Despite increasing public and professional awareness, revised pain-management guidelines and other signs of change, the numbing numbers still stand out: an estimated 130 deaths a day due to an opioid overdose.
Could a lasting solution be as simple as visiting a doctor of chiropractic or other conservative care provider first? You probably know the answer, but now research is proving it. Case in point: a new national study comparing first provider choice with early- and long-term opioid use in patients with low back pain.
Published in BMJ Open, this study evaluated short- and long-term opioid use based on initial provider type seen: conservative care practitioner (chiropractor, acupuncturist or physical therapist) or primary care medical physician (PCP). Participants included 215,000-plus U.S. adults diagnosed with new-onset low back pain and "opioid naive."
The study defined early opioid use as "an opioid fill within 30 days of the index visit" and long-term use as "an initial opioid fill within 60 days of the index date and either 120 or more days' supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months."
Researchers evaluated inpatient / outpatient claims from patient visits and pharmacy claims to correlate first provider type seen with opioid use, finding that LBP patients whose initial visit was with a DC were a staggering 90 percent less likely to use opioids early compared to patients who saw a PCP first.
Significantly reduced odds for early opioid use were also noted for acupuncture and physical therapy patients. LBP patients who first visited a doctor of chiropractic or other conservative provider were also less likely to use opioids long term compared with patients visiting a PCP.
ER physicians, orthopedic surgeons, neurosurgeons and rehab physicians were also included in the analysis. Patients visiting any of the above MD specialists first also had lower odds of early opioid use compared to primary care physicians (although not as significant as visiting a conservative-care provider), with the exception of ER physicians (dramatically higher odds for early use compared with PCPs). However, odds for long-term use were not significantly different compared to primary care providers for all of the above specialist types, with the exception of rehab physicians (still significantly lower odds compared to PCPs).
If that's not enough proof, a second study, this one published in Pain Medicine, reviewed six previous studies involving more than 60,000 participants with spinal pain, finding that patients who saw a chiropractor were 64 percent less likely to use opioids compared to patients who visited another type of health care provider.
It makes sense that patients who visit chiropractors are less likely to use opioids, since chiropractors provide nondrug, nonsurgical care. But the bottom line is, visit a chiropractor, reduce your risk of using a dangerous opioid! In light of the sobering statistics on opioid deaths, visiting a chiropractor for your pain could be a life-saving decision.
Many people suffer from back pain and headaches, so if you're one of these people you're not alone. Chronic back pain and headaches are among the most common disorders worldwide and can significantly affect a person's life. Just as troubling, experiencing one of these conditions may raise your likelihood of experiencing the other.
There's also some good news, the fact that these issues may be connected means that one solution may help with resolving both disorders: Osteopathic care.
According to a large scale research paper in the Journal of Headache and Pain, people who suffer from chronic back pain or chronic headaches are about twice as likely to suffer from both. The paper found 14 studies that reported an association between "primary headache disorders and persistent low back pain."
Although the researchers do not find the cause of the connection between these two conditions, other studies have found links suggesting that dysfunction in the body, particularly involving the spinal joints and spinal nerves, can be a contributing factor with both headaches and back pain.
That makes osteopathic care a great option when you're experiencing either condition – or both! Since an osteopath can help both back pain and tension headaches, there's a good chance that if you're only suffering from one, osteopathic care may prevent the other from occurring at all. Now that's a two-for-one win with osteopathy!
Regardless of a doctor’s specialty, the school they graduated from or their years of experience, they can’t cure headaches, mend broken bones or heal a wound. Only you can do that… If your healing ability isn’t impaired.
Your natural healing ability is responsible for the tremendous success that osteopathic patients enjoy. The only thing doctors can do, regardless of their discipline, is to help reduce barriers to the incredible healing ability you were born with.
Which is why we’re interested in your skeletal and nervous systems. It’s what controls every movement, evey cell, tissue, organ and system of your whole body. The nerves along your spine are the most vulnerable part of your nervous system.
By reducing any blockages to healing and nervous system compromise from the bones of your spine, you can then take over and do the healing!
Do you know anyone whose healing ability needs a boost? Share this article with them.
Depression and anxiety are often unrecognised and as such, unaddressed in older adults. When these disorders are identified, a common treatment option, unfortunately, is the option that's become all-too-standard for any senior health issue: medication. But it doesn't have to be that way. Research suggests a simple mineral can help reduce depression and anxiety symptoms: magnesium.
