Journal of Manipulative and Physiological Therapeutics
Volume 28, Issue 8 , Pages 564-569 , October 2005

Effects of a Managed Chiropractic Benefit on the Use of Specific Diagnostic and Therapeutic Procedures in the Treatment of Low Back and Neck Pain

  • Craig F. Nelson, DC, MS

      Affiliations

    • Director, Health Services Research, American Specialty Health, San Diego, Calif
    • Corresponding Author InformationSubmit requests for reprints to: Craig F. Nelson, DC, American Specialty Health, 777 Front St, San Diego, CA 92101
  • ,
  • R. Douglas Metz, DC

      Affiliations

    • Chief Health Services Officer, American Specialty Health, San Diego, Calif
  • ,
  • Thomas LaBrot, DC

      Affiliations

    • Vice President for Clinical Care Management and Clinical Quality Management, American Specialty Health, San Diego, Calif

Received 7 December 2004

References 

  1. Deyo R, Weinstein JN. Low back pain. N Engl J Med. 2001;344:363–370
  2. Koes B, Scholten RJ, Mens JM, Bouter LM. Efficacy of non-steroidal anti-inflammatory drugs for low back pain: a systematic review of randomised clinical trials. Ann Rheum Dis. 1997;56:214–223
  3. van Tulder M, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine. 1997;22:2128–2156
  4. Malanga G, Nadler SF. Nonoperative treatment of low back pain. Mayo Clin Proc. 1999;74:1135–1148
  5. Bigos SJ, Bowyer OR, Braen GR, Brown K, Deyo R. Acute low back problems in adults. Clinical practice guidelines no. 14. Rockville (Md): Agency for Healthcare Policy and Research, Public Health Service, US Dept. of Health and Health Services; 1994;[Publication No. 95-0642]
  6. Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Ann Intern Med. 2003;138:898–906
  7. Pengel H, Maher CG, Refshauge KM. Systematic review of conservative interventions for subacute low back pain. Clin Rehabil. 2002;16:811–820
  8. Jarvik JG, Deyo RA. Imaging of lumbar intervertebral disk degeneration and aging, excluding disk herniations. Radiol Clin North Am. 2000;38:1255–1266
  9. Jarvik JG. Imaging of adults with low back pain in the primary care setting. Neuroimaging Clin N Am. 2003;13:293–305
  10. Gibson J, Grant IC, Waddell G. The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine. 1999;24:1820–1832
  11. Jellema P, van Tulder MW, van Poppel MN, Nachemson AL, Bouter LM. Lumbar supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine. 2001;26:377–386
  12. Deyo R. Magnetic resonance imaging of the lumbar spine. Terrific test or tar baby?. N Engl J Med. 1994;331:115–116
  13. Simmons E, Guyer RD, Graham-Smith A, Herzog R. Radiographic assessment for patients with low back pain. Spine. 1995;20:1839–1841
  14. van Tulder M, Assendelft WJ, Koes BW, Bouter LM. Spinal radiographic findings and nonspecific low back pain. A systematic review of observational studies. Spine. 1997;22:427–434
  15. Kikuchi S. Values and problems in MR imaging for the evaluation of low back pain (orthopedic surgeon's view). Semin Musculoskelet Radiol. 2001;5:127–128
  16. Savage R, Whitehouse GH, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J. 1997;6:106–114
  17. Carragee E, Tanner CM, Yang B, Brito JL, Truong T. False-positive findings on lumbar discography. Reliability of subjective concordance assessment during provocative disc injection. Spine. 1999;24:2542–2547
  18. Atlas SJ, Nardin RA. Evaluation and treatment of low back pain: an evidence-based approach to clinical care. Muscle Nerve. 2003;27:265–284
  19. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137:586–597
  20. Rao JK, Kroenke K, Mihaliak KA, Eckert GJ, Weinberger M. Can guidelines impact the ordering of magnetic resonance imaging studies by primary care providers for low back pain?. Am J Manag Care. 2002;8:27–35
  21. Negrini S, Politano E, Carabalona R, Mambrini A. General practitioners' management of low back pain: impact of clinical guidelines in a non–English-speaking country. Spine. 2001;26:2727–2733
  22. Goldberg HI, Deyo RA, Taylor VM, Cheadle AD, Conrad DA, Loeser JD, et al. Can evidence change the rate of back surgery? A randomized trial of community-based education. Eff Clin Pract. 2001;4:95–104
  23. Smith M, Stano M. Costs and recurrences of chiropractic and medical episodes of low-back care. J Manipulative Physiol Ther. 1997;20:5–12
  24. Stano M, Smith M. Chiropractic and medical costs of low back care. Med Care. 1996;34:191–204
  25. Stano M. Further analysis of health care costs for chiropractic and medical patients. J Manipulative Physiol Ther. 1994;17:442–446
  26. Stano M. A comparison of health care costs for chiropractic and medical patients. J Manipulative Physiol Ther. 1993;16:291–299
  27. Legorreta AP, Metz RD, Nelson CF, Ray S, Chernicoff HO, Dinubile NA. Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs. Arch Intern Med. 2004;164:1985–1992
  28. Metz RD, Nelson CF, LaBrot T, Pelletier KR. Chiropractic care: is it substitution care or add-on care in corporate medical plans?. J Occup Environ Med. 2004;46:847–855
  29. Tacci JA, Webster BS, Hashemi L, Christiani DC. Healthcare utilization and referral patterns in the initial management of new-onset, uncomplicated, low back workers' compensation disability claims. J Occup Environ Med. 1998;40:958–963
  30. Mahmud MA, Webster BS, Courtney TK, Matz S, Tacci JA, Christiani DC. Clinical management and the duration of disability for work-related low back pain. J Occup Environ Med. 2000;42:1178–1187
  31. Freeborn D, Shye D, Mullooly JP, Eraker S, Romeo J. Primary care physicians' use of lumbar spine imaging tests: effects of guidelines and practice pattern feedback. J Gen Intern Med. 1997;12:619–625
  32. Carey T, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR. Patterns of ordering diagnostic tests for patients with acute low back pain. The North Carolina Back Pain Project. Ann Intern Med. 1996;125:807–814
  33. Tacci JA, Webster BS, Hashemi L, Christiani DC. Clinical practices in the management of new-onset, uncomplicated, low back workers' compensation disability claims. J Occup Environ Med. 1999;41:397–404
  34. Mink JH, Gordon RE, Deutsch AL. The cervical spine: radiologist's perspective. Phys Med Rehabil Clin N Am. 2003;14:493–548
  35. Boyce RH, Wang JC. Evaluation of neck pain, radiculopathy, and myelopathy: imaging, conservative treatment, and surgical indications. Instr Course Lect. 2003;52:489–495
  36. Tong C, Barest G. Approach to imaging the patient with neck pain. J Neuroimaging. 2003;13:5–16
  37. Levy HI. Cervical pain syndromes: primary care diagnosis and management. Compr Ther. 2000;26:82–88

 Sources of support: Funding provided by the American Specialty Health.

PII: S0161-4754(05)00240-X

doi: 10.1016/j.jmpt.2005.08.010

Journal of Manipulative and Physiological Therapeutics
Volume 28, Issue 8 , Pages 564-569 , October 2005