The average medical cost per claim for injured workers with low back pain who were treated exclusively by a chiropractor was 61% lower than for those who did not receive any chiropractic treatment, according to a new report.
Experts say such data could make the industry think about chiropractic care for injured workers, a trend that is lagging behind in some parts of the country.
The report, released May 17 by Cambridge, Massachusetts-based Workers’ Compensation Research Institute, also found that the cost of lost pay and temporary disability was significantly lower for workers whose lower back pain was treated only by a chiropractor: $ 492 in compensation compared to $ 3,604 for workers who did not receive any chiropractic treatment and 0.7 weeks of temporary disability compared to 4.9 weeks.
Melissa Burke, of Southington, Connecticut-based vice president and director of managed care and clinical for AmTrust Financial Services Inc., said the study was “informative to read.”;
WCRI said data bucks studies from the 1990s that indicated chiropractic care increased medical costs.
WCRI economist and co-author Dongchun Wang said the 1990s were marked by rising medical costs overall, leading to states cracking down on physical medicine.
Lawmakers and decision-makers made rule changes to curb spending, Wang said, adding that there were “political reforms at the state level that had the effect of discouraging chiropractors involved in workers’ skills.”
Wang’s research showed that chiropractic care “varied considerably” from state to state, with the percentage of claims of low back pain with chiropractic care ranging from 5% to 34%.
Burke said other studies also confirmed that chiropractic care could lead to lower costs, including a 2011 study in the Journal of Occupational and Environmental Medicine.
“Why do we not see this care? These are part of our guidelines. It is part of the larger state guidelines, she said.
What stood out in the WCRI study for Dr. Nina McIlree, Schaumburg, Illinois-based vice president of medical management for Zurich North America, is saying that the lower costs are “associated with” chiropractic care – and not that chiropractic care is the definitive reason.
The severity of the injury and access to chiropractic care in some states are also issues not addressed in the report, she said.
Wang confirmed the limits of the data in terms of difficulty. WCRI relied on claim data for the study and not medical records about the severity of the injury, she said.
“In terms of access, we feel that … politicians and stakeholders may want to return to chiropractic care in the light of new information and in the light of the chiropractic church itself, (which) has improved over time,” Wang said. “We are not saying that (chiropractic care) is suitable for everyone.”
Reconsidering alternative care for certain pain patients is a step in line with the industry’s transition from pharmacological treatment, says Jeff Zeblut, Orlando, Florida-based vice president of clinical practice with Sedgwick Claims Management Services Inc.
“When they began to realize that there was an opioid problem, chiropractic, acupuncture, massage (and) yoga were added more to the usual medicine, and it became more acceptable for doctors to prescribe to doctors,” he said.
Kate Farley-Agee, Plainfield, Illinois-based Vice President of Network Product Management for Coventry, a company in the Enlyte Group, agreed that the shift from long-term prescribing of painkillers to workers helps open doors for chiropractors in the field.
“Ten years ago, this was not the type of care that was common among workers,” she said. Chiropractic care has been developed. … It has begun to be seen as another way of dealing with certain injuries; pain in the lower back is mild. And there are other types of soft tissue injuries that could fall into that category. “