A study published in a peer-reviewed psychiatry journal found that among nearly 6,000 middle-aged and senior, community-dwelling adults, magnesium intake and depression scores; in other words, higher magnesium intake correlated with lower depression scores and vice versa. The findings remained significant even after adjusting for factors that might contribute to depression, such as socio-economic and lifestyle variables.
Magnesium intake was assessed using comprehensive food-frequency questionnaires, a method that allows participants to chart their food consumption. Good sources of dietary magnesium include spinach, quinoa, nuts, black beans, avocado and dark chocolate. Magnesium supplementation is also an option if dietary sources prove insufficient. Talk to your doctor for more information.
Leg pain pain is a common complaint, especially for people who run a lot. Although running is a great exercise it asks a lot of the muscles in the thigh and hip, and when we have been sedentary for a lot of the day sitting at desks this can be a lot for the body to cope with. A common area for people to experience pain is at the top of the thigh near the pelvis. It often goes with rest only to return as soon as we start training again.
In order to understand what causes this problem we need to know little bit about the muscles around this area. The four main muscles in the thigh (Quadriceps) are mainly concerned with straightening the leg. One of the muscles also helps in assisting the hip flexors which bring the thigh to the front again so we can take the next step forward. However the main hip flexor is a little know muscle called psoas (it’s a silent ‘p’ if you want to impress your friends!). It attaches to the lower back and the inner thigh and can therefore cause problems in both these areas. If this muscle becomes chronically short, for example if we sit a lot, then it can’t operate at its full potential and struggles when we ask it to work hard when we’re running and sprinting.
The reason for the pain at the top of the thigh is often not the psoas muscle itself as this is often working at below full potential, but the small muscle of the quadriceps I mentioned in the previous paragraph. As this assists in flexing the thigh it gets recruited when the psoas isn’t working correctly, and so becomes prone to injury and therefore pain and tenderness. We therefore experience thigh pain from the smaller accessory muscle at the top of the thigh, but it's not because this muscle isn’t working well, it's because it’s working too hard!
To address the problem we need to treat the local inflammation but most importantly the shortened hip flexors. Just treating the injured muscle doesn’t address the root cause and so the injury keeps returning.
I am often asked what the difference is between osteopathy and physiotherapy, and which treatment would be most suitable. It can be hard to know who to see, and if one treatment is better for certain conditions.
In today's private practice the two professions have many similarities and treat pretty much the same problems – equally successfully - albeit with a slightly different ideology and approach.
Osteopaths view the body as a unique, interconnected system which has the ability to heal itself given the right environment. Osteopathic treatment focuses on correcting any disruption in this system - such as restricted joints, poor spinal alignment, muscle tension and imbalances and incorrect posture/movement patterns. Each person is assessed individually and not treated according to any set protocol.
Osteopathic diagnosis and treatment is around 90% 'hands-on'. The techniques employed vary from soft tissue techniques such as massage and passive joint movements to joint manipulations (often referred to by patients as 'cracking'). They may also use ultrasound or acupuncture, and in many cases advise on lifestyle and posture. Exercises and/or stretches may also be given.
Physiotherapists concentrate on restoring optimum function and performance to the problem area. As physiotherapy has been an intrinsic part the NHS for many years, the availability of funding has driven research and enabled studies leading to the development of 'treatment protocols' for the treatment of specific problems.
Physiotherapy diagnosis and treatment is less 'hands-on' (around 60%) as more focus is given to observing movement and correcting technique. The techniques employed by physiotherapists vary from soft tissue techniques, such as massage and passive joint movements, to more extensive rehabilitation exercise programs. Ultrasound may also be employed.
If people who primarily focus on muscles sit at one end of a spectrum (i.e. massage therapists to relax or personal trainers to strengthen) and people who primarily focus on joints sit at the other (i.e. chiropractors), physiotherapists and osteopaths sit together in the middle.
So who should I see?
It really comes down to personal preference. Both professions can successfully treat the same conditions, so if you still can’t decide my advice would be to ask around for a recommendation, as the individual is probably more important than the profession.
But if you have a problem... Do something about it!
It is more important that you see someone (physiotherapist or osteopath) rather than see no one at all!!