The New Zealand Chiropractors’ Association has endorsed international calls for a dramatic shift in the way that society manages low back pain.
Chiropractor and NZCA spokesperson Dr Jenna Duehr explains: ‘The evidence is clear that chiropractors can play an important role in evidence-based, peoplecentred, interprofessional and collaborative care for low back pain patients. As New Zealand grapples with developing a health service fit for the 21st century we need to focus on the vital role of allied health professionals.’
The international focus on the drug free management of back pain follows publication of an editorial in Medpage Today by Christine Goertz, Professor in Musculoskeletal Research at the Duke Clinical Research Institute and Director of System Development and Coordination for Spine Health in the Department of Orthopaedic Surgery at Duke University. Professor Goertz reviews how low back pain has been over-medicalised, making a bad problem worse, and the need for realigned incentives that encourage clinicians to follow current evidence and treatment recommendations .
Professor Goertz’s intervention is the latest in a wave of top ranking publications which have come out in favour of chiropractic care as a tool in the management of back pain.
The Lancet, in an influential series on the management of back pain, calls for improved training and support of primary care doctors and other professionals engaged in activity and lifestyle facilitation, such as chiropractors, which could minimise the use of unnecessary medical care  such as the worldwide overuse of opiate drugs.
Dr Jenna Duehr adds: ‘The Lancet, one of the world’s most prestigious medical publications, has said that crucial to changing behaviour and improving delivery of effective care for back pain, are system changes that integrate and support health professionals from diverse disciplines and care settings to provide patients with consistent messages about mechanisms, causes, prognosis and natural history of low back pain, as well as the benefits of physical activity and exercise. Chiropractors are ideally placed to play a pivotal role in this development.’
A study in JAMA Network Open  looking at U.S. military personnel found that those who used chiropractic care — along with traditional medical care — had better pain relief outcomes than those who only sought out traditional medical care.
Dr Duehr points out: ‘It’s a key finding for this group since low back pain is one of the leading causes of disability among U.S. military personnel. Chiropractic care can include different forms of spinal manipulation, commonly known as adjustments, but it is a myth that it involves cracking bones. What is different though, is that unlike the typical medical remedies for back pain, we do not have to resort to anti-inflammatory medications, opioids, spinal fusions, and epidural steroid injections to provide pain relief for our clients. Increasingly with the ongoing opioid crisis in the United States, the medical community there is looking at better non-addictive treatments. New Zealand doctors are unlikely to be far behind.’
‘We do have to ask ourselves why are some New Zealanders still popping pills when a chiropractic adjustment may be just as, or even more, effective? It looks like patient perceptions and evidence-based guidelines for low back pain are disconnected from what’s happening in our healthcare systems. Many people, with the encouragement of their family doctors, may turn to medication as a regular habit, only considering chiropractic care after traditional treatments have failed instead of making it a first-line treatment option.’
New Zealand’s chiropractors have launched a public website (https://chiropracticnz.org), taking the lead to inform, educate and inspire people to prevent pain and disability by improving their posture, addressing spinal problems and engaging in physical activity.
To Learn more about the New Zealand Chiropractors’ Association visit www.chiropractic.org.nz
Dr Gian Mansell, Chiropractor
References:  https://www.medpagetoday.com/opinion/second-opinions/104026  Lancet Volume 391, No. 10137, p2384–2388, 9 June 2018 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30488-4/fulltext 3  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2680417