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The Association Between Timing and Duration of Chiropractic Care in Work-Related Low Back Pain and Work-Disability Outcomes

Wasiak, Radoslaw PhD; Kim, JaeYoung MD; Pransky, Glenn S. MD, MOccH

Journal of Occupational and Environmental Medicine: October 2007 - Volume 49 - Issue 10 - p 1124-1134
doi: 10.1097/JOM.0b013e31814b2e74
Original Articles

Objective: To examine the timing and duration of chiropractic care in occupational low back pain (OLBP) and their association with work-disability duration and recurrent disability using workers' compensation (WC) claims data.

Methods: Patients from four states who received chiropractic care for uncomplicated OLBP were identified through WC claims. Univariate and multivariate analyses were used, controlling for utilization of chiropractic care and other factors.

Results: Chiropractic care was initiated within 30 days after the onset of OLBP by 89% of claimants. Of those claimants, 48% ended chiropractic care within the first 30 days. After controlling for multiple factors, we found that shorter chiropractic care duration was still significantly associated with a lower likelihood of work-disability recurrence (OR = 0.39) and 8.6% shorter work-disability duration.

Conclusion: Our findings did not support a benefit of longer chiropractic care in preventing work-disability recurrence or reducing work-disability duration in OLBP.

From the Liberty Mutual Research Institute for Safety (Drs Wasiak and Pransky), Center for Disability Research, Hopkinton, Massachusetts; and the Occupational Health Program (Drs Wasiak, Kim, and Pransky), Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.

Address correspondence to: Radoslaw Wasiak, PhD, Liberty Mutual Research Institute for Safety, Center for Disability Research, 71 Frankland Road, Hopkinton, MA 01748; E-mail:

©2007The American College of Occupational and Environmental Medicine