11/05/2025

Injury Care with X-ray Diagnostics Can Expand the Chiropractic Profession

by Jeffrey Cronk, DC, JD

In America today, there will be over 108,000 injuries that will require over 115,000 emergency room visits and will generate over 252,000 medical visits. (1) These by the way are not visits to chiropractors or to physical therapists. These are medical doctor visits.

Auto injuries generate the most costs, followed by home injuries, then work injuries and then injuries outside of the home called public injuries. On the work injury side our employers spend and average of $42,000.00 per medically attended injury (2). Some calculators place a $50,000.00 price tag on just one back injury with the costs going over $275,000.00 if the injury goes beyond three years. (3)

Patients with chronic lower back pain can expect to spend $90,000.00 to $190,000.00 for a year to medically manage this condition according to the American Pain Society. (4)

Spinal ligament injuries are the number one cause of all this chronic pain and disability and these costs are at epidemic levels in the market today. Societal costs of all injuries in America is around 12,000,000,000.00 dollars a day! (5) Yes, that is 12 Billion a day. That is about the total size of the whole year of the chiropractic market in one day. Again, the biggest offenders in this injury market are the spinal soft tissue injuries. If these are just “soft tissue injuries” why are they so out of control in cost, chronic pain and disability? Now a better question is why you as a Doctor of Chiropractic so beaten up in this market or in the case of work comp in some jurisdictions not even really in the market.

How about this fact, our injury experts of yesteryear were so good, some of them even created the current injury guidelines such as the ODG guidelines used in Work Comp. If these injury experts, these injury leaders, these injury guidelines are/were so good, then why are these conditions at unsustainable levels cost and chronic pain wise? Why do top researchers like Dr. William Marris with the Biodynamics Laboratory out of Ohio State University, explain to us in his book, (The Working Back a System View), that 80-90% of all Low Back Disabilities do not have a pathoanatomic cause identified. The doctors treating these patients are not sure what is causing the problem. That is a problem! Yes, diagnosing this condition is a problem for most doctors, but it does not have to be for us.

If the current state of our medical experts and their guidelines are so good, why are there such poor results in the market?

Now some of you reading this may be starting to think that we as a profession have solutions to this, especially in the spinal soft tissue area of spinal injuries. I am glad that you are thinking that, because we do have the solution to this problem on a very broad scale. There has never been a greater time to lead in this market because right now it appears to be led by the confused that are not even sure how to find the underlying cause of the problem in these types of injuries.

Why aren’t we as a profession taking a leading role in solving these problems?

Well it is very easy to understand when you realize we do not apply our own most basic axiom, “alignment improves function” to ourselves as a profession. Where are we aligned in our procedures in this area? Certainly, we are not aligned in our injury procedures. We even have our national organizations trying to reduce the utilization of x-ray which happens to be the only imaging tool that can standardly analyze and assess for the most common cause of spinal pain which is spinal instability due to ligament damage. We tell the public how important spinal alignment is to their health and function, yet some in our ranks seem to specialize in misaligning ourselves so that we stay dysfunctional as a group.

The bottom line to this, to scale we must align our procedures and nowhere is it more evident than in the area of spinal soft tissue injuries.

A patient with a spinal soft tissue injury had ought to be able to walk into any chiropractors’ office and get a standard spinal soft tissue work up. This would be like a patient walking into a dentist’s office with a cavity. Pretty much any patient can go into any dental office and get almost an identical work up. By the way, how is that profession which is so aligned doing?

In our offices the patient must be able to walk in and get a standard spinal instability exam, which includes standard stress x-rays and a standard excessive motion measurement procedure. At Spinal Kinetics which is a national medical company that does spinal ligament damage assessments, we trademarked the term CRMA® Computerized Radiographic Mensuration Analysis as our term for doing this testing.

The doctor also must be able to standardly determine if the complicating factor of a disc herniation also exists with spinal instability.

Early, accurate and standard assessments of this condition by our profession would change the injury market overnight! With this we could begin to approach large industry and insurers with the understanding that we are now able to standardly knock out their number one cost, their biggest problem, the spinal soft tissue injury.

Remember everything we do should be about better early diagnostic procedures that standardly and objectively identify the problem (injury derangement) which leads to earlier and more successful interventions. This of course would lead to far less pain and far less disability. That makes you highly relevant in the market today. Aligning our procedures is the only way!

References:

1. https://www.cdc.gov/nchs/fastats/injury.htm
2. http://www.nsc.org/Membership Site Document Library/2015 Injury Facts/NSC_ InjuryFacts2015Ed.pdf
3. http://www.accurateregoronomics.com/the-cost-of-msd-injuries/
4. http://americanpainsociety.org/uploads/education/guidelines/evaluation-management-lowback-pain.pdf