Doctors Aaron McMichael and Jud Sprandel have been actively working with state and county opioid task force groups to encourage guideline-recommended drug-free treatment for pain before opioids. The Canton Repository published their article on one of the major remaining obstacles preventing patients from accessing this treatment--health care coverage:

"The opioid epidemic has highlighted the necessity of taking a new approach to treating pain, but Ohio's largest health care payers do not appear to be listening.

"Just in time for Drug-Free Pain Management Month, officially recognized in September by Ohio and the city of Canton, a recent analysis of Ohio's largest health care payers indicates they have been reluctant to improve coverage of recommended drug-free pain treatment alternatives. Study results indicate health care coverage often continues to favor prescription opioid use and might be contributing to the ongoing opioid epidemic.
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"Every year Ohio sets a record for drug overdose deaths with no end in sight thus far. As part of the solution, updated treatment guidelines have provided clear recommendations for a new approach to treating non-terminal pain: Use conservative non-pharmacologic options like chiropractic and acupuncture first. Use opioids last, only when needed, and use opioids only in addition to conservative options.

"Health care providers and patients have shown significant interest in pain treatment alternatives. There has been one main barrier to better pain treatment: health care coverage. Health care payers increasingly have restricted coverage for alternatives to pain pills over the years. With one to two years having passed since the publication of updated pain treatment guidelines, it was time to see if health care coverage had improved..."

Researchers from a study of teenagers with low back pain noted, "Low back pain is common in adolescence, but there is a paucity of high-quality research to inform care." Most medical research for treatment of various conditions is performed on adult patients, with limited study of children and teens. Low back pain research similarly has focused more on adults than children. As a solution to the opioid epidemic and overuse of prescription painkillers, current medical guidelines recommend non-drug treatments like chiropractic (spinal manipulation) and physical therapy (exercises) be used before medications or medical procedures. More doctors are recommending these treatment options and more patients are using them, but how effective are they for teens?

The Journal of the International Association for the Study of Pain published a randomized trial that compared treating adolescent low back pain with exercise therapy alone or exercise therapy combined with spinal manipulation. Patients were followed for a year and assessed at 12, 26, and 52 weeks. The researchers concluded, "For adolescents with chronic [low back pain], spinal manipulation combined with [exercise therapy] was more effective than exercise alone over a 1-year period, with the largest differences occurring at 6 months." Both groups demonstrated reduced pain, less medication use, and reduced disability with treatment. However, the patients who received spinal manipulation demonstrated significant improvement beyond that provided by exercise, including higher satisfaction.

While both spinal manipulation/adjusting and exercise therapy can be beneficial for back pain, this study confirms the findings of others that have found additional benefit to spinal manipulation. Other studies have also found that when a chiropractic physician manages the case, treatment is more likely to be consistent with treatment guidelines, less advanced imaging and testing is necessary, fewer specialists are required, and overall costs are reduced. For adults and kids, consider chiropractic first for safe and effective back pain treatment.

Steroid medications are known to reduce inflammation, leading to their use for back pain and other painful or inflammatory conditions. One of the common methods of use is in the form of a dose pack, starting with multiple pills per day and reducing dosage over several days. The American College of Physicians and the American Pain Society recommend other treatments since research demonstrates systemic steroids are no more effective than placebo and carry some risks.

Chiropractic manipulation is a leading alternative for musculoskeletal pain, but the addition of a natural food-based supplement may provide additional benefit by supporting the joints and surrounding soft tissues. Glucosamine Synergy made by Standard Process provides a synergistic blend of nutrients to feed the musculoskeletal system: 

• This supplement includes Boswellia, resin from the bark of Boswellia trees more commonly called Frankincense, but you don't have to wait for a wise man to bring it to you. Boswellia is known for its anti-inflammatory and tissue healing qualities.
• Glucosamine from crab shells helps the normal repair and rebuilding of cartilage that protects bone surfaces of joints.
• Calcium, magnesium, and manganese minerals help support healthy bone and soft tissues around the joints.
• Nutritional yeast provides B-complex vitamins and inositol to encourage healthy nerve function.
• Additional nutrient-dense foods are included that work synergistically with the other nutrients to support health and healthy function of the musculoskeletal system.

Glucoasmine Synergy may be used similarly to a dose pack, starting with a higher dosage and reducing with time, for the greatest benefit following an acute injury or acute aggravation of a chronic condition. Combining hands-on care like chiropractic manipulation and nutrient support helps even the most complicated cases result in a successful outcome.

As the lead author of an analysis on Opioids & Ohio's Healthcare Payers, Aaron McMichael, D.C., was recently interviewed on Cover2Resources. The Ohio State Chiropractic Association Opioid Task Force examined whether Ohio's largest private healthcare insurers and public healthcare payers are covering chiropractic and non-drug treatments recommended by state and national pain treatment guidelines:

"The results of this survey indicate Ohio’s largest healthcare payers have not improved or have only minimally improved coverage for alternatives to opioids as recommended. Most, if not all payers, appear to be continuing to provide better coverage for opioid treatment than for non-pharmacologic alternatives like chiropractic. Survey results indicate this coverage is resulting in increased use of prescription opioids and healthcare payers are therefore contributing to the ongoing opioid epidemic in Ohio."

The study has generated interest from Ohio legislators in increasing coverage of chiropractic and other pain treatment alternatives to opioids. Click here for more information on the study results and chiropractic as a solution to the opioid epidemic: http://ohiochiro.org/2018-report.html