Chalk up another one for the publishers of Newsweek. Less than 18 months ago, the magazine devoted nearly half of its Dec. 18, 2002 issue to "The Science of Alternative Medicine," a series of articles that looked at the most popular forms of complementary and alternative care. While chiropractic wasn't featured as prominently in that issue as some therapies, it was described as one of the leading forms of care for the treatment of back pain.
The April 26, 2004 issue of Newsweek goes one step further in its promotion of chiropractic. In a cover story titled "The Great Back Debate," editor Claudia Kalb explores the role back pain has played on American society, critiques some of the surgical options used to treat the condition, and gives a favorable review of chiropractic and other forms of alternative care.
Back pain is a universal problem. An estimated 80 percent of the U.S. population will suffer at least one episode of back pain in their lives, making it the second most common reason for seeing a doctor, following coughs and other respiratory infections. When one takes into account the medical bills, disability payments, and lost productivity and missed time at work, the costs of back pain add up to more than $100 billion per year.
One of the reasons back pain is so common, Kalb asserts, is because of the spine's delicate nature. "Like an expensive but temperamental sports car, the human spine is beautifully designed and maddeningly unreliable," she writes. To compound matters further, myriad conditions - from physical injuries such as degenerated discs, compressed nerves, spasms, muscle tears and ligament or tendon injuries to psychological issues like depression and anxiety - can cause back pain. Small wonder, then, that Kalb labels back pain a "mystifying mix of physical symptoms and psychological underpinnings."
To treat back pain, many Americans have tried quite invasive - and costly - remedies. The article notes that between 1996 and 2001, spinal-fusion surgical procedures (which cost approximately $34,000 each) increased by 77 percent. In 2001 alone, more than 250,000 spinal-fusion surgeries were performed, the vast majority of which were intended to treat disc problems. However, fusion surgery was originally developed to correct serious instabilities and deformities of the spine, not to treat damaged or herniated discs.
As a result, Kalb notes in her article that "many of these procedures simply don't work." The lackluster results seen in spinal-fusion cases and other types of surgery have caused some practitioners to consider simpler, less invasive forms of care.
"We've come to the point where we have to think out of the box," says Dr. David Eisenberg, a researcher at Harvard Medical School and one of the country's leading authorities on the use of complementary and alternative medicine. "The time is now."
Even an experienced spine surgeon such as Dr. Jeffrey Goldstein, of the New York University Hospital for Joint Diseases, has cautioned that doctors need to be more selective about choosing candidates for spinal fusion, and that "not everyone who has disc degeneration should have an operation."
So, what's a person with back pain to do? For millions of Americans, the choice has become some form of complementary and alternative medicine - in particular, chiropractic. According to Kalb, "Chiropractic treatment, the most popular nonsurgical back therapy, is booming, with 60,000 chiropractors practicing today, a 50 percent increase over 1990. Some happy clients visit their chiropractors more than their barbers." She also states that "experts generally agree that the treatment, which involves spinal manipulation and stretching, is safe for the lower back," but notes a lack of research showing its long-term effectiveness.
Americans are also using other forms of CAM for back pain, such as massage and acupuncture. One institution, the Hospital for Special Surgery in New York, employs a variety of health care providers, including chiropractors, acupuncturists, massage therapies, tai chi instructors, personal trainers and rehabilitation specialists, at its complementary medicine center, all working together for the good of the patient. The facility sees about 13,000 patients a year, many of them with bad backs, and uses "any noninvasive approach they can find" to relieve the pain.
As alternative forms of back pain care have increased in popularity, so has the amount of research into these therapies. Dr. Dan Cherkin, a researcher at the Center for Health Studies in Seattle, Wash., has conducted several large trials on the effectiveness of chiropractic care for back pain, along with similar studies using massage and acupuncture. And Dr. Eisenberg is leading a study funded by the National Institutes of Health, using chiropractors, acupuncturists, massage therapists, neurologists, orthopedists and other practitioners, to see if there are more efficient and cost-effective ways of treating back pain from a multi disciplinary perspective.
"After centuries of agony, humanity could certainly use some relief" from back pain, Kalb concludes. "But more important than the success of any given treatment is the good news that both back pain sufferers and the medical establishment are embracing bold new ways to think about that most exquisite and frustrating work of art: the spine."
What will the impact of Newsweek's cover story be? If nothing else, perhaps the American public will truly recognize the value of chiropractic in the treatment of back pain. According to the World Press Group, Newsweek is one of the most widely read publications in the world. It is distributed in more than 190 countries and six languages, and has a weekly circulation of approximately 4.4 million (3.85 million in the United States).
Read "The Great Back Debate" Online
If you didn't pick up a copy of the April 26 issue of Newsweek at your local newsstand, fear not: The magazine has a partnership with the Microsoft Network and NBC that allows people to view its stories on the Internet via www.msnbc.com. Copies of "The Great Back Debate," along with interactive features such as online polls and audio clips, are available at www.msnbc.msn.com/id/4767268/
