Conservative Pain Management: A First-Line Defense Against Prescription Drug Abuse Crisis

May 5, 2011 — The American Chiropractic Association (ACA) applauds federal efforts to curb prescription drug abuse following the U.S. government’s announcement in late April that the problem has reached crisis level.

ACA encourages patients and healthcare providers to explore drug-free, conservative approaches to pain management as a first-line defense against painkiller abuse.

The government’s report, “Epidemic: Responding to America’s Prescription Drug Abuse Crisis,” notes that while the use of some illegal drugs has diminished, the abuse of prescription medications has sharply increased, particularly prescription opioid pain relievers such as Oxycontin and Vicodin. It points out unintentional opioid overdoses — once almost exclusively the fate of heroin abusers — are today increasingly caused by prescription painkiller abuse.

“This new report shows that while sometimes the use of these powerful drugs may be necessary, their overuse and abuse can lead to deadly consequences. The chiropractic profession offers non-drug interventions for pain relief,” said ACA President Dr. Rick McMichael. “We urge healthcare providers, whenever possible, to recommend drug-free conservative care interventions for their patients before prescribing medications that may be associated with harmful side effects. It’s critical that patients know their options.”

The government report outlines a four-part strategy to reduce the incidence of overdose caused by painkiller abuse, including increased education; monitoring of “doctor-shoppers” who obtain multiple prescriptions; the safe disposal of prescription medications; and cracking down on “pill mill” clinics that dispense hundreds of pills per patient. ACA believes prevention is also key and that increased use of conservative approaches for pain management may curb the need for painkillers and thereby reduce the likelihood of patient dependency, overuse and possible overdose.

Chiropractic care is best known for its effectiveness in treating painful conditions such as back pain, neck pain, and headaches — which are serious causes of disability in the United States. According to the U.S. Bone and Joint Decade, the number of prescription medications has increased in the past 10 years.

Chiropractic care may lessen or eliminate the need for medications in some cases and help patients avoid unnecessary surgery. Chiropractic physicians treat the whole person, promote wellness and strive to address the underlying cause of patients’ ailments, not just their symptoms.

Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain. In 2007, the Annals of Internal Medicine published low back pain guidelines developed by the American Pain Society and the American College of Physicians recommending that, for patients who do not improve with self-care, doctors should consider non-pharmacologic therapies such as chiropractic care, massage therapy and acupuncture.

Source: American Chiropractic Association, www.acatoday.org

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Spinal Manipulation Proves Equally Beneficial As Surgery In Sciatica Treatment

In a recent study, “Manipulation or Microdisketomy for Sciatica? A Prospective Randomized Clinical Study,” (Journal of Manipulative and Physiological Therapeutics, October 2010, Vol. 33 Iss. 8, p: 576-584), researchers concluded that spinal manipulation was just as effective as microdiskectomy for patients struggling with sciatica secondary to lumbar disk herniation (LDH).

The patient population studied included people experiencing chronic sciatica (symptoms greater than six months) that had failed traditional, medical management. Overall, 60 percent of patients who received spinal manipulation benefited to the same degree as those who underwent surgery.

“Sciatica is a serious spinal condition that causes pain, numbness, or weakness in one or both legs. Many times when symptoms become debilitating and without further help, surgery is prescribed to alleviate discomfort. But surgery is not without financial and physical drawbacks.”

“To our knowledge, this is the first, randomized trial that directly compared spinal manipulation, which in this study was delivered by a doctor of chiropractic, and back surgery, two popular treatment choices for this prevalent health condition,” says Dr. Gordon McMorland, who co-authored the paper with neurosurgeons Steve Casha, MD, PhD, FRCSC, Stephan J. du Plessis, MD, and R. John Hubert, MD, PhD, FRCSC, FACS.

“Sciatica is a serious spinal condition that causes pain, numbness, or weakness in one or both legs. Many times when symptoms become debilitating and without further help, surgery is prescribed to alleviate discomfort. But surgery is not without financial and physical drawbacks.”

According to the study, “Outpatient Lumbar Microdiscectomy: A Prospective Study in 122 Patients”, more than 200,000 microdiskectomies are performed annually in the United States, at a direct cost of $5 billion, or $25,000 per procedure. In this year-long study, consenting participants were chosen randomly to receive either an average of 21 chiropractic sessions over a year or a single microdiskectomy, both with the additional integration of six supervised active rehabilitation sessions and a patient education program. If cost is assumed at $100 per chiropractic visit, there is a direct, total savings of $22,900 per manipulation patient. System-wide, this could save $2.75 billion dollars annually.

“After a year, no significant complications were seen in either treatment group, and the 60 percent patients who benefitted from spinal manipulation improved to the same degree as their surgical counterparts,” says Dr. McMorland, who also points out that, “The 40 percent of patients who were not helped by manipulation did receive subsequent surgical intervention. These patients benefitted to the same degree as those that underwent surgery initially, suggesting there was no detrimental effect caused by delaying their surgical treatment.”

“Our research supports spinal manipulation performed by a doctor of chiropractic is a valuable and safe treatment option for those experiencing symptomatic LDH, failing traditional medical management. These individuals should consider spinal manipulation as a primary treatment, followed by surgery if unsuccessful.”

Source: Foundation for Chiropractic Progress

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Some Surprising Statistics About Back Pain

Some Surprising Statistics About Back Pain
 
Back pain relief is just one component of chiropractic care, but it is often a patient’s first introduction.  Back pain is horribly debilitating affecting all aspects of work and personal life.  If you are suffering from back pain, you are not alone.  Here are a few facts about back pain that may (or may not) surprise you. 
  • Back pain is the number one disability for those under age 45.  
  • In the United States of America alone, there is an expected 31 million people with lower back pain at any given time.  
  • Back pain runs second, after only the common cold, as the top reason for visiting a healthcare provider in the United States.  
  • Experts place the likelihood of any person to experience some type of back problem in their lifetime at about 80%.  That’s four out of every fivepeople!
  • Over 50 billion dollars are spent per year in the pursuit of clearing up cases of back pain.  
  • Around 30 to 40 percent of all workplace absences are due to back pain. 
  • Approximately one quarter of U. S.  adults reported having low back pain lasting at least one whole day in the past three months, and 7.  6 percent reported at least one episode of severe acute low back pain within a one-year period. 
  • One-half of all working Americans admit to having back pain symptoms each year. 
  • Approximately 2 percent of the U. S. work force is compensated for backinjuries each year.
  • Lower back pain accounts for two thirds of all back pain-related cases. 
  • More than two-thirds of back strains are caused by lifting and other exertions like pulling and pushing. 
  • Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer. 
The key to proper treatment of back pain is to understand the cause. Remember, pain is always a sign that something else is wrong and if continually ignored may lead to more serious harm.  Chiropractors are experts in assessing the root cause of your back pain and putting you on the right course to recovery

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