To Your Health
March, 2024 (Vol. 18, Issue 03)
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Best for Spinal Pain

By Editorial Staff

Wondering why chiropractors are the best choice for spinal pain? A new review study counts all the ways. The study compared the cost of caring for patients with spine-related pain, examining the difference in downstream use and costs between chiropractic care and medical management.1 The authors conducted a Medline search, initially finding 2,256 citations from which they identified 44 applicable studies of high or acceptable quality.

It is the first such study conducted since a similar paper was published in 2015.2 This is important, as most of the papers published since then identified not only initial costs of care, but downstream costs as well, which can be even more expensive than the initial care. Here are all the ways chiropractic management resulted in lower downstream utilization and costs compared to medical management:

  • Diagnostic Imaging – 15 studies found chiropractic care resulted in less diagnostic imaging, particularly advanced imaging like MRI.
  • Opioids – 11 studies found chiropractic care resulted in fewer opioid prescriptions.
  • Surgery – Eight studies found fewer surgeries with chiropractic management.
  • Hospitalization – Seven studies found chiropractic care resulted in fewer hospitalizations.
  • First Provider – Six studies associated lower downstream cost with a DC as the first provider.
  • Injections – Five studies found decreased use of injections with chiropractic care.
  • Specialist Visits – Five studies associated chiropractic care with fewer referrals to specialists.
  • ER Visits – Two studies found chiropractic care resulted in fewer emergency department visits.

Better for Spinal Pain - Copyright – Stock Photo / Register Mark The authors concluded: "Patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management."


  1. Farabaugh R, Hawk C, Taylor D, et al. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review. Chiropr Man Therap , 2024;32:Article 8.
  2. Dagenais S, Brady O, Haldeman S, Manga P. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC Health Serv Res, 2015;15:474.