Chiropractic and Back Pain

* Re “Chiropractic’s Success on Back Pain Disputed in Study,” Oct. 8: The low back studies which are cited so often, including the one mentioned, do not ever seem to address the question of mercy. Is it merciful to let a patient leave the office with a pamphlet on back exercises, leaving it up to the patient to work through the misery alone? Further, I wonder how well any study measures the economic losses due to poor workplace performance versus absence resulting from pain.

The provider’s role--be that a physician, chiropractor or physical therapist--includes that of an educator, a coach and entails reassurance, all of which may be difficult to distinguish from the placebo effect, but are essential components of care. As long as humans have emotion, there will never be an objective back study--unless, of course, the empiricists finally realize that it must be considered and somehow factored in.

THOMAS MERRYMAN DC

La Habra

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The Times’ report on a new back pain study which questions the value of chiropractic is bound to upset many health care professionals. As a physician specializing in back pain and former research scientist, I find the study itself of limited value.

For one, chiropractic and physical therapy represent more than just spinal adjustments and McKenzie exercises. Further, patients with sciatica and other back-related problems, which often can be treated effectively by physical therapy and chiropractic, were excluded from the study.

Published reports from medical schools have shown that physical therapy methods involving “pelvic stabilization” are superior to the more passive McKenzie approach.

RICHARD BERKMAN MD

Santa Barbara