Right now, it is highly likely an employee is suffering.

I’ve been helping employees stay on the job for more than 20 years. I often see employees in the large manufacturing complexes once a week just to stay on the job. It is well known that even sitting for extended periods of time is harmful to the low back.

Here is something not well known: chiropractic care is very helpful at improving a person’s brain function, reducing pain, and saving companies money. If you try and google any of that, you’ll likely come up empty. If you google best ways to reduce back pain, you’ll get lots of advertised products and the stock medical websites. These don’t tell a whole story, because when a study adds chiropractic care, nothing else compares well.

Below I’m going to share a small fraction of published studies on science and the use of chiropractic care to improve employee health. This will give you hard data to decide on how to best improve employee health and happiness. Since low back pain is the most common cause of disability, I’ll make most references to that. Pain isn’t the only concern for employers.

are your employees as productive as possible?

The American productivity audit surveyed 29,000 working adults to quantify the impact of reduced performance at work due to pain. Researchers questioned respondents regarding the cost implications of reduced performance were due to headaches, arthritis, back pain and other musculoskeletal pain. Respondents were also asked if the common pain conditions had caused them to lose concentration, repeat jobs, do nothing or feel fatigued at work. The cost of lost productive time in the US workforce was found to be $61 billion, and 76% of that cost was attributed to health-related reduced performance. This is consistent with prior studies that concluded loss of productive time is more significant than absenteeism. The data revealed that 1.1% of the workforce were absent one or more days per week because of common pain conditions.

(Lost Productive Time And Cost Due To Common Pain Conditions In The US Workforce-JAMA. 2003 (Nov 12); 290 (18): 2443-54)

Learn more about how to make changes in the brain with the video below.

Long-term outcomes are worse than reported following standard medical recommendations.

This study contradicts Clinical Practice Guidelines that suggest that recovery from an episode of recent onset low back pain is usually rapid and complete. Their findings with 973 consecutive primary care patients was that recovery was slow for most patients, and almost 1/3 of patients did not recover within one year (when following standard medical recommendations). This study was designed to determine the one year prognosis of patients with low back pain. 973 patients with low back pain that had lasted less than 2 weeks completed a baseline questionnaire. Patients were reassessed through a phone interview at six weeks, three months and 12 months. The study found that the prognosis claimed in clinical guidelines was more favorable than the actual prognosis for the patients in the study. Recovery was slow for most patients and almost 1/3 of patients did not recover within one year.

Prognosis in Patients with Recent Onset Low Back Pain in Australian Primary Care: Inception Cohort Study - British Medical Journal 2008 (Jul 7); 337: a171

Exercise isn’t the only answer

This study contradicts the common belief that low back pain will extinguish with simple core exercises. This study provided significant benefits for only 1 out of 5 LPB sufferers. Researchers followed 790 patients who initially sought care for low back pain from 70 different caregivers. After 5 years, only 21% of patients studied reported no continued pain while only 37% reported no disability. Pain and disability scores dropped significantly at 6 months, then remained flat at 2 yrs and 5 yrs. Nonspecific regular exercise did not affect recovery. Between 27% and 66% of the study population experienced a recurrence of low back pain.

Low Back Pain In A General Population. Natural Course And Influence Of Physical Exercise--A 5-Year Follow-Up -Spine. 2006 (Dec 15); 31 (26): 3045-51

What happens when you give patients a choice?

This important 2010 study evaluated low back pain care for Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population over a two-year period. The 85,000 BCBS subscribers in the insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Thus, the data from this study reflect what happens when chiropractic and medical services compete on a level playing field. The researchers, led by an actuary, compared the costs of low back pain care initiated with a doctor of chiropractic with care initiated through a medical doctor or osteopathic physician. They found that costs for the chiropractic group were 40 percent lower. Even after factoring in the severity of the conditions with which patients presented, costs when initiating care with a DC rather than an MD/DO were 20 percent lower. The researchers concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions. According to this analysis, had all of the low back cases initiated care with a DC, this would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.

Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician:Experience of One Tennessee-Based General Health Insurer -J Manipulative Physiol Ther 2010 (Nov); 33 (9): 640–643

What happens when a person sees a chiropractor first?

In 1999, a large Chicago HMO began to utilize doctors of chiropractic (DCs) in a primary care provider role. The DCs focused on assessment and evaluation of risk factors and practiced with a non-pharmaceutical/non-surgical approach. Insurance claims and patient surveys were analyzed to compare clinical outcomes, costs and member satisfaction with a normative control group. During the 4-year study, this integrative medical approach, emphasizing a variety of complimentary and alternative medical (CAM) therapies, resulted in lower patient costs and improved clinical outcomes for patients. The patients who went to DCs as their primary care providers had 43 percent decreases in hospital admissions, 52 percent reductions in pharmaceutical costs and 43 percent fewer outpatient surgeries and procedures.

