National Chiropractic Health Month

Move4Life: Key Facts and Figures
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National Chiropractic Health MonthMovement and Musculoskeletal Health
More than one in two adults report experiencing a musculoskeletal condition. Some of the most common include low back pain, neck pain, arthritis, osteoporosis and injuries.1
Musculoskeletal conditions are the most commonly reported medical conditions among those under age 65 and the second most commonly reported condition among those age 65 and older.1
Fifty-two percent (52%) of people with musculoskeletal disorders say that it interferes with their activities of daily living.1
Overall, the volume of years lived with disability has increased in the aging U.S. population.2
Fear of movement is one consequence of persistent pain, and it is also a main contributor to pain and disability.3
Movement (physical activity) can improve symptoms, decrease disability and improve function and well-being in a range of chronic musculoskeletal pain conditions.3
An active lifestyle, leading to a higher level of physical fitness, is related to better spinal control in middle-aged men and women.4
In the United States, more than half of all adults fail to meet the surgeon general’s physical activity recommendations of 30 minutes of moderate-intensity exercise daily or 75 minutes of vigorous-intensity exercise weekly.5
Physical inactivity has been labeled by some as a pandemic because of its increasing global prevalence and the significant impact it has on society’s health as well as its economic wellness due to lost work days and productivity.5
There is substantial evidence that physical activity has beneficial effects on most musculoskeletal conditions, including low back pain. 6
More than a quarter of all adults worldwide (1.4 billion worldwide) do not get enough physical activity.7
Worldwide, women more frequently report that they are insufficiently active. In the U.S., 48% of women compared to 32% of men report that they do not get enough physical activity.7
The trend toward inactivity in wealthier countries is attributed in part to sedentary occupations, more recreation and motorized transport. The increasing use of technology is also a factor.7
Back Pain
Low back pain is the single leading cause of disability worldwide.8
Back pain is one of the most common reasons for missed work. One-half of all working Americans admit to having back pain symptoms each year.9
Back pain alone accounts for more than 264 million lost U.S. work days in one year.10
Back pain is the third most common reason for visits to the doctor’s office, behind skin disorders and osteoarthritis/joint disorders.11
Experts estimate that as much as 80% of the population will experience back pain at some time in their lives.12
There is a significant association between high body mass index (BMI) and low back pain.13
Low-back pain costs Americans at least $50 billion in health care costs each year14—add in lost wages and decreased productivity and that figure easily rises to more than $100 billion.15
Back Pain and the Opioid Epidemic
Almost half of all U.S. opioid overdose deaths involve a prescription opioid.16
Back pain is one of the leading reasons why people are prescribed opioids.17
Research shows that opioids do not provide clinically meaningful pain relief for people with chronic back pain.18
As many as one in four people who receive prescription opioids long term for non-cancer pain in primary care settings struggle with addiction.19
In 2014, almost 2 million Americans abused or were dependent on prescription opioids.20
Almost 80 percent of Americans prefer to first use options other than prescription drugs for their pain.21
Effectiveness of Chiropractic Care
Chiropractors are widely recognized as providing the safest drug-free, non-invasive therapies available for the treatment of back pain and other musculoskeletal complaints.22
A recent clinical comparative trial found that chiropractic care combined with usual medical care for low back pain provides greater pain relief and a greater reduction in disability than medical care alone.23
Injured workers with similar injuries are 28 times less likely to have spinal surgery if the first point of contact is a doctor of chiropractic (DC) rather than a surgeon (MD).24
In 2017, the American College of Physicians (ACP) updated its guideline for the treatment of acute and chronic low back pain to recommend first using noninvasive, nondrug treatments—including spinal manipulation—before resorting to over-the-counter and prescription drugs.25
In January 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. including every major hospital, recognized the value of nondrug approaches by adding care provided by doctors of chiropractic to its pain management standard.26


The Hidden Impact of Musculoskeletal Disorders on Americans, United State Bone and Joint Initiative, 2018.
Murray CJ et al. The state of U.S. health, 1990-2010: Burden of diseases, injuries, and risk factors. JAMA 2013, Aug 14; 310(6):591-608. doi: 10.1001/jama.2013.13805.
Booth et al. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal Care. 2017;15:413–421. doi: 10.1002/msc.1191.
Aasa U et al. Physical activity might be of greater Importance for good spinal control than if you have had pain or not. Spine 2015; 40:1926–1933.
Eijsvogels T. Exercise is medicine. At any dose? JAMA 2015, Nov. 10; 314 (18); 1915-16.
Olaya-Contreras et al. The effect of the stay active advice on physical activity and on the course of acute severe low back pain. BMC Sports Science, Medicine, and Rehabilitation, 2015; 7:19.
Guthold et al. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Global Health, Sept. 2018; doi
Hoy D et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases. Ann Rheum Dis. 2014 June; 73(6):968-74. doi: 10.1136/annrheumdis-2013-204428.
Vallfors B. Acute, subacute and chronic low back pain: Clinical symptoms, absenteeism and working environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
The Hidden Impact of Musculoskeletal Disorders on Americans, United State Bone and Joint Initiative, 2018.
St. Sauver, JL et al. Why patients visit their doctors: Assessing the most prevalent conditions in a defined American population. Mayo Clinic Proceedings, Volume 88, Issue 1, 56–67.
Rubin Dl. Epidemiology and risk factors for spine pain. Neurol Clin. 2007; May; 25(2):353-71.
Peng T et al. The association among overweight, obesity, and low back pain in U.S. adults: A cross-sectional study of the 2015 National Health Interview Survey. JMPT 2018; 41(4): 294-303.
In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
Katz JN. Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. J Bone Joint Surg Am. 2006; 88(suppl 2): 21-24.
Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at
Mojtabai R. National trends in long-term use of prescription opioids. Pharmacoepidemiology and Drug Safety, 2017; doi 10.1002/pds.4278.
Abdel Shaheed C et al. Efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain: A systematic review and meta-analysis. JAMA Intern Med. 2016;176(7):958–968. doi:10.1001/jamainternmed.2016.1251
Boscarino JA et al. Risk factors for drug dependence among out-patients on opioid therapy in a large U.S. health-care system. Addiction 2010;105:1776–82. http://dx.doi. org/10.1111/j.1360-0443.2010.03052.
Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2014.
“Americans Prefer Drug-Free Pain Management Over Opioids,” Gallup-Palmer College of Chiropractic Annual Survey of Americans,
Meeker WC, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Annals of Internal Medicine, Feb 2002; 136(3):216-27.
Goertz CM et al. Effect of usual medical care plus chiropractic care vs usual medical care alone on pain and disability among US service members with low back pain: A comparative effectiveness clinical trial. JAMA Network Open, 2018;1(1):e180105. doi:10.1001/jamanetworkopen.2018.0105.
Keeney BJ et al. Early predictors of lumbar spinal surgery after occupational back injury; Results from a prospective study of workers in Washington State. Spine, May 2013; 38(11):953-64. doi: 10.1097/BRS.0b013e3182814ed5.
Qaseem A et al. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi: 10.7326/M16-2367.
“Clarification of the Pain Management Standard,” The Joint Commission, 2015: