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Flipping the Standard for Low Back Pain Management

According to a 2010 study in the journal “Addiction,” as many as 1 in 4 people who receive a prescription opioid for non-cancer pain in primary care settings struggle with addiction. By exposing patients to non-drug treatments first, the hope is that some will find enough relief to reduce or even avoid their exposure to prescription pain medications.

A promising future

Evidence supports that hope. A 2018 study published in the “Journal of Alternative and Complementary Medicine found that patients who received services from a chiropractor for back pain — one of the most common conditions for which opioids are prescribed — were 55 percent less likely to fill a prescription for an opioid medication than other patients.

Expanding access

Efforts to integrate non-drug treatment alternatives for pain have been going on for more than 10 years in the U.S. military and the veterans’ healthcare systems, yielding positive outcomes. Results of a clinical trial published in 2018 in “JAMA Open Network,featuring 750 active-duty members of the U.S. military, showed that chiropractic care combined with usual medical care — self-care, medications, physical therapy, etc. — for low back pain provides greater pain relief and a greater reduction in disability than medical care alone.

States such as Ohio, West Virginia, and Oregon also have taken steps to make non-drug pain treatments more accessible and to encourage their use as a first line of defense against pain. In Ohio, residents with work-related back injuries in many cases are required under a new guideline to try treatments like rest, chiropractic care, and physical therapy before taking prescription pain medications.

Attempts to increase seniors’ access to pain management alternatives have gained steam. A bill introduced this summer, H.R. 3654 (www.hr3654.org), would give Medicare beneficiaries access to more non-drug options for pain management available in their chiropractors’ clinics. The Centers for Medicare and Medicaid Services also released a proposal this year to cover acupuncture under Medicare.

When it comes to common musculoskeletal conditions such as back pain, neck pain, and joint pain, starting with non-drug treatments may help patients address the source of their pain rather than just mask its symptoms, potentially improving recovery.

For more information about chiropractic, visit www.acatoday.org/patients.

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