Chiropractors are educated to diagnose and treat conditions of the musculoskeletal system. The profile of their patients has been studied over the years and in various countries.
The research dealing with clinical results, cost efficacy and safety of spinal manipulation is substantial and chiropractic management of spinal pain – both acute and chronic – is recommended in both national and international guidelines.
It is therefore not surprising that the overwhelming majority of patients seeking chiropractic care suffer from spine related conditions.
According to a Swedish study in which 78% of the Swedish chiropractors provided data on 630 patients, the vast majority complain of a local spinal problem (back or neck) with or without radiating pain, and few will consult with multiple complaints. Less than 1% will present only for a non-musculoskeletal problem.
According to the same study, the area of complaint (with several alternatives possible per patient) would be the lower back (approximately 65%, followed by the neck/head (approximately 25%)). Complaints from the hip/buttock/leg, shoulder/arm, mid back or upper back would be much less common, and “other” complaints virtually non-existent.
The duration of the complaint varied between max. 1 week to more than 6 months. Chiropractors therefore treat both acute and chronic spinal pain syndromes.
Another study, which contained approximately 1500 Swedish chiropractic patients gave more specific information on the patients’ primary symptoms, again with the possibility of providing more than one reply per patient. Table 1 shows the prevalence of findings, in order of occurrence.
|Symptom at first visit||Percentage|
|Lower back pain||62|
Again, the lumbar spine dominated the picture, and non-musculoskeletal problems were absent.
According to an international study, low back pain was, again, the most commonly reported reason for consulting (60%), followed by neck pain (51%), mid back pain (30%), pelvic/hip (23%), and headache (29%). Other musculoskeletal areas were also listed, but none exceeded 20%.
A Danish study involving 85% of clinics and including 1595 patients of whom 81% filled out a self-administered questionnaire revealed that the most common presenting complaint was lower back pain (50%), followed by pain in other regions of the spine.
Quite a few chiropractors have become skilled at diagnosing and treating peripheral joint conditions and this is of course to be welcomed.
The evidence relating to the effectiveness and safety of chiropractic treatment for the vast majority of conditions that patients present with is underscored by the fact that chiropractic care for lower back and neck pain is recommended by both European and National Clinical Guidelines.