism, this form of “professional racism” is a type of discrimination that’s hard to escape, especially when its perpetrators are considered cultural authorities and the press willingly disseminates their misinformation. Fighting against these medical icons and a biased press makes for a tough battle in the court of public opinion, but this obscure medical minority has prevailed for over 100 years to bring a new healing method to the public, although not unscathed, that’s for sure. Do you know who they are?

If you haven’t figured out whom I’m talking about yet, it’s the chiropractors. Yes, those doctors who adjust the spine to help with back pain and nerve-related conditions. These professionals, often perceived as redheaded stepchildren in the health care profession, have fought to survive in practice and finally prevailed in their century-old battle to bring a new concept of health care to the American public. And now research is proving them right!

New Research Supports Chiropractic Care

Experts tell us that back pain is a $50-$75 billion industry in the US alone, back problems is the second-leading cause of disability, and back surgery is the third-leading reason for hospital admissions. Here in the US, low back pain will strike 8 of 10 adults sometime in their lifetime, it is the leading cause of disability for folks under the age of 45, and remains the leading on-the-job injury. As one researcher, Dr. Gordon Waddell, concluded, “Low back pain has been a 20^th century health care disaster.”

With nearly fifty randomized controlled trials during the past ten years, scientists have now shown repeatedly that spinal manipulation is the best treatment for the epidemic of back pain. With the escalating cost for back problems both in terms of money spent and lost workdays, many governments are seeking new solutions to this silent epidemic, and chiropractic care has shown the research intelligentsia its clinical and cost-effectiveness. As Canadian researcher, Dr. Pran Manga, said about chiropractic care, “The evidence is overwhelming.”

Even the US Public Health Service, which released in 1994 their findings of the largest investigation ever done into acute low back pain—a two-year study of nearly 4,000 articles from the Library of Medicine—stated that spinal manipulation was a “proven treatment” for low back pain. This report also states “Surgery has been found to be helpful in only one in 100 cases of low back problems.” Despite the US federal guideline’s recommendation for spinal manipulation for acute low back pain, more back surgeries are being done today than ever before despite their high costs and ineffectiveness. Incredibly, the US does five-times more back surgery per capita than England and Scotland combined; either we Americans intrinsically have very weak backs or, more plausibly, too many surgeons who ignore the federal guideline!

Moreover, the Department of Defense conducted a 5-year demonstration project on chiropractic care and concluded that it would save the military health system over $25 million annually and decrease lost workdays by 199,000. President Clinton signed into law last year a bill extends chiropractic care to every active military personnel, and Congress now wants the same benefit in the VA and TriCare for retirees.

A recent article by Dr. Richard Deyo in The New England Journal of Medicine states that 97% of back pain is due to “mechanical” problems such as misaligned spinal joints, and less than 3% have to do with disk problems or referred pain. When the Bible of the medical society admits to this, you know the tide has turned as far as research is concerned, although some experts estimate that it takes 17 years before the latest research becomes routine care among practitioners. Indeed, if the electronics industry were as intransigent as the medical profession, we would still be in the vacuum tube era.

It’s easy to understand why spinal manipulation is effective once you understand the spine itself. The most amazing thing about the human backbone is that it’s not one bone but actually a pillar of 24 small vertebrae bones sitting on top of 3 pelvic bones interconnected by 23 disks and 137 joints. Once this pillar of joints is misaligned from injuries, whether it’s from sports, falls or car accidents, or just from prolonged sitting or standing for too long, these joints will misalign by becoming compressed, wrenched apart or twisted in some way. In turn, once this mechanical misalignment of the joints causes the disk to swell, then the “pinched nerve” reflex will cause muscle spasms, pain radiating down a leg or arm or into the head, and in many cases, pinched nerves may also cause organs to become dysfunctional. But the primary cause in this snowball effect begins with the misaligned spinal joints, which explains why manipulation works so well to correct these mechanical problems in the spine.

The Failure and High Costs of Back Surgery

The unsuccessful outcomes for back surgery are staggering. Recently a study by Dr. E. Berger in Surgical Neurology of one thousand workers’ comp cases with lumbar spinal fusions startled the medical world. Of 600 single-surgery patients, 71% never returned to work, and of the 400 patients with multiple-surgeries, 95% never returned to work. Despite these low rates of success and the recommendation by the USPHS for spinal manipulation as a first avenue of treatment, surgeons ignore these facts as back surgeries continue to increase due to their profitability, nearly $30,000 for a spinal fusion. So, the battle now between chiropractors and surgeons has less to do with helping patients with the best methods as much as it has to do with controlling the almighty dollar.

Before anyone contemplates back surgery, many experts now believe the “slipped disk” theory has misled patients for decades, and recent MRI research studies affirm that disk problems account for only 1% of back problems. Despite MRI studies that debunk the disk theory, it remains the single largest reason why surgeons do spinal fusions. These exams found disk abnormalities in patients with no back pain, leading one orthopedic/researcher, Dr. Scott Boden, at Emory to state that “finding disk abnormalities is like finding gray hair” in that everyone has it, but it doesn’t mean you need surgery. But most orthopedic surgeons will never tell you that!

Consider Georgia’s workers’ compensation statistics from 1999: there were nearly 3,000 low back cases that cost the state over $28 million, which equates to nearly $10,000 per case. Interestingly, this included only 81 chiropractic cases that cost $79,000, which equates to less than $1,000 per case for the same diagnostic condition. Although chiropractic care is covered by workers’ comp, most patients are tracked into surgery despite their expense and poor outcomes due to the for-profit nature of workers’ comp insurance, again illustrating how the “system” profits at the demise of the patients forced into back surgeries with low success rates.

