Disabling low back Oregon workers' compensation claims. Part I: Methodology and clinical categorization of chiropractic and medical cases.

This paper reports on a case-control study of 201 randomly selected workers' compensation cases involving disabling low back injuries. To control for claim severity prior to comparison studies on time loss and treatment cost, a classification scheme based on documented clinical signs and symptoms was used to subgroup the claims from two provider groups, chiropractic (DC) and medical (MD), into three categories of clinical presentation. Soft tissue strain/sprain predominated in both provider groups. The two provider groups differed in the proportion of claimants who had physical factors contributing to low back compromise. DC claimants were less likely than MD claimants to have sought initial treatment in the emergency room, more likely to have a history of chronic, recurrent low back pain and more likely to have suffered exacerbation episodes. These differences suggest a greater level of chronicity among chiropractic claimants.