The change from biomedicine to the integrated practice is accelerated by managed care and is forcing major changes in allopathic practice. Now is the opportunity for the chiropractic profession to offer important complementary health care services within this integrated model. Lest we forget, the internet offers patients information for their problems, which further fuels the pressure on MDs. With a broadened view of health management, a DC with a holistic practice has services that are needed for tomorrow's market. In contrast to the guidelines for acute LBP, chronic LBP has had little attention from researchers.
Chronic conditions are much more complex than just pain control.
The focus shifts from pain to helping patients feel better and function better at work and in the activities of daily living. Many interventions for chronic LBP are either ineffective or show little evidence-based efficacy. However, patients with poor outcomes at seven weeks are likely to have poor outcomes one year later. Treatment goals for chronic LBP should focus on using evidence-based data to improve or restore range of motion activity levels, which are a key function for reintegration into the work force or society. Clearly, chronic problems necessitate pain control, but they go far beyond this single problem.