The call for non-pharmacologic approaches to address chronic pain in Kentucky

By Gerard Clum


The Unites States has awakened on every level to the crushing impact of the opioid use/abuse epidemic. Calls have come for a shift away from opioid use toward non-pharmacologic approaches to address chronic pain. An important non-pharmacologic approach in helping to solve this crisis is chiropractic care.

Collectively, we must begin to extricate ourselves from our current ineffective, dangerous and often fatal reality. The use of opiate drugs and the abuse of these products, has become the story of the day in the popular press — as well as in the scientific literature. In the process, pain management is finally getting the attention it deserves.

The data speaks for itself. Overdose deaths involving prescription opioids have quadrupled since 1999, as have sales of these prescription drugs. From 1999 to 2014, more than 165,000 people have died in the U.S. from overdoses related to prescription opioids. Kentucky holds one of the highest rates of death due to drug overdose in the U.S., according to the Centers for Disease Control and Prevention (CDC).

The problem remains that opioids frequently are prescribed for acute and subacute low back pain, despite low quality or inconclusive supporting evidence regarding their use in this circumstance. Furthermore, there are no randomized control trials that have shown opioids to improve function.

A New Way

The CDC guidelines and the National Pain Strategy share an important element to address the out-of-control opiate environment in the U.S.: encouraging medical doctors to utilize non-pharmacologic, conservative care and consider nonaddictive alternative options, behavioral changes and non-addictive pain relievers.

Chiropractic care is a hands on, non-invasive approach documented to be effective in the acute and chronic neuro-musculoskeletal pain environment, yielding improved clinical outcomes, reduced costs and high levels of patient satisfaction.

Chiropractic patients may receive spinal adjustments and/or alternative drugless therapies that assist the innate capabilities of the body to relieve pain, restore health and prevent disease. Chiropractic adjustments may aid in musculoskeletal mobilization to reduce pain and improve function.

With the prevalence of back, low back and neck pain, and the documented role of non-invasive, drug-free chiropractic care to successfully address these conditions and alleviate pain, providers in multiple disciplines and throughout the healthcare continuum are now advocating chiropractic care as a leading alternative to usual medical care.

The addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in U.S. employer sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

-Gerard Clum, DC, is president emeritus at Life Chiropractic College West in Hayward, California.