"If you aren't seeing a chiropractor, you must be on drugs."

September 6, 2005 [Volume 6, Issue 19]

Profiles in Chiropractic

Chiropractic is one of the most sought-after forms of primary health care in the nation. In fact, it is estimated that two-thirds of all outpatient visits for back pain are made to doctors of chiropractic for care. While much is known about the typical patient who visits a chiropractor, less is known about the typical doctor of chiropractic. A recently published study sought to get a better picture of the average chiropractor, and has found that both doctors and their patients have a favorable impression of the profession.

In the study, researchers collected data on 131 chiropractors and 1,275 chiropractic patients in the U.S. and Canada. Among the factors they examined were annual income and the types of therapies a chiropractor uses in practice. For chiropractic patients, the researchers looked at several demographics, including health status, reasons for seeing a chiropractor, and satisfaction with treatment.

Eighty-three percent of the chiropractors surveyed reported working full-time; 80 percent owned their own practices. Seventy-eight percent reported an annual income of at least $80,000, and just under half (48 percent) had been in practice for 11 years or longer. In terms of chiropractic patients, the majority of them (76 percent) reported seeing a chiropractor for back pain. Most patients were highly confident of the care they received; on a scale of 1 to 10 (10 being best), 78 percent rated their care an 8 or better. In addition, 90 percent of the patients said they would "definitely" recommend chiropractic to their family and friends.

In their conclusion, the authors wrote, "The results ... describing the practice, the practitioners, and the patients would seem to imply that chiropractors have firmly established themselves within the health delivery system of North America." They added that "for a majority of patients, the chiropractor is the primary contact provider for the current episode being treated by chiropractic."

Coulter ID, Shekelle PG. Chiropractic in North America: a descriptive analysis. Journal of Manipulative and Physiological Therapeutics, February 2005;28(2):83-9.

Prescription Drugs and Pregnancy: What Are the Risks?

Everyone knows that taking prescription drugs while pregnant can put both the mother and her unborn child at risk. Everyone also knows - or should know - that some drugs are safer than others. The question is, how often do pregnant women receive drugs that might compromise their health, or put their children's lives in danger? That's what a team of researchers in the U.S. tried to answer.

In their study, the authors looked at the health records of more than 152,000 women to determine the number and types of drugs they received before and during pregnancy. The drugs were divided into five categories developed by the Food and Drug Administration, according to their risk to the developing fetus. Category X medications were considered by the FDA as drugs that possessed a "definite fetal risk" that clearly outweighed any benefits.

Results: Sixty-four percent of the women received at least one drug or medical supply other than a vitamin or mineral supplement. Over 47 percent of the women received a drug from the three riskiest categories. Using these figures as a blueprint, the authors estimated that of the 4 million women who deliver a child in the United States each year, "as many as 280,000 ... are exposed to drugs with evidence of potential fetal risk."

If you or someone you know is pregnant, please make sure to talk with your doctor about the risks of any medications before you start taking them. Also, make sure to provide your doctor with a list of any drugs, herbal remedies or dietary supplements you are currently taking, to help reduce the risk of side-effects or potential interactions.

Andrade SE, Gurwitz JH, Davis RL, et al. Prescription drug use in pregnancy. American Journal of Obstetrics & Gynecology, August 2004;191(2):398-407.

The Power of Positive Feedback and Motivation

Previously published studies have shown that regular exercise can help people who suffer from chronic low back pain (LBP). Unfortunately, however, many LBP sufferers do not follow through and complete their recommended exercise program. Part of the reason, some scientists believe, is that these people do not receive enough motivation from their doctor to complete the program.

In this study, researchers looked at the effect motivation and positive feedback could have on people with chronic low back pain. Ninety-three patients were randomized into two groups and followed at different intervals for 5 years. The first group participated in a series of 10 25-minute training sessions an average of 2.3 times per week, with gradual increases in exercise over time. The second group engaged in the same series of exercises, but also received other interventions, such as counseling, problem-solving strategies, positive feedback from practitioners, and the signing a "contract" in which the patient agreed to stay on the exercise program.

While patients in both groups showed significant improvements in disability scores, "the cumulative effect in the motivational group across all points of assessment was more than twice that in the control group." In addition, only patients who received motivation and positive feedback showed a significant increase in the ability to return to their original level of work activity. The authors concluded that "the combined exercise and motivation program was superior to the standard exercise program" for patients with chronic low back pain.

Exercise is an important tool that can be used to treat low back pain, but it is by no means the only one. Receiving encouragement and support from others, along with a balanced diet, are just as important. Using these therapies together will help relieve your back pain - and make you a happier, healthier person.

Friedrich M, Gittler G, Arendasy M, Friedrich KM. Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain. Spine, 2005;30(9):995-1000.