Why Physical Medicine, Why Now…

FDA Calls on Doctors to Rethink How They Treat Pain

In 2016, the CDC released updated guidelines for prescribing opioids for chronic pain. Notably, they listed non-opioid therapy as the preferred treatment for chronic pain. In an Education Blueprint for Health Care Providers released in May 2017, the U.S. Food and Drug Administration (FDA) similarly proposed changes in how doctors treat pain.

Specifically, the FDA urged physicians to get information about non-drug options, including cognitive behavioral therapy, physical therapy, chiropractic care, and acupuncture, noting:

A number of non pharmacologic therapies are available that can play an important role in managing pain, particularly musculoskeletal pain and chronic pain. HCPs [health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management.

It’s about time. According to a study published in the Annals of Internal Medicine, and funded by the National Institutes of Health (NIH), patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain-free in 12 weeks, compared to those who took medication.

Many Physicians Have Little Training On How To Treat Pain

The FDA’s proposed guidelines are long overdue, as a 2013 study revealed new physicians learn shockingly little about how to treat pain, despite it being one of the most common, and most debilitating, medical conditions around. The study, which surveyed undergraduate medical schools in Europe, found that even when compulsory pain courses are in place, these courses represent just 12 hours of the six-year medical program — or 0.2 percent.

I know what you are thinking! WOW!!!

Further, most of the schools actually have no required courses on pain that all students must take. This means that 12 hours of pain study represents a best-case scenario; at the 82 percent of medical schools without compulsory pain courses, the students may be receiving even less or no pain training at all.

Even when the pain courses are compulsory, there is no consistency with what topics are covered, and most of the schools included only classroom-based teaching, not practical-based or placement-based teaching that could offer future physicians valuable hands-on experience.

The researchers called for a major overhaul to address the urgent public health need to adequately manage chronic pain. With no other knowledge of how to treat pain, most physicians treat it with prescription painkillers, and now we have an epidemic of prescription drug abuse and related deaths.

Physical Medicine is the Way to Go!

One of the major benefits of choosing Downtown’s Healthcare is that we provide multiple disciplines under one roof such as Physical Medicine, Chiropractic, Rehab, and Massage! The benefits of choosing Physical Medicine over a drug solution, is that the former can help relieve your pain, while offering you whole-body benefits. For instance, research by Dr. Dean Harrison and others suggests chiropractic treatments can help prevent progressive spinal degeneration, i.e., osteoarthritis or disc disease.

Just like regular dental care will prolong the useful life of your teeth, getting regular chiropractic treatments can do the same for your spine. Further, contrary to popular belief, chiropractic can be used to optimize wellness, not just treat pain.

According to Dr. Billy DeMoss, a chiropractor with a practice in Newport Beach, California, “Chiropractic is like brushing your teeth.” It’s something you need to do on a regular basis to maintain the life of your spine, because regular activities, such as chronic sitting, can contribute to its functioning less than optimally.

While many will only consider chiropractic when they have back or neck pain, the point to remember is that its scope actually goes far beyond that. DeMoss said:

“I try to get people to understand that your nervous system and your brain control every function of your body. When we have a condition in chiropractic we call subluxation, which is misalignment or dysfunction in the spine as far as mobility is concerned, it can cause nerve interference, which will interfere with the expression of intelligence that flows over the spinal cord and nerves. It can contribute [to] not only causing pain that most people perceive as a chiropractic problem but also can cause organs not to function 100 percent.”

Why You Should Be Wary of Back Surgery

If you’re not offered a prescription drug to treat your back pain, many conventional health care providers will turn to offering surgery like spinal fusion, or epidural steroids. Dr. David Hanscom, an orthopedic surgeon with a practice in Seattle, is unusual in that he tells most of his patients they don’t need surgery. He’s written a book detailing his novel approach to chronic pain treatment, called “Back in Control: A Surgeon’s Roadmap Out of Chronic Pain.” According to Hanscom:

“There’s maybe a 20 percent to 25 percent success rate of spinal fusion for back pain. And the downside of a failed spine surgery is terrible. It’s really bad. These people are condemned to live their entire lifetime, 30 to 40 more years, in chronic pain.”

Golden State Warriors coach Steve Kerr knows this all too well. He has had complications from having back surgery in 2015 for a ruptured disk. Kerr experienced leaking cerebrospinal fluid (CSF) as a result of the surgery, which led to another surgery.

CSF leakages can cause a range of symptoms, from headaches and problems with hearing to balance problems, nausea, and vomiting. Kerr told The Washington Post, “I can tell you if you’re listening out there, stay away from back surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anyone get in there.”

At Downtown’s Healthcare we have also added Regenerative Medicine to our service offering. This has been an extraordinary success in that we are seeing people with chronic joint arthritis/ degeneration who are up for surgery. With Regenerative Medicine treatment, we have seen countless people cancel their surgeries.

The Facts on Back Pain

Back pain is a common health issue today that affects at least eight out of 10 people. It is a prevalent problem among Americans. In fact, statistics from the American Chiropractic Association (ACA) reveal that at least 31 million Americans experience lower back pain at any given time.

The ACA report also says that:

  • One-half of all working Americans admit to having back pain symptoms each year.
  • Back pain is one of the most common reasons for missed work. In fact, it is the second most common reason for visits to the doctor’s office (next to upper-respiratory infections).
  • As many as 75 to 85 percent of the population will experience a back problem at some time in their lives. In most cases, this pain is mechanical in nature – it is NOT caused by a serious medical condition, such as inflammatory arthritis, or fracture.

Chronic back pain has become such a debilitating problem – and it’s costly, too. According to the ACA, Americans spend at least 86 billion dollars each year on back pain—and those are just the more easily identified costs!

I cannot stress enough that preventing or treating disease is possible without the intervention of medications. At Downtown’s Healthcare we pride ourselves on helping people get off of medications, and avoid unnecessary surgeries – every single day.

Gary Rademacher D.C., CCST

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