Mayo Clinic Study Confirms Benefit of Seeing Chiropractor First

Don't be a turkey. See a chiropractor first.

​Updated pain management guidelines recommend patients start with non-drug treatment like chiropractic first for non-terminal pain, but how does seeing a chiropractor first really effect treatment?

Research indicates starting with non-drug treatment like chiropractic is a much safer and more effective method of treating most patients compared to the overuse of opioids and other medications. A recent study published by the Mayo Clinic looked at how the initial provider a patient sees for neck pain can have a significant impact on the subsequent treatment they receive.
 
Researchers compared treatments and medical services provided to patients when they initially see a primary care medical doctor (PCP), Physical Therapist (PT), Doctor of Chiropractic (DC) or specialist (pain management, orthopedic surgeon, etc.). The study found multiple benefits to starting treatment with a DC compared to PCP:

• Patients who saw a DC first were least likely to use opioids
• DC patients were least likely to undergo surgery (none of the 383 chiropractic patients underwent neck surgery during the study period)
• DC patients were least likely to undergo MRI testing or xrays
• DC patients were least likely to receive injections
• PT patients were less likely than PCP patients to use opioids, though more likely to undergo injections or surgery, and more likely to undergo MRI testing
• Specialist patients were most likely to undergo surgery, injections, receive opioids, and get MRI testing.

 
The researchers noted, "These findings are consistent with the recent [American College of Physicians] low back and [Center for Disease Control] opioid prescription guidelines, which favor nonpharmacological interventions often provided by DCs and PTs. There are important practice and policy implications of our findings given current recommendations in favor of front-line nonpharmacological management in patients with neck pain, yet many systems are not structured to provide care in this manner. Stronger alignment of PTs and DCs as front-line providers by health care systems may be needed in light of the widespread addiction, which has been identified as a public health epidemic."

This study confirms the wisdom of seeing a DC first for musculoskeletal pain to avoid riskier and more expensive treatments or testing. It also highlights the work that needs to be done by health systems to ensure this treatment is appropriately covered and encouraged to be used first whenever possible.

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