What is it about?
Researchers analyzed 11,000+ episodes of back pain care, which were grouped into no spinal manipulation (SMT) visits, low (1 SMT visit), moderate (2-12 SMT visits) and high (13+ SMT visits) dose cohorts. The SMT and no SMT cohorts were compared regarding exposure to imaging studies, injection procedures, emergency room visits, surgery and opioid medications (e.g., escalated spine care). Statistical matching made the groups more comparable. The findings showed that exposure to escalated spine care was significantly reduced in the low and moderate dose SMT cohorts, with mixed results in the high SMT cohort. Those in the low dose cohort were 55% less likely to be exposed to any escalated care, while those in the moderate dose were 42% less likely (both vs no SMT). The high dose and no SMT cohorts were about equally likely to be exposed to any escalated care.
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Why is it important?
The dose-response relationship between SMT visits and low value care exposures has important implications for providers deciding on best practices and for policymakers determining insurance coverage for SMT, which is often limited to a specific number of visits per year.
Perspectives
Read the Original
This page is a summary of: Dosing of lumbar spinal manipulative therapy and its association with escalated spine care: A cohort study of insurance claims, PLoS ONE, January 2024, PLOS,
DOI: 10.1371/journal.pone.0283252.
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