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Twin Falls, ID

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Evidence Based Approach to Low Back Pain

The benefits of integrated spine care are well documented. According to one award winning paper (2010 Outstanding Paper: Medical and Interventional Science) published in the journal Spine, providers who follow the current evidence based guidelines get better results than their colleagues who are resistant to change. The paper states, “The evidence-based care group demonstrated significantly greater improvements in reported function through 6 months follow up.” “The results of this study demonstrated that in equivalent groups of patients with Acute Low Back Pain of less than 4 weeks duration, carefully controlled and comprehensive clinical practice guideline based care was associated with greater improvement...”

The authors went on to raise concerns regarding providers who are resistant to modern evidence based care. “This study follows two previous studies conducted by our group that demonstrated that treatments commonly recommended by primary care physicians are often highly guideline discordant, and other studies have demonstrated that PCP’s are highly resistant to changing their patterns of practice for managing patients...”

The phrases “highly guideline discordant” and “highly resistant to change” are particularly concerning in light of our current opioid crisis. Gone are the days where it was acceptable to only manage a patient's pain with opioid medication. Many medical groups (including the American College of Physicians) now advocate for early introduction of evidence based chiropractic care or physical therapy prior to the onset of NSAID and/or opioid therapy for low back pain.

However, it is wise to remember that when you point your finger there are three pointing right back at you! The same concerns regarding behaviors that are "highly guideline discordant” and “highly resistant to change” can likely be applied to chiropractors and other therapists. Many pracitioners still prefer treatment approaches rooted in phiosophical or clinical dogmas of the past. 

When choosing a Twin Falls chiropractor, physician, or physical therapist to treat your back pain, consider a provider who employs the best evidenced-based methods and guidelines and avoids the dogma and philosophies of the past. Dr. Arrington utilizes these methods in the care of his patients. Dr. Arrington, a chiropractic physician with 15 years of experience, is also licensed as a family nurse practitioner. He works to provide the highest quality integrated care to the Twin Falls and greater Magic Valley community. Give is a call today to see how you can benefit from the combination of medical and chiropractic care. 


American College of Physicians. (2017). American College of Physicians issues guideline for treating nonradicular low back pain. Retrieved Electronically Dec 2018 from: https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain

Bishop PB, Quon JA, Fisher CG, Dvorak MF. (2010). The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine Journal. Dec;10(12):1055-64. doi: 10.1016/j.spinee.2010.08.019.

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November 27, 2018
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Dr. Rusty Arrington

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