The opioid epidemic may have been exposed several years ago, followed swiftly by a spate of evidence-based guidelines outlining the dangers of opioids and urging nondrug pain management (including chiropractic care), but that doesn't mean the primary prescribers of opioids – medical doctors – have listened, much less changed their prescribing behavior. This relative inaction with regard to opioid prescribing persists despite the reality that opioid misuse, overuse and addiction continues to kill thousands of Americans every year.
Perhaps this will help move the needle. A new study1 published in Spine compared the safety of seniors (65-84 years old) using spinal manipulative therapy (SMT) with those using opioid analgesic therapy (OAT) for chronic low back pain (cLBP). In reviewing five years of data, the study authors found that "the adjusted rate of ADE [adverse drug events] was more than 42 times higher for initial choice of OAT versus initial choice of SMT." (Italics added)
In reaching their conclusion, the research team "reviewed Medicare claims data spanning a 5-year period on fee-for-service beneficiaries aged 65 to 84 years, continuously enrolled under Medicare Parts A, B, and D for a 60-month study period, and with an episode of cLBP in 2013." Patients with a cancer diagnosis or history of hospice care were excluded from the analysis.
All patients received SMT or opioids long-term for their pain and were categorized into one of three comparative groups based on use: SMT only, OAT only or a combination of the two treatments – patients who "crossed over," as the authors stated, at some point during their care, from spinal manipulative therapy to opioid use, or vice versa.
Regardless of whether the patient crossed over from one therapy to the other, initial choice of SMT vs. opioid therapy proved significantly safer in terms of adverse drug events.
This latest study is important in that is quantifies just how dangerous opioids are for chronic low back pain compared to spinal manipulation. It is also important in that older adults are more likely to use opioids than younger patients; and are significantly more likely to engage in polypharmacy (concurrent use of multiple medications). Opioids represent just one more drug for an often already overburdened elderly patient.
By comparing OAT directly with SMT, the authors are pointing to chiropractic as a better, safer choice. Clinicians now have a reliable study upon which to base their referrals to doctors of chiropractic. With MDs finally listen? Time will tell. But with research suggesting it can take years for evidence to be incorporated into clinical practice,2 it may continue to be up to you to make chiropractic's value – and medicine's dangers – crystal clear to patients, their families, and your community as a whole.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
