For almost twenty minutes, show host Steve Roberts kept the discussion lively and informative. Representing the chiropractic profession was Louis Sportelli, D.C. Representing medicine was Neil Kahanovitz, M.D., an orthopedic surgeon and author of the book "Diagnosis and Treatment of Lower Back Pain." Additional insight was provided by Scott Haldeman, D.C., M.D., Ph.D.
Steve Roberts began by presenting statistics which demonstrated how serious and prevalent back pain is in the United States: 80% of Americans will suffer back pain sometime in their lives at a cost of over $17 billion annually -- NOT including lost productivity. Mr. Roberts went on to reveal the reason for the discussion: "Preliminary results of a new study by the RAND Corporation shows surprising agreement on the value of spinal manipulation."
Dr. Haldeman then upgraded the total cost of back pain to a staggering $100 billion per year, noting that this is "the fastest growing cause of disability in the U.S." At this point, the discussion began to open up.
It was very satisfying to hear Dr. Kahanovitz admit that medicine was not certain what the best treatment was for back pain, and that they needed much more data.
Dr. Sportelli presented a film clip of motion palpation and chiropractic manipulation being performed on a patient in his office. This was particularly compelling viewing as millions of viewers, many for the first time, were seeing and understanding chiropractic at work. Dr. Sportelli's explanation during the film clip was in itself a fantastic piece of PR.
The focus of the program then shifted back to where it had started: What does research have to say about chiropractic care?
The Meade et al. study was presented by Dr. Haldeman along with a cooperative study conducted by the University of California at Irvine and Palmer College of Chiropractic. In both studies, chiropractic care was concluded to be more effective that the medical comparisons. This information caused Dr. Kahanovitz to agree that DCs achieved short term relief with their patients (not an admission you'll often hear from an MD on national television). Dr. Kahanovitz added that there was a need for more collaborative studies by the two disciplines on back pain due to the serious lack of knowledge.
The only time in the program where chiropractors were criticized was when Dr. Kahanovitz stated he "had a problem with patients who have seen a DC three times a week for months without any results and without referral." This observation was not contested.
On the brighter side, Dr. Kahanovitz was of the opinion that 98% of back pain patients did not require surgery. When questioned by host Steve Roberts about misdiagnoisis, Dr. Kahanovitz said he did not see any more cases of misdiagnosis in referrals by DCs than in referrals by MDs.
But Scott Haldeman best summarized why chiropractic received the exposure it did and where we are headed: "We are now entering a research based era with scientific trial leading the way to decide which treatment is best for which patient."
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