You have probably heard of Chiropractic or Acupuncture treatment referred to as “alternative”, but is that correct. The definition of alternative is one of two or more available possibilities, but something with the label of alternative gives the impression of not being the first choice.
According to Spinehealth.com the most commonly used treatments for lower back pain are medication, rest and exercise. If we look at which treatments have the most evidence to support their effectiveness we find something different.
In 1994 the Agency for Health Care Policy and Research published treatment guidelines for acute lower back pain and found that the three most effective treatments at that time were over-the-counter medication, not prescription, light exercise and manipulation.
Since then there have been other guidelines published, and two I would like to examine are the American Academy of Family Physicians and the American College of Physicians. Both of those medical groups recommend that the initial treatment for lower back pain that is acute and chronic (acute is pain that began recently and chronic is pain that has persisted for over three months) be non-drug. Of the non-drug options Acupuncture and manipulation was listed as the recommended initial treatment for acute and chronic lower back pain.
So, if Acupuncture and Chiropractic are the recommended first treatment why are they referred to as alternative? Shouldn’t drugs be called the alternative? Why isn’t Acupuncture and Chiropractic utilized more since the research shows them to be more effective, cheaper, and safer? The 2015 journal of pain management had a paper that showed how the insurance industry propagated the opioid crisis through cost containment strategies. They would only pay for opioids because it was cheaper than paying for physical therapy, Acupuncture, or Chiropractic. This policy became a huge problem for workers compensation insurance companies because they are responsible for bringing the worker back to pre-injury status or covering future medical care. It is much more expensive to care for a disabled addict than to have paid for better care in the beginning.
When we think of something as alternative rather than the standard of care we do not demand its inclusion in our coverage. Stitches are the standard of care for a deep cut, would we tolerate an insurance company not covering them? We need to think differently and not think of Chiropractic or Acupuncture as alternatives but the research recommended standard of care.
