Chiropractic Physicians Urge Conservative Approach to Pain Management

Painkiller overuse has led to negative outcomes for musculoskeletal conditions, reveals JAAOS study
Arlington, Va.— With new research highlighting more risks associated with the increased use of opioids for pain, the American Chiropractic Association (ACA) strongly urges patients and healthcare providers to consider first exhausting conservative forms of pain management. According to a recent report published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), the increased usage of opioids has led to unanticipated consequences such as a tolerance among some patients to the drug hydrocodone and negative treatment outcomes for conditions such as work-related musculoskeletal disorders, joint replacements and spine surgery.

"Beyond the risks of overuse and addiction, prescription drugs that numb pain may convince a patient that a musculoskeletal condition is less severe than it is, or that it has healed. That misunderstanding can lead to over-exertion and a delay in the healing process or even to permanent injury," says ACA media spokesperson Robert Hayden, DC, PhD.

JAAOS points out that more than 80 percent of the world’s opioids are consumed in the United States and that orthopedic surgeons are the third-highest prescribers of these medications – behind primary care physicians and internists. Researchers note that orthopedic surgeons must continue to treat pain but also implement strategies to battle the opioid epidemic.  

According to Dr. Hayden, one potential strategy is the use of conservative forms of care for pain before initiating higher-risk options such as opioids. A conservative health care model emphasizes more cost-effective and safer approaches over potentially addictive medications or surgery for pain management and health enhancement. For example, conservative management of back pain may include trying spinal manipulation combined with exercise and stretching prior to moving on to procedures involving higher risk.

Health care quality organizations now recognize the value of a conservative approach. Earlier this year, the Joint Commission, which certifies more than 20,000 health care organizations and programs in the United States, including every major hospital, revised its pain management standard to include chiropractic services and acupuncture. Clinical experts in pain management who provide input to the Commission’s standards affirmed that treatment strategies may consider both pharmacologic and nonpharmacologic approaches.