Contact: Luke Henry, DC
1314 Pelham Road, Greenville, SC 29615
(864) 288-7797
Low back pain is the #1 cause of disability worldwide. Chiropractic physicians provide higher patient satisfaction at lower cost and seeing a chiropractor first is associated with decreased risk for back surgery.
I had a great time at the South Carolina Public Health Association Annual Conference. I met a lot of great people. The presentations were excellent and I enjoyed Dr. Benjamin’s (executive director of the American Public Health Association) message. As a chiropractor, I strive to help my patients with pain and injuries and make their lives better. Health is about much more than just the absence of disease. That’s why I encourage patients to lose weight, quit smoking, eat healthy, exercise and reduce stress. I decided to join the South Carolina Public Health Association, an organization dedicated to improving the health of all South Carolinians.
Here are the key points from my presentation:
Chiropractic Physicians: A Solution to the Primary Care Shortage for Low Back Pain
Lucian Henry, DC – private practice of chiropractic, Henry Chiropractic Clinic, LLC, Greenville, SC
Low back pain
- The leading cause of disability worldwide
- Estimated lifetime prevalence of 80% in adults
- The 3rd most burdensome condition (after ischemic heart disease and COPD)
- 20% of cases become chronic
- Will most likely worsen due to population aging
(due to degeneration of the intervertebral discs)
Predictors of Lower Back Pain:
- Physical workload
- Childhood socioeconomic status
- Educational inequality (in men)
- Minorities with pain are chronically underserved
A Primary Care Problem
- Projected shortage of 20,400 primary care physicians by 2020
- Demand for primary care will increase:
- Population aging
- Increasing health coverage
- Back pain is among the most common conditions
Chiropractic
- A complementary health approach
- Educated as primary care, portal of entry providers with musculoskeletal emphasis
- Licensed in all 50 states
- Growing internationally (regulated in 40 countries)
- Recognized as physicians by the Joint Commission
- Included in Medicare, Medicaid, the Department of Veterans Affairs, Federal Blue Cross Blue Shield, SC State Health Plan, most private plans
- Half of U.S. adults have been treated by a chiropractor
- 14% of Americans treated each year
- Cost-effective with high patient satisfaction
- Availability of chiropractic care decreased visits to primary care for Medicare patients with neck and low back pain
- Decreased pharmaceutical costs
- Reduced hospital admissions
- Less back surgery
- Chiropractors help rural, inner city and underserved patient populations
Barriers to implementation
- Insurance coverage limitations
- Scope of practice restrictions
- Lack of public awareness accounts for inequity in utilization of chiropractic and other forms of complementary medicine.
- Nearly half of Americans don’t know whether their insurance covers chiropractic
- Minorities and disadvantaged patients (lower education and lower socioeconomic level) are less likely to benefit from chiropractic and other complementary medicine
Conclusion
An expanded role for chiropractic physicians would help decrease the burden on primary care and improve access for underserved populations.
Abstract
Low back pain is the leading cause of disability worldwide, and is the third most burdensome condition, after ischemic heart disease and chronic obstructive pulmonary disease. The lifetime prevalence is 80% in adults, with 20% of cases becoming chronic. Physical workload, childhood socioeconomic status, and educational inequality are predictors for increasing back pain. A primary care physician shortage is expected. Back pain is among the most common reasons patients see a primary care provider. Chiropractic physicians are considered complementary but are educated as primary health care providers. Evidence supports efficacy and cost effectiveness for neck and back pain and suggests that chiropractic decreases pharmaceutical costs, hospital admissions, and burden on primary care. Barriers to utilization include insurance limitations, antiquated scope of practice laws, and lack of public awareness. An expanded role for chiropractors would help decrease the burden on primary care and improve access for underserved populations.
Objective 1 Participant will learn that low back pain disproportionately affects those with lower education and socioeconomic levels
Objective 2 Participant will gain an appreciation for the burden to society caused by low back pain and a proposed solution
Objective 3 Participant will benefit from a brief review of the literature on efficacy and cost effectiveness of chiropractic care for spinal pain
Biosketch
Dr. Henry has provided conservative treatment to thousands of patients suffering from neck and back pain and directed a multidisciplinary practice in Greenville, SC. He has authored published peer-reviewed research, served as a reviewer for several scientific journals, and served on a research advisory board at Sherman College of Chiropractic. Dr. Henry has presented at continuing education programs for the South Carolina Chiropractic Association, Sherman College of Chiropractic, Parker University and the University of Massachusetts Amherst. He has been recognized by managed care companies for cost efficiency. He is a member of the SC Chiropractic Association, the SC Public Health Association, and the International Medical Advisory Board on Spinal Decompression. He has volunteered at Greenville Rescue Mission since 2006, providing chiropractic services to the homeless.
Topic expertise
Licensed chiropractic physician: South Carolina (Therapeutic Modalities Qualified) and North Carolina. Published in peer-reviewed chiropractic journals. Postgraduate continuing education speaker at chiropractic colleges. Qualified as an expert in the field of chiropractic medicine, Greenville County Court.
References
Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386:743–800.
Low Back Pain Fact Sheet. National Institute of Neurological Disorders and Stroke., U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health Bethesda, Maryland. December 2014.
U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. Projecting the Supply and Demand for Primary Care Practitioners Through 2020. Rockville, Maryland: U.S. Department of Health and Human Services, 2013.
Davis MA, Yakusheva O, Gottlieb DJ, Bynum JP. Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain. J Am Board Fam Med. 2015 Jul-Aug;28(4):481-90.
Horwitz AD1, Hosek R, Boyle J, Cianciulli A, Glass J, Codario R. A new gatekeeper for back pain. Am J Manag Care. 1998 Apr;4(4):576-9.
Baldwin ML, Côté P, Frank JW, Johnson WG. Cost-effectiveness studies of medical and chiropractic care for occupational low back pain. a critical review of the literature. Spine J. 2001 Mar-Apr;1(2):138-47.
Smith M, Carber L. Chiropractic Health Care in Health Professional Shortage Areas in the United States. American Journal of Public Health. 2002;92(12):2001-2009.
Passmore SR, Toth A, Kanovsky J, Olin G. Initial integration of chiropractic services into a provincially funded inner city community health centre: a program description.J Can Chiropr Assoc. 2015 Dec;59(4):363-72.
Whedon JM, Song Y, Davis MA, Lurie JD. Use of Chiropractic Spinal Manipulation in Older Adults is Strongly Correlated with Supply. Spine. 2012;37(20):1771-1777. doi:10.1097/BRS.0b013e31825762b7.
Hawk C, Long CR, Boulanger K, Morschhauser E, Fuhr A. Chiropractic care for patients aged 55 years and older: report from a practice-based research program. J Am Geriatr Soc 2000;48:534–45.
Killinger LZ. Chiropractic and geriatrics: a review of the training, role, and scope of chiropractic in caring for aging patients. Clin Geriatr Med. 2004