Opioid addiction and death is still out of control. New guidelines and regulations are reducing the number prescriptions for opioid medications. The death rate for opioid deaths dropped 4% in 2018 relative to 2017, but it was still close to 2000 in Massachusetts alone.
It’s crazy. The US makes of 5% of the world’s population and consumes approximately 80% of prescribed pain medication. Is it because culturally we can’t live with pain? Or is the medical community only masking symptoms, not getting to the cause of the pain contributing to pain medication abuse and addiction?
Another fact- According to the National Institute of Drug Abuse nearly 80% of heroin users started with prescription opioids.
We can and should talk about causes of pain in the US. We are meant to move, but we don’t. Many of us sit all day at work, then go home and watch TV and go on our computers. According a paper published in April 2019 in the Journal of the American Medical Association (JAMA) the average amount of TV/video viewing time averages 2 hours a day and outside-of-work computer time increased by over an hour. Total sitting time on a daily basis continues to increase.
“Sitting is the new smoking” now goes the mantra. Sitting has been attributed to increased musculoskeletal pain in addition to increased risk of multiple diseases including obesity, cardiovascular disease, diabetes, cancer. A recent study suggests it takes 1 hour of exercise on a daily basis to counteract the detrimental effects of sitting 8 hours. Not enough of you reading this exercise one hour a day. One solution is Active Sitting, and there is only one chair that can do that. (Read More about Active Sitting)
Yes there are traumatic causes of pain including car accidents and injuries, and probably more commonly repetitive stress. The key to correct treatment is a detailed history and examination. The majority of neck or back pain in the medical literature is labeled as “non-specific”. That means there is no obvious cause. It is not caused by an apparent pathology or disc lesion. From 34 years of clinical experience it is my opinion that these “non-specific” causes of pain are in fact caused by dysfunction in the mechanical movement of the body. The spinal column is made up of 24 vertebrae, over 125 moveable joints, ligaments that hold them together and muscles that move them. That doesn’t include the spinal cord which runs through it with a pair of spinal nerves exiting through small holes on either side of the spine (33 pair of spinal nerves in total). Abnormal movement or restriction in any of these structures can cause pain.
A functional exam can usually uncover the cause of pain caused by dysfunction. If the pain is more pathological of course imaging and referral is in the best interest of the patient. If the pain is functional than chiropractic care treats the symptoms and offer pain relief, but more importantly works to correct the cause.
Medications whether NSAIDs or opioids which are prescribed for pain relief only mask symptoms. The goal of chiropractic care is correct the cause and advice patients on how to improve their lifestyle and ergonomics so they don’t keep hurting themselves.
At the American Association of Pain Management’s Annual Meeting in March 2019, a study from Yale University was presented titled, “Is the Use of Chiropractic Care Associated with the Receipt of Opioid Prescriptions? A Systematic Review”. This was a Meta-analysis with a 95% confidence interval. The results found that 49% of chiropractic patients were less likely to receive an opioid prescription than those who went the medical route for pain. That is a huge difference.
One solution is for primary care doctors to refer to chiropractors before prescribing opioids or any medications for musculoskeletal pain. That is not just my opinion. Another JAMA study from May 2018 found that patients who had “usual medical care” plus chiropractic care felt better faster, with less medications and greater satisfaction than those with just “usual medical care” alone. In this study the patients with “plus chiropractic are” were referred by their PCP to a chiropractor. (read more about this study)
The key to preventing opioid deaths is to stop the prescription of pain medications. An excellent start is to refer musculoskeletal pain patients for chiropractic care as the first treatment. The research has been done repeatedly in some of the most respected medical journals in the world. Why aren’t medical physician groups encouraging treatments that are more effective and safer than medication? Why aren’t insurance companies encouraging a greater use of chiropractic care? I don’t have the answer. They should! There is a cost savings as well as faster outcomes in pain relief, without the dangerous side-effects of medications and addiction. With this information please make sure you and your loved ones make better choices when it comes to pain relief.
If you have any questions, please email me at [email protected]