Chiropractic Spinal Care:
JC Smith, MA, DC
“If we do not fix our health care system, America may go the way of General Motors; paying more, getting less, and going broke.” 
President Barack Obama
President Obama’s opinion of “paying more, getting less, and going broke,” is most apparent in medical spine care. The present pandemic of back pain demands attention considering back pain is the leading cause of work injury and disability in this country.
Back pain is virtually inescapable considering it will strike most of the 250 million American adults sometime in their lifetime.
- Nearly one-third of adults will suffer daily with low back pain, which equates to 92.5 million people;
- two-thirds of adults will have a back attack within the year, which equates to 190 million;
- 85% or 212.5 million adults will have a severe back attack in their lifetime, and
- 20% will describe their pain as severe and crippling.
Indeed, few people realize these numbers and the staggering costs. Musculoskeletal disorders (MSDs) alone currently costs our society an estimated $267.2 billion every year, and when combined with all persons with MSDs in addition to other medical conditions, the cost of treatment in the 2002-2004 time period was estimated to be $849 billion per year.
One of the most unexpected places to find innovative solutions to the back pain pandemic is the chiropractic profession. After nearly a century of defamation by the AMA, the chiropractic profession is now poised to help millions as America’s primary spine care providers.
This paradigm shift in spine care will also save the healthcare system billions of dollars by avoiding the use of addictive opioid drugs, dangerous epidural shots found to be no more effective than placebo, unnecessary MRI scans, expensive hospital stays, and ineffective and over-utilized spine surgery based on a disproved disc theory according to new research.
Despite the call by every international guideline to encourage conservative spine care to reduce the use of drugs, shots, and spine surgery, an inexplicable upsurge of these medical spine treatments poured fuel on the fire of these rising costs. From 1994 to 2007, the patient population increased by only 12%, but MRIs increased 307%, spinal fusion surgery increased 204%, spinal injections increased 629%, and opiate use increased 423%. The most complex type of back surgery has increased dramatically between 2002 and 2007 with a 15-fold increase.
Richard Deyo, MD, MPH, one of the most vocal critics of medical spine care, mentioned the obvious motivation for such a large increase is the “financial incentives involving both surgeons and hospitals…We’ve witnessed disturbing practices that seem designed to maximize someone’s income, regardless of whether there was benefit or harm to patients.”,
These costs are unsustainable and can certainly be lowered drastically if chiropractors were utilized more rather than being marginalized as the proverbial “last resort.”
Fortunately, this change is happening as more people speak out in favor of chiropractic care. An editorial in the Annals of Internal Medicine published jointly by the American College of Physicians and the American Society of Internal Medicine noted that “spinal manipulation is the treatment of choice”. 
Regrettably, some have chosen to ignore this evidence. This frustration is most evident in medical spine care as mentioned by Dr. Deyo:
People say, ‘I’m not going to put up with it,’ and we in the medical profession have turned to ever more aggressive medication, narcotic medication, and more invasive surgery.”
This deception will continue by the medical spine community, primarily the upsurge in “pain management” clinics, aka, “pill mills,” offering opioid drugs and ESIs, and the spine surgeons who still cling to an outdated disc theory that leads to the overuse of complex spine surgeries spurred by million dollar commissions from device manufacturers.
Unfortunately, victims in the medical war on chiropractic include not only chiropractors who were slandered, but the collateral damage includes patients who were not informed by their MDs that conservative chiropractic care may be the best treatment for their back pain.
This sentiment was best expressed by Gordon Waddell, DSc, MD, FRCS, orthopedic surgeon, and author of The Back Pain Revolution.
Low back pain has been a 20th century health care disaster….Back surgery has been accused of leaving more tragic human wreckage in its wake than any other operation in history.
Dr. Waddell also suggests chiropractic care as a solution: “There is now considerable evidence that manipulation can be an effective method of providing symptomatic relief for some patients with acute low back pain.”
However, too many lives already have been wrecked by unsuccessful spine fusions or addictions to opioid drugs that certainly could have been avoided as every chiropractor knows. Until the virtual boycott of chiropractic is totally eliminated, the medical spine care market will continue to see deplorable results, astronomical costs, and Americans will experience the “get less for more” story.
 Text of President Obama’s health-care speech, Jun 15, 2009, by MarketWatch
 Scott Haldeman DC, MD, PhD, FRCP(C) and Simon Dagenais DC, PhD. A supermarket approach to the evidence-informed management of chronic low back pain. The Spine Journal, vol. 8, Issue 1, January-February 2008, Pages 1-7.
 Martin BI, Deyo RA, Mirza SK et al. Expenditures and health status among adults with back and neck problems. JAMA 2008; 299: 656-64
 J Silberner, “Surgery May Not Be The Answer To An Aching Back,” All Things Considered, NPR (April 6, 2010)
 Richard A. Deyo, MD, MPH and Donald L. Patrick, PhD, MSPH, Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises, AMACOM books, (2005): ix-x.
 “New Study Demonstrates A Three-Fold Increase N Life-Threatening Complications With Complex Surgery,” The BACKLETTER, 25/6 (June 2010):66
 MS Micozz, “Complementary Care: When Is It Appropriate? Who Will Provide It?” Annals of Internal Medicine 129/1 ( July 1998):65-66
 G Kolata, “With Costs Rising, Treating Back Pain Often Seems Futile,” NY Times (February 9, 2004)
 BARRY MEIER and DUFF WILSON, Spine Experts Repudiate Medtronic Studies, June 28, 2011, New York Times
 Gordon Waddell and OB Allan, “A Historical Perspective On Low Back Pain And Disability, “Acta Orthop Scand 60 (suppl 234), 1989.
 G Waddell and OB Allan, “A Historical Perspective On Low Back Pain And disability, “Acta Orthop Scand 60 (suppl 234), (1989)
 Dave Chase, “Aetna’s Remarkable Reinvention Underway,” Forbes, 3/17/2012