The Human Toll of Back Pain

The saddest part in the damage done to these disabled surgical victims is the fact that, in most cases, they never needed any disk surgery in the first place. Aside from the science and economics of back pain treatments, there’s a very personal aspect that’s rarely included in these statistics—the emotions of disabled lives from failed back surgery.

What would you say to a patient with failed back surgery syndrome who was misdiagnosed with a slipped disk, mistreated by unnecessary spinal surgery, misinformed about chiropractic care as a viable alternative, and now has a permanent spinal problem and constant pain due to the surgery itself? To make matters worse, many patients have multiple back surgeries until they are finally sent home with a morphine pump to live in pain the rest of their lives. As they say in poker, it’s equivalent to “throwin’ good money in after bad.”

As the late author Dr. Robert Mendelsohn once said, “Anyone who has a back surgery without seeing a chiropractor first should also have his head examined!” But I understand why patients have unnecessary back surgeries. Many are lied to about their condition, lied to about chiropractic care, and many are coerced into surgery by surgeons and insurance companies who profit greatly in this seedy scenario. Ironically, some insurance companies still discriminate against chiropractic because, in effect, it’s too cheap! These companies work on a “cost-plus” basis, so the more they pay out in claims, the more they can charge in premiums. Indeed, only in the medical world is the “better mousetrap” concept a bad idea—saving money is not their idea of good business.

15 Minutes of Fame?

The chiropractic profession leads the trend to alternative health care, yet these unheralded health libertarians have remained out of the spotlight for the most part. Rarely has the media told the chiropractic story from a positive light, never explaining why 30 million Americans sought chiropractic care last year. Never has the public seen a TV program, “Marcus Welby, Chiropractor.” Never has a chiropractor been made a hero even when they keep athletes like Tiger Woods, Barry Bonds, Joe Montana, Olympic athletes and thousands of others feeling good to play well. If everyone is due their 15 minutes of fame, never has this underdog had his day.

Instead, the usual media slant is to reiterate the tired old medical propaganda or they embellish the maverick chiropractor who has caused some problem. Sometimes the media just makes me want to scream with their dire lack of objective information how chiropractic care can help millions of suffering people and, for the most part, remains a taboo issue in the media. Indeed, when was the last time anyone has read a newspaper article touting the effectiveness of chiropractic care?

What You Need to Know

Since the media has been mum, what would the chiropractic profession like to tell the world about the good news of our spinal care?

• Don’t believe the medical propaganda that you may have heard in the past. Much was slander of the worst type—it impugned the character of men and women whose only crime was getting sick folks well without drugs and surgery. And if your MD still demeans chiropractors, find yourself another MD who is honest.
• Just like your teeth, get your spine checked regularly by a chiropractor, especially if you’re active in sports or strain your back at work with prolonged sitting or manual labor. For your kids, consider a chiropractic exam annually since most scoliosis starts in the youth and can be managed best in these early years.
• If you have a bout of severe low back pain, follow the federal guideline on acute low back pain and seek chiropractic care before drugs or surgery. Their recommendations are simple: ice, aspirin and spinal manipulation. If you need medical attention, rest assured that your chiropractor will refer you on if need be, but remember that only 3% of back pain needs medical intervention because 97% of back pain is “mechanical” in nature, meaning joint problems.
• The spinal nerves also control muscles and organs, so if you have a health problem that isn’t responding to medical treatments, consider the possibility that your problem may stem from nerve interference, aka, “pinched nerves.”
• Learn to prevent spinal problems with an ounce of prevention. Just as the dentists have taught you to brush your teeth daily and see your dentist for regular checkups, I recommend that you do the same routine for your back—do daily back exercises and see your chiropractor for periodic checkups.
• As the leaders in this trend to alternative health care, trust in your doctor of chiropractic to help you not only with musculoskeletal disorders, but many teach patients about many types of natural, holistic health care methods. Indeed, a visit to a professional chiropractor may be one of the most enlightening experiences you may ever have in any doctor’s office.

Learn for Yourself

If you’ve never been to a good chiropractor, you don’t know how good you can feel until your spine is free of joint dysfunction and nerve pressure. Learn for yourself why chiropractic is the leader in this trend to alternative health care in America, and perhaps you’ll then understand why 30 million Americans visited chiropractors last year.

And the next time you see your chiropractor, shake his or her hand and thank them for their trials and tribulations they still endure in order to bring this healing art to the public despite the medical opposition. Just think if the early chiropractors had caved in and this healing art had been lost—the millions of suffering folks and the huge costs from ineffective back surgeries and disability that would have occurred. Moreover, without chiropractic care, there would be no freedom of choice, no alternatives to drugs and surgery, and no good solution to this epidemic of back pain.

Just as MLK, Jr. and other civil rights leaders are now honored for their fight for freedom, the early chiropractors fought just as hard to bring forth a new healing method to help ailing folks get well naturally. They deserve the same appreciation and respect as any other libertarians, and considering 15,000 chiropractors went to jail in order to keep the chiropractic principle alive, every American should acknowledge their dedication. It’s now time for them to crow after a century of ordeals that no other health care profession has ever known. Indeed, this underdog David has prevailed against its medical Goliath, thankfully for millions of folks who rely upon this effective form of spinal care.

[References upon request]