by American Chiropractic Association (ACA) President Anthony Hamm, DC, FACO
There is a consensus that pain in America is a problem of epidemic proportion and that many types of prescription management and some surgical procedures to control pain have associated risks and may lead to further health-related issues. In many of these cases, dependence on prescription opioids — and eventually heroin — can be traced back to an epidemic of chronic pain that has been improperly treated in our nation’s health care system.
Chronic pain has been described as a disease in itself. According to the American Academy of Pain Medicine, “Chronic pain affects more Americans than diabetes, heart disease and cancer combined. When asked about four common types of pain, respondents in a National Institutes of Health statistics survey indicated that low back pain was the most common, followed by severe headache or migraine, neck pain and facial ache or pain. Back pain is the leading cause of disability in Americans under the age of 45.”1
While a multi-faceted plan is needed to fight this scourge, one potential strategy is the use of conservative forms of care for pain before resorting to higher risk options such as opioids. A conservative health care model emphasizes more cost-effective and safer approaches over potentially addictive medications or surgery for pain management and health enhancement. Health care quality organizations have begun to recognize the value of this conservative approach. Earlier this year, the Joint Commission, which certifies more than 20,000 health care organizations and programs in the United States, revised its pain management standard to include chiropractic services and acupuncture2.
The vast majority of practicing chiropractic physicians have a high level of interest and expertise in managing painful conditions and are therefore poised to play a vital role in the conservative management of many painful syndromes and, indeed, chronic pain. Many active self-care and complementary and integrative strategies, which may be accessed through a chiropractic physician, provide a solution for chronic pain sufferers. Treatment modalities that have been associated with pain relief include manipulation/mobilization, acupressure and acupuncture, self-correcting exercises, TENS application, massage and others. Chiropractic physicians are trained and competent in many of these interventions, and these procedures are associated with lower risks, decreased pain levels and increased physical function.
Earlier this month, a first-ever nationally representative Gallup survey, commissioned by Palmer College of Chiropractic in Davenport, Iowa, found that 33.6 million Americans sought chiropractic care in 2014, compared to a previously reported estimate of 20.6 million in 2012. The survey discovered that a majority of U.S. adults believe chiropractic physicians are effective at treating neck and back pain. According to the report, more than half of all U.S. adults have visited a chiropractic physician, and more than a quarter of them would choose chiropractic care first for back or neck pain3.
Chiropractic’s role in pain management is currently being demonstrated in community health centers, the Department of Defense and the U.S. Department of Veterans Affairs. In many states, chiropractic physicians are participating in the management of injured workers. The American Pain Society now has a complementary and alternative medicine shared interest group, co-chaired by a doctor of chiropractic. Beginning Jan. 1, 2016, the Oregon Health Plan (OHP) will prioritize chiropractic and other complementary therapies over painkillers or surgery for patients with back pain. This marks a huge shift from the previous policy, which heavily favored narcotics as the first line of defense against pain. Under the new policy, OHP patients will be able to receive chiropractic treatment – as well as acupuncture, cognitive behavioral therapies, osteopathic manipulation and physical and occupational therapy – up to 30 times a year4.
Next month is National Chiropractic Health Month. This year, the American Chiropractic Association (ACA) will mark the observance by working with members of the profession to spread the word about chiropractic’s conservative, broad-spectrum and nonaddictive pain management methods, and help create a #PainFreeNation. Visit ACA’s website at www.acatoday.org for more information on the chiropractic profession and to find a doctor of chiropractic near you.
- AAPM Facts and Figures on Pain. The American Academy of Pain Medicine. Retrieved from http://www.painmed.org/patientcenter/facts_on_pain.aspx
- Revisions to pain management standard effective January 1, 2015. The Joint Commission. Retrieved from www.jointcommission.org/assets/1/23/jconline_November_12_14.pdf
- 2015 Gallup-Palmer Inaugural Report: Americans’ Perceptions of Chiropractic
- Oregon Prioritizes Chiropractic, Complementary Therapies Over Painkillers and Surgery. Palmer News. Aug. 11, 2015. Retrieved from http://blogs.palmer.edu/news/2015/08/11/oregon-prioritizes-chiropractic-complementary-therapies-over-painkillers-and-surgery/