The Role of Chiropractic Care and Physical Therapy in Low Back Pain Management
In the realm of healthcare, a pressing concern revolves around the alarming statistics related to opioid prescriptions and their consequences. Currently, it's noteworthy that a staggering 52% of all opioid prescriptions are issued to patients grappling with low back pain. Moreover, over two million Americans find themselves trapped in the clutches of opioid use disorder (OUD), with a devastating 47,000 fatalities attributed to OUD in 2017. In the face of this opioid epidemic, the soaring costs of diagnostic tests and invasive treatments, and the dismal levels of patient satisfaction with such interventions, researchers from the Boston University School of Public Health embarked on a mission to unearth better alternatives for managing low back pain. Their discoveries underscore the pivotal role played by a patient's initial choice of healthcare provider, a factor that profoundly impacts both the patient and the insurance company.
This groundbreaking revelation prompted a significant health insurance carrier to take action by notifying its policyholders of the advantages of initially seeking care for low back pain from either a doctor of chiropractic (DC) or a physical therapist (PT). This insurer's proactive step is anticipated to yield substantial benefits, including a projected 21% reduction in the utilization of spinal imaging tests, a corresponding 21% decrease in spinal surgeries, and a 19% drop in opioid prescriptions. These changes promise to translate into cost savings for both employers and plan participants.
This recommendation is not merely a novel concept; it aligns seamlessly with guidelines laid out by the American College of Physicians, advocating that non-drug, non-surgical interventions should serve as the primary mode of treatment for individuals grappling with low back pain. Furthermore, it mirrors the growing body of research that underscores the effectiveness of non-surgical, non-pharmacological approaches in addressing low back pain.
For instance, a study conducted in 2020 found that 22% of patients who initially consulted their primary care doctors (PCPs) were prescribed short-term opioids. In stark contrast, those who first sought care from a PT or DC exhibited an 85-90% reduction in the likelihood of requiring opioid prescriptions. Similarly, a study from 2015 uncovered that patients who initially sought care from a DC not only reported higher satisfaction levels with their treatment but also experienced lower overall treatment costs.
Intriguingly, in 2013, researchers delved into data from worker's compensation cases in Washington state. They found that a substantial 43% of workers with back injuries who initially consulted with a surgeon ultimately underwent surgical procedures for their back pain. In contrast, a mere 1.5% of those who initially received chiropractic treatment eventually required surgery. This striking contrast underscores the potential benefits of choosing non-surgical care options as an initial approach.
Furthermore, a 2019 study shed light on how insurance plan designs can influence patient choices. The research found that low back pain patients were less likely to seek care from DCs or PTs when their insurance plans imposed greater restrictions on these providers, such as higher co-pays, deductibles, or participation in programs like health savings accounts. The study authors suggested that changing health insurance benefit designs to encourage low back pain patients to seek care from DCs or PTs could yield long-term economic and social advantages.
In conclusion, the evidence is increasingly clear: conservative treatment methods like chiropractic care should be strongly recommended for patients dealing with low back pain and other musculoskeletal conditions. Not only does this approach reduce the reliance on potentially harmful opioids and the associated risks of misuse, but it also promises cost savings for both patients and insurers. As is often the case with health conditions, seeking care at the earliest opportunity enhances the likelihood of a successful treatment outcome. Therefore, advocating for non-pharmacological, non-surgical care as the initial course of action in managing low back pain is a significant step towards addressing the opioid crisis and improving patient well-being.