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The Research

Listed below are excerpts from research articles showing the prevalence of low back and neck pain in the work place and how Chiropractic can help.

  • The direct costs of back pain in the United States in 2010 were $34 billion, with additional indirect costs including lost workplace productivity estimated at $200 billion.

  • Musculoskeletal disorders are the second leading cause of disability worldwide, led by low back pain (LBP), with an estimated LBP prevalence among US adults of 20%.

  • The US opioid crisis creates an urgent need to evaluate cost-effective and low-risk non-pharmacological treatments. One option is chiropractic care. 

  • Chiropractic care, when added to usual medical care, resulted in moderate short-term treatment benefits in both low-back pain intensity and disability, demonstrated a low risk of harms, and led to high patient satisfaction and perceived improvement.

  • With this new understanding of spinal pain as a condition with exacerbations and remissions throughout life, it might be wise to shift the focus of treatment from cure of the condition to management of pain trajectories.

  • ‘Maintenance Care’ is a well-known concept in the chiropractic profession, describing continued care beyond that of reducing symptoms. [...] They clearly described Maintenance Care as a type of prolonged care delivered at regular intervals. 

  • Patient-related factors such as being worried, having a stressful life or a hard physical job, would be considered before recommending Maintenance Care. 

  • Back pain is a chronic disease for most, with episodes at short or long intervals. A preventive approach such as Maintenance Care, therefore, makes sense. 

  • Musculoskeletal (MSK) problems remain the most frequent reason why individuals are absent from work, including those with work- related musculoskeletal disorders (WRMSDs or MSDs) and those with chronic MSK problems. 

  • WRMSDs is the number one type of lost-time work injury, accounting for 40% of all lost-time claims.

  • Considerations must be made at the individual level (internal motivation), organizational level (a supportive manager) and self-management of symptoms. 

  • For people with MSK conditions, maintaining capacity to work is known to contribute to physical benefits, including sustained joint strength, and psychological benefits, such as social engagement and brain activity.

Goertz, C. M., Long, C. R., Vining, R. D., Pohlman, K. A., Walter, J., & Coulter, I. (2018, May 18). Effect of usual medical care plus chiropractic care vs usual medical care alone on pain and disability among US service members with low back pain: A comparative effectiveness clinical trial. JAMA network open. Retrieved April 11, 2023, from 

Axén, I., Hestbaek, L., & Leboeuf-Yde, C. (2020, January 28). Chiropractic maintenance care - what's new? A systematic review of the literature - chiropractic & manual therapies. BioMed Central. Retrieved April 11, 2023, from 

Crawford, J. O., Berkovic, D., Erwin, J., Copsey, S. M., Davis, A., Giagloglou, E., Yazdani, A., Hartvigsen, J., Graveling, R., & Woolf, A. (2020, October). Musculoskeletal Health in the Workplace. ELSEVIER. Retrieved April 11, 2023, from 

  • Mechanical neck pain (MNP) is broadly defined as pain experienced in the posterior neck or shoulders, caused by abnormal stress and strain on cervical musculoskeletal structures in the absence of serious pathology.

  • Workplace health promotion interventions (WHPI) are defined as: interventions to prevent, minimize, and eliminate workplace health hazards and aim to maintain and promote quality work ability. 

  • [We can separate] WHPI into 4 main categories of interventions targeting: (1) mental body functions and mental health education, (2) musculoskeletal body functions and physical education and relaxation breaks, (3) modification of activity performance, and (4) physical modification of activity performance. 

  • Multidimensional WHPI focusing on mental and physical functioning […] activity performance and modifications […] and environmental modifications […] appear to reduce MNP severity and disability primarily in office workers, particularly in the long term.

  • Low back pain (LBP) is the leading contributor to disability, followed closely by neck pain.

  • Low back pain and neck pain are responsible for more than 10% of the total years lived with disability worldwide.

  • Both chronic non-specific low back and neck pain have been classified as chronic primary pain syndromes under the new International Association for the Study of Pain.

  • Pain affecting the spine, as most of the current Clinical Practice Guidelines, recommend the use of spinal manipulative therapy for the management of low back pain and neck pain.

  • Safer and more effective interventions are needed. Amongst conservative approaches, chiropractic spinal manipulative therapy (SMT) is one of the potentially effective interventions for these conditions. 

  • In the USA, low back pain accounts for more lost workdays than any other occupational musculoskeletal condition.

  • Low back pain is a very common symptom. It occurs in [all] countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015.

  • Low back pain is now the leading cause of disability worldwide. [...] People with physically demanding jobs, physical and mental co-morbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. [...] Most people with new episodes of low back pain recover quickly.

  • In 2015, the global point prevalence of activity-limiting low back pain [implied] that 540 million people were affected at any one time. 

  • Disability from low back pain is highest in working age groups worldwide.

Martin Frutiger, Peter Jeffery Tuchin; Chiropractic curriculum mapping and congruence of the evidence for workplace interventions in work-related neck pain. J Chiropr Educ 1 October 2017; 31 (2): 115–124. doi:

Gevers-Montoro C, Provencher B, Descarreaux M, Ortega de Mues A, Piché M. Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain. Eur J Pain. 2021 Aug;25(7):1429-1448. doi: 10.1002/ejp.1773. Epub 2021 Apr 15. PMID: 33786932.

Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., & Underwood, M. (2018, March 21). What low back pain is and why we need to pay attention. The Lancet. Retrieved April 11, 2023, from 

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