A Big Step for Chronic Pain Management

According to a paper published last year, approximately 22 percent of U.S. adults with chronic pain use opioids.¹ This is based on data from the 2019 National Health Interview Survey (NHIS), which concluded that more than 50 million adults experience chronic pain.²

But what about the remaining 78 percent of chronic pain patients? What are they using to manage their pain?

Managing Chronic Pain: Nondrug Therapies (or Nothing at All)

A recent review of the 2019 NHIS data examined 11 pain management techniques used over a three-month period. The authors found that more than half (54.7 percent) of patients only used nonopioid pain management techniques, 4.4 percent only used opioids, 10.7 percent used both and almost a third (31.7 percent) did not use any pain management techniques during the previous three months.³

Of those who utilized non-opioid pain management techniques, more than a third (35.4 percent) used "complementary techniques," with 11.6 percent using "spinal manipulation or other forms of chiropractic care" – approximately 5.8 million U.S. adults in chronic pain.

While the demographic information is not provided for chiropractic care specifically, it is for complementary therapies, which also include: yoga or tai chi, massage for pain and meditation, guided imagery, or other relaxation techniques.

Profile of the Chronic Pain Patient Who Uses Complementary Therapies

• More likely to be younger than age 44 and less likely to be older than age 65
• A little more likely to be female
• More likely to have household incomes over $100,000 and less likely to earn less than $35,000
• A little more likely to be insured
• More likely to have greater than a high-school education

Chiropractic Takeaways

Chiropractically speaking, there are a number of positive takeaways from this study. First, the "spinal manipulation or other forms of chiropractic care" category not only recognizes spinal manipulation as primarily chiropractic, but also acknowledges that there are many other forms of care provided by doctors of chiropractic.

Second, as chronic pain management techniques appeared for the first time in the 2019 NHIS data, it is important that chiropractic care was included prominently in this study (used by more than one in nine adults). Chiropractic is thus likely to be included in most future studies of chronic pain care.

Finally, while chiropractic is lumped into complementary therapies, the data reinforces the fact that chiropractic care is among the preferred choices of younger, higher-educated and more affluent Americans, particularly when it comes to chronic pain relief. This has to be seen as a trend by those paying attention.

References

1. Dahlhamer JM, Connor EM, Bose J, et al. Prescription opioid use among adults with chronic pain: United States, 2019. Natl Health Stat Report, 2021;(162):1-9.
2. Zelaya CE, Dahlhamer JM, Lucas JW, Connor EM. Chronic pain and high-impact chronic pain among U.S. adults, 2019. NCHS Data Brief, 2020 Nov;(390):1-8.
3. Groenewald CB, Murray CB, Battaglia M, et al. Prevalence of pain management techniques among adults with chronic pain in the United States, 2019. JAMA Netw Open, 2022;5(2):e2146697.

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