Chiropractic Care Reduces Opioid Use in Pain Management

Opioid analgesics are frequently prescribed to manage acute and chronic pain, with over 60 million patients receiving at least one prescription in 2016. Unfortunately, the widespread use of these potent painkillers has contributed to an opioid addiction crisis that has affected the entire nation.

Opioid abuse has significant effects on individuals, their families, and society, both in terms of health and economic burdens. For example, according to a Milliman report, the annual cost of opioid use in the United States is estimated to be as high as 179 billion dollars, covering various expenses such as healthcare, productivity loss, addiction treatment, mortality, support for children and families, and expenses related to criminal justice system involvement.

By dream@do

Every year, numerous individuals suffer from musculoskeletal problems, particularly back and neck pain, resulting in substantial expenses for our healthcare system. Some cases of back or neck issues may require surgery, opioids, or a combination of both as the only available treatments.

Approximately 22 million Americans seek chiropractic care yearly to alleviate the pain caused by various conditions. First, chiropractors focus on identifying the root cause of the patient’s problem. Then, they may use manual therapy techniques, such as spinal and extremity manipulation, to enhance joint function and relieve pain, if necessary.

Dr. Brett reviewing a thermographic spine analysis.

Chiropractic education programs emphasize the importance of training student interns to identify and manage patients most likely to benefit from conservative manual manipulation. The goal is to relieve pain in patients and potentially reduce the need for opioids or surgery. Another critical aspect of chiropractic education is teaching future healthcare providers to recognize potential health issues and contraindications to manual therapy and to suggest appropriate referral and co-management for various medical conditions. This prepares them to become portal of entry healthcare providers who can provide comprehensive patient care.

The effectiveness of prescribed pain medication is widely acknowledged as they provide significant relief for individuals suffering from various conditions, including cancer and chronic pain. They can also be highly beneficial for managing short-term, post-surgical pain. In addition, pain relief can result in greater comfort and better rest, aiding the healing process, particularly for those who have undergone invasive surgical procedures. Therefore, the value of prescribed pain medication is not in question.

But what if the need for drugs and surgery could be reduced?

Many healthcare professionals are exploring non-surgical, non-pharmaceutical alternatives to manage pain, such as chiropractic care, exercise, tai chi, yoga, acupuncture, and other options. If such activities can provide effective pain relief and reduce the need for opioids, patients may benefit greatly. This approach can be precious in managing musculoskeletal pain, and patients who opt for these alternatives may receive better care.

It is widely accepted that opioids can be a powerful pain reliever. However, the severe consequences of addiction cannot be ignored. The dangers of pain medication are evident in the statistics and illustrate how rapidly their use can lead to a downward spiral if not closely monitored. While opioids may provide relief in the short term, the potential risks of addiction and associated harm underscore the need for careful management and alternatives where possible.

What does the research say?

Recent research has revealed that even a single day of opioid use increases the risk of continued usage. For example, after one day of use, the chance of being on opioids after one year is approximately 6%. This risk increases to 13.5% after eight days of use and spikes to almost 30% after 31 days of use. These findings highlight the critical importance of carefully considering and monitoring opioid use to avoid potential addiction and harm.

West Virginia, which previously had the highest prescription opioid death rate in the country, has enacted the “Opioid Reduction Act” to address the issue. This act urges healthcare practitioners to consider non-opioid treatment options, such as physical therapy, acupuncture, massage therapy, osteopathic manipulations, or chiropractic care. As per state legislation, insurers licensed in West Virginia must cover up to 20 visits for these alternative treatments. This approach reflects the growing recognition of the value of non-opioid treatments in managing pain and reducing the risks associated with opioid use.

Research has shown that chiropractic care can be valuable in reducing opioid use for various conditions, including back pain, neck pain, headaches, and other musculoskeletal pain. In addition, studies have demonstrated that chiropractic care can effectively manage pain and improve function, allowing patients to avoid or reduce their reliance on opioids. This evidence highlights the potential benefits of incorporating chiropractic care into pain management strategies and promoting non-opioid alternatives to treat pain. These are conditions where opioids should be used with caution or avoided altogether. In cases where chiropractic care has been shown to decrease reliance on opioids, it may be a valuable alternative for patients seeking pain relief.

It is encouraging to see that support for non-opioid approaches, including chiropractic care, is growing. For example, the recent European guidelines that promote patient education, exercise, and manual therapy align with the typical chiropractic approach to managing musculoskeletal pain. In addition, these guidelines highlight the importance of caution when using opioids for low back pain and radiculopathy, emphasizing the need for non-pharmacological options. This growing support for non-opioid approaches suggests that healthcare professionals recognize the need to shift towards safer, more effective pain management strategies.

The 2017 JAMA systematic review on spinal manipulative therapy for low back pain found a statistically significant association between spinal manipulative therapy and improvements in pain and function. This review analyzed data from 26 randomized clinical trials and concluded that spinal manipulative therapy was a safe and effective treatment option for low back pain. Furthermore, the review found no serious adverse effects associated with spinal manipulation, highlighting the safety of this treatment approach.

The mission of chiropractors is to improve movement, reduce pain, and ensure proper function of the spine and extremities. By providing a more conservative approach to care, chiropractors can offer a viable option to reduce the reliance on opioids for pain management. In addition, as researchers continue to explore non-pharmaceutical options for pain relief, chiropractic care is gaining recognition as an effective and safe treatment option for various musculoskeletal conditions.

Recent studies have found that patients who received chiropractic care were less likely to be prescribed opioids for their pain, and those who did receive chiropractic care had a lower likelihood of filling opioid prescriptions than patients who did not. For example, one study published in the Journal of Alternative and Complementary Medicine found that chiropractic patients had a 55% lower likelihood of filling a prescription for an opioid analgesic than non-chiropractic patients. Another study published in the Journal of Pain found that chiropractic patients had a 64% lower chance of receiving an opioid prescription than non-chiropractic patients.

Takeaway

The inclusion of non-pharmacological approaches for treating back pain and other musculoskeletal conditions has become an important part of guideline-based pain management. This approach includes conservative interventions such as chiropractic care, physical therapy, exercise, acupuncture, and other non-pharmacological therapies. By reducing their reliance on opioids, patients can potentially avoid the risks associated with opioid use, and experience improved pain relief and function outcomes.

Disclaimer:

Dr. Berner does not diagnose, treat, or prevent any medical diseases or conditions; instead, he analyzes and corrects the structure of his patients with Foundational Correction to improve their overall quality of life. He works with their physicians, who regulate their medications. This blog post is not designed to provide medical advice, professional diagnosis, opinion, treatment, or services to you or any other individual. The information provided in this post or through linkages to other sites is not a substitute for medical or professional care. You should not use the information in place of a visit, consultation, or the advice of your physician or another healthcare provider. Foundation Chiropractic and Dr. Brett Berner are not liable or responsible for any advice, the course of treatment, diagnosis, or any other information, services, or product you obtain through this article or others.