SAN JOSE, California, February 24, 2021 / PRNewswire / – The Foundation for Chiropractic Progress (F4CP), a nonprofit that educates the public about the benefits of chiropractic care, has issued a public statement in support of the results of a published cohort study February 16 in the Journal of the American Medical Association (JAMA Network Open).
The study, “Risk Factors Associated with the Transition from Acute to Chronic Lower Back Pain (LBP) in US Patients Seeking Primary Care” concluded that the transition from acute to chronic lower back pain (LBP) was associated with 32% is much larger than previously assumed. and increased accordingly with early exposure to mismatched guidelines. This is an important finding because the prevailing belief in the medical community has been that acute LBP will go away on its own within three months and therefore receive little attention. It turns out that more attention is needed in the acute initial stages so that LBP does not become chronic even in low-risk patients. The study’s authors suggest that accumulating evidence suggests that compliant care in primary care has not been successfully implemented.
Clinical guidelines consistently recommend reassurance (e.g., most episodes of acute LBP resolve quickly and have a very low likelihood of serious underlying pathology) and advice to maintain activity as tolerated. Recently, non-pharmacological interventions such as spinal manipulation (commonly known as chiropractic adjustment), heat, massage or acupuncture are recommended as initial treatment options, while opioid drugs without red flags (e.g. fever) are specially advised and prescribed, fracture, malignant neoplasia ) are not recommended.
“These results suggest that more emphasis should be placed on strategies to successfully implement concordant guideline care in primary care to reduce the development of chronic lower back pain,” he said Sherry McAllister, DC, President, F4CP. “The F4CP is working to raise awareness of the effectiveness of spinal manipulation as a recommended first-line treatment option when administered by a chiropractor versus another health care provider. In the US, DC programs include rigorous clinical training focused on pain in the lower back focused. ”
When is lower back pain considered chronic?
Patients with chronic LBP were classified as chronic LBP if they 1) reported pain for more than three months and 2) had pain for at least half of the days in the six months.
Lower back pain is the leading cause of disability in The United StatesThis corresponds to twice the burden of any other health condition. Treatment of LBP and related spinal diseases is the most expensive medical problem in the United States today, with most of the costs incurred in outpatient settings, including primary care. Chronic LBP is the main contributor to long-term disability, morbidity, health care, and societal costs.
The study suggests that one reason for poor implementation could be due to doctors’ musculoskeletal training. Medical educators have recognized for years that training in musculoskeletal medicine is not optimal for medical students, local residents, and general practitioners.
Define non-concordant maintenance
The cohort study defines mismatched care as:
- All prescriptions that contain opioids
- Prescriptions containing benzodiazepines and / or systemic corticosteroids alone without the presence of nonsteroidal anti-inflammatory drugs or short-term skeletal muscle relaxants
- Orders for a lumbar x-ray or computed tomography / magnetic resonance imaging (CT / MRI)
- Referrals to non-surgical or surgical specialties (e.g. physiotherapists, orthopedists, neurologists, neurosurgeons or pain specialists).
Of the 5,233 patients with acute LBP from 77 primary care practices in the study, nearly half received at least one mismatched recommendation within the first three weeks of the initial visit. The study found 1,544 patients received prescriptions for non-recommended drugs, 999 of whom received opioids.
Even after controlling for patient characteristics (e.g. obesity) and clinical characteristics (e.g. basic disability), an increasing number of inconsistent management approaches increased the likelihood of chronic LBP after six months. Mismatched care can lead to direct and indirect damage as it is associated with medicalization and unnecessary use of health care.
“Referrals to chiropractors for back pain should be part of the consistent treatment,” said Dr. McAllister. “Studies show that rates of opioid use decrease when patients start with a non-prescriber (provider). While the availability of non-prescription treatment is not a panacea for the opioid crisis, it is clear that it is reducing the prescription can take into account the pain management needs of patients while it still exists. “
For more information on chiropractic support and the effectiveness of spine manipulation, please visit https://www.f4cp.org/new-research/.
About the Foundation for the Advancement of Chiropractic
The Foundation for Chiropractic Advancement (F4CP) is a non-profit organization with nearly 29,000 members, educating and educating the public about the value of chiropractic care by Doctors of Chiropractic (DC) and its role in drug-free pain management. Visit www.f4cp.org; Call 866-901-F4CP (3427).
SOURCE Foundation for Chiropractic Progress