Positive Health Online

Abstract

SHERMAN and others, Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA, sherman.k@ghc.org, have studied the diagnosis and treatment of chronic back pain by Acupuncturists, Chiropractors, and Massage therapists.

Background

The aim of this study was to describe the diagnostic and therapeutic content of visits for chronic back pain to Acupuncturists, Chiropractors, and Massage therapists.

Methodology

Randomly selected Acupuncturists, Chiropractors, and Massage therapists collected data on consecutive patient visits. The authors analyzed information on diagnosis, treatment, and self-care recommendations for chronic back pain patients collected during consecutive patient visits to these CAM providers.

Results

Back pain was the most common reason for visits to each of these providers, with chronic back pain representing about 10% of visits to Acupuncturists, 20% of visits to Chiropractors, and 12% of visits to Massage therapists. Diagnosis by Acupuncturists included traditional questioning and inspecting the patient as well as pulse and tongue assessment and palpation of the Acupuncture meridians. Treatments usually included acupuncture (needling), heat of some sort, and other modalities, such as East Asian Massage, herbs, and/or cupping. Lifestyle recommendations were common, particularly exercise and dietary counselling. Visits to Chiropractors usually included spinal and muscle/soft tissue examinations and spinal manipulation. Soft tissue techniques, stretch or strength training, and home exercise recommendations were much less common. Massage therapists usually performed a tissue assessment and commonly assessed range of motion. They emphasized Swedish, deep tissue, and trigger point massage techniques and usually made self-care recommendations, particularly increased water intake, hot/cold therapy, exercise, and body awareness.

Conclusion

Information on the care patients routinely receive from CAM providers will help physicians better understand these increasingly popular forms of care.

References

Sherman KJ, Cherkin DC, Deyo RA, Erro JH, Hrbek A, Davis RB, Eisenberg DM. The diagnosis and treatment of chronic back pain by acupuncturists, chiropractors, and massage therapists. Clinical Journal of Pain 22 (3): 227-234, Mar-Apr 2006.