When someone comes in to my clinic with a problem such as lower back pain, one of my standard questions is always: “Have you been to see anyone else with this problem?”. It’s not that I want to be nosy, it’s not that if you say you have been to see a physiotherapist I am going to throw you out because you chose Chiropractic second to another profession – it is simply that I want to get a picture of what therapies you have already tried, and what worked (or didn’t) so that I don’t do something you already have experienced and know doesn’t work for you. However, a common response to this question is: “No – well, there’s no point in going to see the GP is there? All they will do is give you pills.”
But is this true, and if it is then is there actually an argument for this “usual” medical care? As a profession, we Chiropractors are very keen to have everything we say and do support by appropriate scientific evidence, and sometimes this means we must ask ourselves questions that perhaps we would rather avoid…like, are we actually any better than anyone else at treating lower back pain?!
A recent study in the journal Spine, conducted by Schneider et al set out to investigate just this question. They randomly allocated a group of patients who were all as comparable as possible to various forms of manual therapy used by Chiropractors, and to “usual medical care”, consisting of over-the-counter painkillers and anti-inflammatories, and being told that most new episodes of back pain are self-limiting, and that they should stay physically active and avoid bed-rest.
The outcome? Well, thankfully for me and my fellow-manual therapists, we’ve once again been shown to be more effective than popping a few pills and mouthing a few reassurances. By the end of the study, the majority of patients who were receiving the type of care I make use of in my treatments were significantly better off in terms of pain and disability than those who had been through the usual medical care.
I can’t emphasise enough how important evidence like this is, both in terms of making sure I am giving my patients the best and most appropriate care possible, and in reassuring you that you are doing the right thing. So if you know someone who is suffering from low back pain, and they are thinking of going and seeing their GP, why not suggest they visit a Chiropractor first?