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New study shows patients chiropractic patients are much less likely to use Opioids than those under traditional medical care.
The information about who patients should go to for back pain first, combined with the Annals of Internal Medicine’s new guidelines recommending medication as a last resort for back problems has been in the news over the past month. Primary physicians who have relied on medications for pain relief are now reevaluating their roles in the management of back pain and even pain itself.
Opioids have become a huge problem, as patients who had a short course for pain relief have found themselves addicted in a relatively short period of time. The problem with opioids is that those who become dependent have more pain when they attempt to withdraw, and those who are highly addicted can become quite ill. What has made matters worse is that drug companies have priced opioid medications higher than Heroin, which many addicts have switched to. Canada has responded to the problem by allowing doctors to prescribe heroin as described in the Washington Post.have
The law of unintended consequences has been one of the reasons the opioid problem exists. Most medical physicians have never learned how to properly assess patients with musculoskeletal pain properly, and use pain control and management as their main tool. Pain management clinics have treated pain and the neurological pathways of pain, using invasive methods to damage nerves that sense pain, however, the mechanism of why people hurt is often poorly addressed, and remains a huge blind spot for most medical providers. The referral patterns to orthopedic and physical therapy providers are part of the problem, since most medical providers learned to look at the body as parts that dysfunction, and even therapists will apply therapy to parts instead of individualizing the care to the patient.
Back pain is more of a movement problem, and chiropractors have earned the highest satisfaction levels for the treatment of painful conditions, and are in high demand by the athletic community for their abilities to quickly assess and improve many painful conditions. The chiropractic approach is more about individualizing the care and restoring movement.
The study which will be published soon evaluated 12,000 patients found that those who saw a chiropractor were 55% less likely to use opioid medication. This, combined to the more restrictive controls for opioid prescription placed on the primary care and physician community will also reduce opioid usage.
The culture of pain relief needs to move toward functional improvement. The idea of managing pain without understanding why it is occurring can be expensive, damaging and create long term disability and in the case of opioids, addiction.
Healthcare has many moving parts, and one of them is the insurance industry who has placed unofficial roadblocks to people getting chiropractic care including high deductibles, tiered networks and poor levels of reimbursement which are incompatible with high quality care.
Doctors of chiropractic are highly skilled in manipulation, exercise, and evaluation as well as soft tissue methods. The combination of all of these skills is likely why chiropractors should be the first choice for referral for many painful back and neck and even extremity problems.