RRS Education Chiropractic BLOG - Musculoskeletal Research Reviews

 
Established guidelines for the management of back pain promote non-pharmacological and conservative measures as a first line treatment. However, there continues to be an over-reliance on opioid analgesics and unwarranted diagnostic imaging for back pain.
 
Previous retrospective cohort studies have demonstrated that utilization of chiropractic services can decrease the likelihood of an opioid prescription being filled and reduce annual health care costs and clinical services. Another recent study confirmed that chiropractic services reduce opioid prescriptions in people with spine pain. A national retrospective cohort study also found that if the initial provider for a patient with a new onset of low back pain was a physical therapist, chiropractor or acupuncturist, there was a reduction of 85-90% in early use of opioid therapy compared to seeing a family physician first. In addition, long term use of opioid therapy was reduced by 75% who initially underwent chiropractic care and approximately 50% for those who initially visited a physical therapist. Furthermore, one prospective cohort study demonstrated that the use of chiropractic services for back pain significantly decreases the likelihood that injured workers would receive long term opioid therapy by approximately 70% (all references listed in the Review).
 
This Review summarizes two papers related to access to chiropractors and the subsequent effect on medical services provided and opioid prescriptions administered. The purpose of the first paper (Rosa et al. 2021) was to describe changes in opioid therapy use after a family medicine practice included on-site chiropractic services. The purpose of the second paper (Davis et al. 2021) was to examine how access to chiropractic care affects the use of medical services for spine conditions among older adults…the results of both papers add more support to the utilization of chiropractic care as a first line option for NMSK pain!
 
THIS WEEK'S RESEARCH REVIEW: “Effects of Chiropractic on Opioid Prescription Rates & Medical Service Usage”
 
These papers were published in the Journal of Manipulative and Physiological Therapeutics (2021) and this Review is posted in Recent Reviews, Geriatrics, Clinical Practice and the 2021 Archive.
 
 
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