Initial findings from the Gallup-Palmer College of Chiropractic Annual Study of Americans provide insight into U.S. adults' experiences with pain and their perceptions of and opinions regarding pharmaceutical vs. conservative pain management, particularly opioids.
"Americans Prefer Drug-Free Pain Management Over Opioids," a Gallup brief based on specific findings from the 2017 survey, is now available; the complete Gallup-Palmer report, analyzing data gathered February-March 2017, will be released in October. Here's a sampling of the findings outlined in the brief:
Pain is an ongoing issue for Americans: "About one in four adults in the U.S. (27%) have seen a healthcare professional for significant neck or back pain in the last 12 months. More than half of those adults (54%) have had an ongoing problem with neck or back pain for five years or more."
Nearly eight in 10 (78 percent) of Americans "prefer to try other ways to address their physical pain before they take pain medication prescribed by a doctor." However, pain medications are still widely used: "Among those who have had ongoing neck or back pain for less than 12 months, seven in 10 have taken a nonsteroidal anti-inflammatory drug (NSAID), such as Advil®, aspirin or Aleve®, to manage the pain, and 45% have taken acetaminophen, such as Tylenol®. One in four of these new neck or back pain sufferers say they took an opioid for pain management."
For managing back / neck pain, chiropractic is perceived as "very effective" by 29 percent of Americans – higher than prescription pain medication (22 percent), back surgery (15 percent) and self-care (9 percent). Only physical therapy (41 percent "very effective") scored higher.
Americans also perceive chiropractic as safer than prescription and OTC medication and back surgery for neck / back pain: 33 percent "very safe," vs. 23 percent for OTC medication, 12 percent for prescription meds and 6 percent for surgery. (By comparison, 68 percent perceive PT as "very safe.")
While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
The New Jersey Board of Chiropractic Examiners has made a precedential decision, concurring with the Association of New Jersey Chiropractors' (ANJC) position paper on chiropractic X-ray guidelines. In plain terms, the board ruled, consistent with the ANJC position, that insurance companies cannot use medical X-ray rules or recommendations, like those written by the American College of Radiology (ACR), to decide whether a chiropractor's X-ray was necessary.
For decades, chiropractors have been told the answer to more professional referrals is simple: educate medical doctors about chiropractic. There is some truth in that advice; but it is also incomplete. The modern challenge is not simply getting another healthcare professional to know that chiropractors exist. It is becoming the kind of clinician (and building the kind of professional relationship) that makes collaboration easy and sustainable.