Clinical and Cost Outcomes Of An Integrative Medicine IPA -J Manipulative Physiol Ther 2004 (Jun) ; 27 (5): 336–347

Lower total annual healthcare costs

A 4-year retrospective review of claims from 1.7 million health plan members were analyzed to determine the cost effects of the inclusion of a chiropractic benefit in an HMO insurance plan. The data revealed that members with a chiropractic benefit had lower overall total annual health care costs. Back pain patients with chiropractic coverage also realized lower utilization of plain radiographs, low back surgery, hospitalizations and MRI’s. Back pain episode-related costs were also 25 percent lower for those with chiropractic coverage ($289 vs. $399).

Comparative Analysis Of Individuals With And Without Chiropractic Coverage -Arch Intern Med 2004 (Oct 11); 164 (18): 1985–1892

Patients liked having a corporate benefit plan

In this study, the claims of 8 million members insured by a managed health plan were evaluated to determine how patients utilize chiropractic treatment when they have a chiropractic benefit. They found that patients use chiropractic as a direct substitution for medical care, choosing chiropractic 34 percent of the time. Having a chiropractic benefit rider did not increase the number of patients seeking care for neuromusculoskeletal complaints.

Chiropractic Care: Is It Substitution Care or Add-on Care in Corporate Medical Plans? -J Occup Environ Med 2004 (Aug); 46 (8): 847–855

For those employees that are rubbing their neck on the job

Patients who received care from general practitioners for neck pain were randomly allocated to receive manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs). Throughout this 52-week study, patients rated their perceived recovery, intensity of pain and functional disability. Manual therapy proved to be the most effective treatment for neck pain. The clinical outcome measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. While achieving this superior outcome, the total costs of the manual therapy-treated patients were about one third of the costs of physiotherapy or general practitioner care.

Cost Effectiveness of Physiotherapy, Manual Therapy, and General Practitioner Care for Neck Pain: Economic Evaluation Alongside a Randomised Controlled Trial - British Medical Journal 2003 (Apr 26); 326 (7395): 911

Costs are higher if you use a gatekeeper

This study compared the health insurance payments and patient utilization patterns of individuals suffering from recurring low back pain who visited doctors of chiropractic or medical doctors. Insurance payments were higher for medically initiated episodes. Those who visited chiropractors paid a lower cost and were also more satisfied with the care given. Because of this, the study suggests that chiropractic care should be given careful attention by employers when using gate-keeper strategies.

Costs and Recurrences of Chiropractic and Medical Episodes of Low-back Care - J Manipulative Physiol Ther 1997 (Jan); 20 (1): 5–12

Preventative chiropractic works for low back pain

Non-specific back pain patients were treated with twelve chiropractic spinal manipulations over a one-month intensive period. The patients were then divided into two groups, one group acting as a control and another receiving maintenance spinal manipulation every three weeks for nine months. Both groups improved with chiropractic care and maintained that improvement during the tenth month study. The group receiving maintenance treatment every three weeks reported better disability scores after nine months than the control group. This study appears to confirm previous reports showing that low back pain and disability scores are reduced after spinal manipulation. It also shows the positive effects of preventive chiropractic treatment in maintaining functional capacities and a reduction in the amount and intensity of pain episodes after an acute phase of treatment.

Efficacy of Preventive Spinal Manipulation for Chronic Low-Back Pain and Related Disabilities: A Preliminary Study - J Manipulative Physiol Ther 2004 (Oct); 27 (8): 509–514

Manipulation vs. Acupuncture vs. Medications

In this study, patients with chronic lower back pain of at least 13 weeks duration were randomly assigned either to medication, needle acupuncture or spinal manipulation. The results provided evidence that in patients with chronic spinal pain, manipulation results in greater short-term improvement than acupuncture or medication. The patients receiving spinal manipulation also reported a much higher full recovery rate (27%) than either those receiving acupuncture (9%) or medication (5%).

Chronic Spinal Pain: A Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation - Spine (Phila Pa 1976) 2003 (Jul 15); 28 (14): 1490–1502

Injury Prevention and chiropractic

There are many aspects to injury prevention and health. Each company is different and has different desires for their employees. If you’d like to add chiropractic or just talk about what can be done for your company just fill out some info below.

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