Is It More Affordable to See a Chiropractor First for Low Back Pain?

When low back pain strikes, one of the first questions many people ask is: “Who should I see first?” Should you start with a medical doctor? Or a chiropractor?

A large insurance-based study looked at this exact question and found something important: starting care with a chiropractor was associated with significantly lower overall costs for low back pain episodes.

What Did the Study Examine?

Researchers analyzed insurance claims from Blue Cross Blue Shield of Tennessee over a two-year period. Importantly, patients in this study had equal access to both medical doctors (MDs) and doctors of chiropractic (DCs). There were:

• No referral requirements

• No visit limits

• No differences in co-pays

This means patients could freely choose who they wanted to see first.

The researchers grouped care into “episodes.” An episode included all treatment related to low back pain from the first visit until care ended (with a 60-day gap defining a new episode).

They then compared the total costs of episodes that began with a medical doctor versus those that began with a chiropractor.

What Were the Results?

The findings were clear.

Episodes of care that began with a chiropractor were:

• Nearly 40% less expensive based on total paid claims

• Still about 20% less expensive even after adjusting for patient health risk and complexity

In other words, even when accounting for differences in patient health status, starting with a chiropractor was associated with significantly lower overall costs.

Why Might Starting With a Chiropractor Cost Less?

While this particular study focused on cost rather than clinical outcomes, there are a few likely reasons:

Chiropractors typically begin with conservative, hands-on care focused on restoring movement and reducing pain without immediately relying on imaging, injections, or medications. When appropriate, this approach may reduce the need for more invasive or higher-cost interventions.

It’s important to note that this study did not suggest medical doctors provide unnecessary care. Instead, it highlights how the starting point in the healthcare system can influence the total cost of an episode of back pain treatment.

What This Means for Patients

Low back pain is one of the most common reasons people seek medical care. It’s also one of the leading causes of disability worldwide.

This research suggests that when patients have equal access and can choose their provider freely, beginning care with a chiropractor may reduce the overall cost of treatment for low back pain.

For many individuals, conservative care first is a practical, cost-conscious, and non-invasive approach.

The Bottom Line

If you’re dealing with low back pain and wondering where to start, evidence suggests that initiating care with a chiropractor may lower overall treatment costs compared to beginning with a medical doctor.

Every case is different, and collaboration between providers is often appropriate. But when safe and suitable, starting with conservative chiropractic care may be both clinically reasonable and financially beneficial.

We proudly serve Springfield, Missouri and the surrounding communities.

Come see us!

📍 The Well Chiropractic- Springfield, MO

📅 Schedule and Appointment Today!

Source

Liliedahl RL, Finch MD, Axene DV, Goertz CM.

 Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer.

 Journal of Manipulative and Physiological Therapeutics. 2010;33(9).