ArticleJournal of general internal medicine2024
Trends in Chiropractic Care and Physical Rehabilitation Use Among Adults with Low Back Pain in the United States, 2002 to 2018.
Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 10 citations in OpenAlex.
- Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial.Chiropractic & manual therapies · 2025Trial
- The impact of core training combined with breathing exercises on individuals with chronic non-specific low back pain.Frontiers in public health · 2025Trial
- Whole health and chiropractic: a commentary on historical roots, contemporary relevance, and future directions.Chiropractic & manual therapies · 2026Article
- Health care epidemiology, characteristics, and regional variation of chiropractic care in Switzerland: a descriptive study using insurance claims data.BMC health services research · 2026Article
- Primary care barriers and facilitators to nonpharmacologic treatments for low back pain: A qualitative pilot study.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- An introduction to implementation science in rehabilitation medicine.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Cervical radiculopathy management with physical, chiropractic, and acupuncture therapy: Factors associated with different therapy utilization patterns.North American Spine Society journal · 2025Article
- A multi-level implementation strategy to increase adoption of chiropractic care for low back pain in primary care clinics: a randomized stepped-wedge pilot study protocol.Chiropractic & manual therapies · 2025Article
- Process mapping with failure mode and effects analysis to identify determinants of implementation in healthcare settings: a guide.Implementation science communications · 2024Article
- Nonpharmacologic Back Pain Treatment Use and Associated Patient Reported Outcomes in US-Based Integrative Medicine Clinics.Global advances in integrative medicine and healthArticle
- Qualitative Assessment CIH Institutions' Engagement With Underserved Communities to Enhance Healthcare Access and Utilization.Global advances in integrative medicine and healthArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundWhile nonpharmacologic treatments are increasingly endorsed as first-line therapy for low back pain (LBP) in clinical practice guidelines, it is unclear if use of these treatments is increasing or equitable.
objectiveExamine national trends in chiropractic care and physical rehabilitation (occupational/physical therapy (OT/PT)) use among adults with LBP. DESIGN/
settingSerial cross-sectional analysis of the National Health Interview Survey, 2002 to 2018.
participants146,087 adults reporting LBP in prior 3 months.
methodsWe evaluated the association of survey year with chiropractic care or OT/PT use in prior 12 months. Logistic regression with multilevel linear splines was used to determine if chiropractic care or OT/PT use increased after the introduction of clinical guidelines. We also examined trends in use by age, sex, race, and ethnicity. When trends were similar over time, we present differences by these demographic characteristics as unadjusted ORs using data from all respondents.
resultsBetween 2002 and 2018, less than one-third of adults with LBP reported use of either chiropractic care or OT/PT. Rates did not change until 2016 when uptake increased with the introduction of clinical guidelines (2016-2018 vs 2002-2015, OR = 1.15; 95% CI: 1.10-1.19). Trends did not differ significantly by sex, race, or ethnicity (p for interactions > 0.05). Racial and ethnic disparities in chiropractic care or OT/PT use were identified and persisted over time. For example, compared to non-Hispanic adults, either chiropractic care or OT/PT use was lower among Hispanic adults (combined OR = 0.62, 95% CI: 0.65-0.73). By contrast, compared to White adults, Black adults had similar OT/PT use (OR = 0.98; 95% CI: 0.94-1.03) but lower for chiropractic care use (OR = 0.50; 95% CI: 0.47-0.53).
conclusionsAlthough use of chiropractic care or OT/PT for LBP increased after the introduction of clinical guidelines in 2016, only about a third of US adults with LBP reported using these services between 2016 and 2018 and disparities in use have not improved.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.