- Dr. Bob
Who Needs Opiates?
When doctors look for research to guide their clinical decisions, they look for journals where other doctors publish. It is important that articles submitted to those journals are carefully scrutinized by a committee of knowledgeable research critics so that potential flaws may be identified. Journals that have this process are called “refereed journals” and are better sources for information.
One such refereed journal is Pain Medicine, which in their February issue published a meta-analysis, which is a kind of research that combines multiple published works with similar subjects to increase the numbers of the sample. This creates more statistically powerful conclusions.
The study by Corcoran, et al., examined five groups with low back pain and one group with neck pain. One group was under chiropractic care, while the other group was not. Opioid use was the focus of the research. What they found was not a shock: those under chiropractic care for these conditions were 64% less likely to get opioid prescriptions.
Let’s examine that for a moment: this does not suggest that they used 64% fewer opiates. It states that 64% of those under chiropractic care did not get opiate prescriptions at all.
Let’s look a little further: those who were not under chiropractic care were probably seen by a physician, physician’s assistant, or nurse practitioner. A prescription was given to cover pain, which may or may not have been effective. Other research suggests that opiates are noneffective with low back pain at all. There may have been some follow-up days or weeks later.
Those in the chiropractic group were seen on a regular basis. By whatever technique employed, a doctor followed these patients with the regular care plan directed at correcting the cause of the pain. Physiotherapeutic techniques can be used to control pain during the process: ultrasound, electrotherapy, trigger point work, stretching, neuromuscular massage, cryotherapy, and even lasers. These techniques reduce pain and enhance the effectiveness of the chiropractic work.
We know that many opiate addictions begin on a doctor’s prescription pad. The world is looking for safe, effective, comfortable, and convenient ways to attack musculoskeletal pain. The prescription pad does not offer with the world seeks.
If you have musculoskeletal problems or pain issues, come in for a visit. I will be glad to sit down and talk to you about your condition and what your realistic options might be. Most of the people I see get better with conservative care. If you have a condition that I cannot realistically treat with success, I will direct you to a source of help.
Have a great day – healthy, successful, and fulfilled.
Pain Medicine, Volume 21, Issue 2, February 2020