Chiropractic Reduces Need for Opioids but May Be Hard to Access

Highlights

• A new study showed that chiropractic care could prevent the need for opioid painkillers for many chronic pain sufferers.
• There are many barriers to getting chiropractic care that must be overcome, however.

New research could bolster the use of chiropractic care for people with severe, chronic pain, but can enough people get access to the care that will keep them off opioid painkillers and help them avoid becoming dependent?

A recent study that looked at subjects with chronic pain showed that they were 64% less likely to use opioids if they saw a chiropractor first. The study reviewed previously published research that met certain criteria and found that 11% to 51% of subjects in the research had gotten chiropractic care first, before opioids were considered as an option.

While some people in the studies reviewed still received and used opioids to help with their pain, the number was significantly lower than those who did not get chiropractic care. This study seemed to show that chiropractic treatment could help a significant number of injured people manage their pain without opioid painkillers.

In addition, it could prevent dependence on opioids or give those who have pain but struggle with dependence a conservative, non-narcotic treatment option.

Study Details

The study looked at more than 62,000 subjects with spinal pain from injury. Of the number who used chiropractic care, far fewer ended up needing opioids.

“Patients with spinal pain who visit a chiropractor may receive treatments such as spinal manipulation, massage, acupuncture, exercises and education as appropriate,” lead author Kelsey Corcoran of Yale School of Medicine in New Haven, Connecticut told Physician’s Weekly when the study was published.

“These therapies may lead to decreased pain, improved range of motion and increased function,” Corcoran said. “If a patient’s pain is well controlled by the treatment they received from a chiropractor, they may subsequently need less pain medication or even none at all.”

Barriers to Chiropractic Care

Despite the effectiveness of this drug-free treatment, however, there are significant barriers to chiropractic care when compared to conventional medical care that would lead to an opioid prescription.

While many people would prefer to have non-opioid medical care for their chronic pain if it were effective, it may not be an option for them.

Chiropractic care may not be available in all areas, particularly rural areas with small populations. There may be care available in a nearby larger city, but it will often take several hours to travel back and forth, which may not be possible for most people to do.

Even where chiropractic care is available, many insurance plans don’t cover it. This is slowly changing, but it can still be an impediment for those whose budgets don’t allow them to pay out of pocket for treatment.

In addition, not everyone has medical insurance. Ironically, those who are chronically injured and need treatment the most are less likely to have insurance because of inability to work.

Another barrier to chiropractic care is that some primary care physicians are hesitant to refer patients to chiropractors because of negative perceptions about the quality or general effectiveness of care. These attitudes are less likely with younger PCPs or those who keep up with current treatment trends, but this can still be a significant barrier for some.

Unfortunately, in many cases, it can be a lot easier to get opioids than to get chiropractic care. As more studies show the effectiveness of chiropractic treatment on those in chronic pain, however, these barriers may be breached, resulting in more people getting the care they need.

When Opioids Are Not an Option

According to an interview with News 5 Cleveland, Paul Byrd of Northeast Ohio had back pain from several car accidents, but long-term use of opioids led to an addiction that put him in repeated conflict with the police. When he finally got clean, he still had chronic pain to deal with.

Byrd found Dr. Patrick Ensminger, who was able to provide care that helped the pain, even in the absence of opioids.

“We are attempting to create a sea change towards increased access to and coverage for chiropractic care,” Ensminger said. He was hopeful that new data “will lead many medical physicians to begin increasing referrals to doctors of chiropractic and other drug-free care.”

About his severe pain, Byrd said, “It’s not waking me up in the middle of the night anymore.”

Byrd gets chiropractic care coverage through Medicaid, but is limited to 15 visits a year. Ensminger said he would continue the care even when coverage runs out, since a lack of care could derail Byrd’s progress and lead him back to opioid use.

“It’s just helping me stay focused on my recovery now. The treatment I’m getting from chiropractic is actually helping a lot more than the pills were,” Byrd said.

For Many, Chiropractic Care May Be the Answer

Chiropractors know the benefits of quality care and the potential for what chiropractic care can accomplish. Opioids can only treat the symptoms of chronic pain; they cannot heal the injury or improve a person’s overall health.

A quality chiropractic regimen including prescribed exercises between visits can lead to long-term healing and a return to a normal, active life. Chiropractors are uniquely prepared and trained to strengthen weaker parts of the body and bring balance and function back to the parts that aren’t functioning so well after an injury.

Spreading the word about chiropractic care is an important way to help more people with their chronic pain and increase acceptance of this form of conservative treatment. If more people lobby their insurance companies to cover chiropractic services, it is more likely they will do so.

Chiropractors can encourage this by asking their satisfied patients to tell their friends and neighbors about what chiropractic care has done for them and to encourage them to try it for themselves.

Chiropractors might also keep their patients informed about the benefits of chiropractic treatment for those living with chronic pain. Good ways to do this include publishing educational content periodically via social posts, email, office pamphlets, and even podcasts and videos posted on practice websites.

It’s possible to create change and even decrease opioid dependence and overdoses by promoting natural, conservative treatment that really works.

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