Chiropractic Associated with Reduced Need for Post-Injury Back Surgery

In any industry, healthy employees are at the core of a successful business.  When workers are unable to work due to illness or injury, there is the cost of healthcare expenses as well as a cost for the lost work.  Therefore, it is in the best interest of both the employee and employer to utilize the most effective treatments in order to enable workers to continue to work, or return to work, as soon as possible after illness or injury.

This infographic from the National Safety Council shows the top 3 causes of injury/illness resulting in missed work for 2020.

It is understandable that the data for this infographic reflects the impact of COVID-19 within the workplace, causing “Exposure to harmful substances or environments” to leapfrog from #6 to #1 as the most common cause of injury or illness.  It may also not be surprising to many that, close behind, at #2 and #3 are back injuries from overexertion and sprains, strains and tears from fall injuries.

According to the US Department of Labor, Bureau of Labor Statistics, the total numbers for 2021 showed a slight decrease with a total of over 2 ½ million nonfatal workplace injuries and illnesses.  However, it’s important to note that this decrease was directly related to lower illness rates – and that the injury cases actually increased 6.3% to 2.2 million cases.  Overexertion, bodily reaction, falls, slips and trips are musculoskeletal in nature, with back injuries repeatedly being the most common by far as is shown in yellow in this 2016 chart from Bureau of Labor Statistics.

Studying the Impact of Chiropractic Care on Workplace Injury Outcomes

Costs for the treatment of occupational back pain has been growing faster than inflation.  A significant portion of the increased costs are related to spinal surgeries, yet there has not been a corresponding increase in positive outcomes.

There is considerable interest in finding the best possible treatment and studies on this topic continue to be a hot topic amongst the research community.

Some researchers have speculated that if early identifiers of low back surgery could be identified, then these employees could be identified, and their outcomes improved with evidence-cased care.

In their study, utilizing data from the Washington State Worker’s Compensation Disability Risk Identification Study Cohort (D-RISC), 1,885 workers “who received some wage-replacement compensation for temporary total disability (four days off work) due to the injury” were recruited and completed phone interviews.  Their medical records and claims related to the injury were also analyzed.  Over the course of 3 years from their injury, 174 (9.2%) had undergone one of more lumbar spine operations.

Results of the analysis revealed several key variables that were associated with the employee having surgery.

Variables associated with higher rates of surgery included workers who:

  • had high baseline Roland-Morris Disability Questionnaire (RMDQ) scores (Originally published in 1983 by Martin Roland, MA, MRCP, MRCGP and Richard Morris, MSC, the RMDQ is a questionnaire designed to measure self-rated disability due to back pain. It is now one of the most widely used health status measures used in both research and clinical practice, and has been translated into over 50 versions.)
  • had greater injury severity
  • first saw a surgeon to receive care for the injury

Two facts that stand out:

“Workers with baseline RMDQ scores of 17 or higher on the 0 – 24 scale had 6 times the odds of surgery, as compared with those with scores of 0–8.  The RMDQ has also been shown to be predictive of chronic work disability (in a previous study involving the D-RISC sample), longer duration of sick leave, chronic pain, and other measures of function.”

“Approximately 43% of workers who saw a surgeon had surgery within 3 years, in contrast to only 1.5% of those who saw a chiropractor.”

Researchers also noted that those who see a chiropractor for initial treatment after a back injury also tend to experience:

  • Lower odds of chronic work disability
  • Lower odds of requiring an MRI
  • Higher rates of satisfaction

The evidence consistently points to chiropractic being a safe, effective treatment for workplace injuries and many types of musculoskeletal pain without opioids or surgery.

When you consider the pain medications needed during and post-surgery, chiropractic has the added benefit of allowing many patients to avoid that initial opioid prescription that opens the door to dependence and addiction.

Chiropractors are trained to provide high-quality care for their patients and to recognize red flags for conditions that may need care from another healthcare provider in order to make appropriate referrals.  Many chiropractors work with a wide array of other health care specialists in order to coordinate care and provide the best possible outcome.

If you or a loved one have suffered an injury, talk to your chiropractor about how their natural approach to care may help.  If you are experiencing back pain or other musculoskeletal pain as a result of your occupation, your chiropractor can also work with your employers’ workers compensation department to ensure you receive the best care for your injury.



Keeney BJ, Fulton-Kehoe D, Turner JA, Wickizer TM, Chan KC, Franklin GM. Early predictors of lumbar spine surgery after occupational back injury: results from a prospective study of workers in Washington State. Spine (Phila Pa 1976). 2013 May 15;38(11):953-64. doi: 10.1097/BRS.0b013e3182814ed5. PMID: 23238486; PMCID: PMC4258106.

U.S. Bureau of Statistics TED: The Economics Daily “Back injuries prominent in work-related musculoskeletal disorder cases in 2016” posted August 28, 2018.  accessed 4/3/2023.

U.S. Department of Labor, Bureau of Labor Statistics News Release “EMPLOYER-REPORTED WORKPLACE I NJURIES AND ILLNESSES – 2021” released Nov. 9, 2022.  Accessed 4/3/2023.

National Safety Council Top Work-related Injury Causes Accessed 4/3/2023.

Roland Morris Disability Questionnaire  Accessed April 5, 2023