Neuromusculoskeletal disorders are the most common problems of active-duty service members and veterans
Neuromusculoskeletal disorders are the most common problems of active-duty service members and veterans
Serving Those Who Served
Neuromusculoskeletal disorders are the most common problems of active-duty service members and veterans
The International Chiropractors Association (ICA)has set the theme for 2024 and our 98th Annual Convention (Dallas, Texas, April 11-13, 2024) as one of service to those who have served us. In the 21st century, in the United States, we no longer have a draft, mandating military service. Those who serve in uniform, to protect and defend the United States volunteer for this duty. Today, less than one percent of Americans are making that choice, and about six percent of Americans are veterans of military service. Seventy-eight percent of today’s veterans served during wartime. Thirty years ago, the military, with significant congressional pressure, began evaluating and then providing chiropractic care on military bases.[1] Chiropractic care continues to be expanded within the military and veteran facility environment.
Military Service Comes at a Price. Data indicates that military veterans have a higher incidence of chronic diseases across the board. Not surprising, these include higher prevalence of arthritis and pain. A 2018 study reported, “Of the 5.7 million patients served annually in Department of Veterans Affairs (VA) facilities, more than half experience chronic pain. Much of the chronic pain reported by veterans is musculoskeletal (MSK) pain, with around 25% consistently reporting low back pain (LBP). The prevalence of severe pain is more common in veterans with LBP than in nonveterans.”[2] Also reported was a co-diagnosis of depression or post-traumatic stress.
A 2022 paper reporting on a survey of 40 veterans reported among other things, that more chiropractors be hired to meet the patient population needs, including to reduce waiting times.[3]
A 2023 Systematic Review[4] reported, “Musculoskeletal injuries and associated pain disorders are one of the primary causes for soldiers not being medically fit to be deployed and are the leading cause for disability within military services. In the U.S. Army, more than 50% of soldiers sought medical care for MSK injuries in 2018, resulting in over 2 million medical encounters, more than 8 million limited duty days, and US$434 million in direct patient care costs.”
The paper noted that these issues are not unique to the US military population alone, it is a global issue. An additional concern from this paper was that half of the studies reviewed for potential inclusion in the systematic review were rejected over quality issues. Quality peer review data is essential.
The focus of chiropractic care is on the diagnosis and nonpharmacologic, nonsurgical treatment of neuromusculoskeletal (NMSK) disorders. Positive treatment outcomes have been published for a variety of NMSK problems. Doctors of Chiropractic (DCs) “… are among the most commonly sought-out health care providers for back pain in the United States… High-quality and high-value care is badly needed for NMSK problems…”[5] This is particularly true in the military and veterans health facilities.
Neuromusculoskeletal disorders are the most common problems of active duty service members (ADSMs) and veterans, and they contribute substantial morbidity and burden to these members of society. Spine pain is significant in this population and often leads to chronic pain. “Chiropractors are ideally suited with the knowledge and skills needed to treat NMSK conditions… Chiropractors are a ready and able workforce with expertise in spine care, and patients consistently provide high satisfaction ratings with chiropractic care.”[5]
In 2024, we are pleased to note that an independent, academically managed series of research activities focused on the chiropractic experience in the military and veterans’ population is launching, which will result in two surveys – one for chiropractors and the second for military and veteran patients of chiropractic. The surveys will cover both clinical care issues as well as the access and reimbursement issues (i.e., the bureaucracy). When this launches, we hope the entire profession will engage and notify their veteran and active-duty patients so that the resulting data is as robust as possible.
Life University’s Dr. Stephanie Sullivan will be reporting on this activity at the ICA 98th Annual Convention April 13th in Dallas. This convention is open to all in the chiropractic community. To learn more, and to register visit https://www.chiropractic.org/events
Beth Clay, Executive Director/CEO
International Chiropractors Association
Sources Cited
1.Chiropractic in the United States Military Health System: A 25th-Anniversary Celebration of the Early Years. J Chiropr Humanit, 2020. 27: p. 37-58.
2.Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process. J Manipulative Physiol Ther, 2018. 41(2): p. 137-148.
3.Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care. Pilot Feasibility Stud, 2022. 8(1): p. 6.
4.Efficacy of Conservative Interventions for Musculoskeletal Conditions on Pain and Disability in Active Serving Military Personnel-A Systematic Review. Mil Med, 2023.
5.An Essential Guide to Chiropractic in the United States Military Health System and Veterans Health Administration. J Chiropr Humanit, 2021. 28: p. 35-48.
