Pain is what drives prescription medication. Opioids are derived from opium, and as we all know that is extremely addicting. It’s a manmade synthetic substance and some say on the addiction scale it’s at the top. So, it is no surprise that patients that take them feel great and then can’t function without them, unfortunately.
If someone has been prescribed a heavy dose of opioids, then it has to be for an acute episode of pain to manage that pain. For example, they have been in a car wreck and there is a lot of soft tissue damage, and they are really struggling to function. Surgery is needed in some acute situations. For example, if someone fractures their leg and the bone is poking out, they need surgery. Or, if someone is playing high level sports, they spin and blow out their ACL, they would require surgery in order to perform at that high level again. Also, there are some patients out there that just have chronic pain due to conditions such as fibromyalgia or bone on bone joint degeneration, that might need the opioids to function.
When you see a chiropractor, they’re not addressing a symptom of pain like the opioid is. Chiropractors are addressing the root cause of the pain. They would perform a detailed history. “When did it start? How did it start? How does it feel? How does it impact your life?” They perform an orthopedic exam, a neurological exam, take an x-ray based on clinical presentation, and then devise a plan that’s going to address the root cause of that issue, which is going to be case dependent.
Typically, patients are coming in to see us who are not in an acute type of situation. It’s more chronic. We have many patients come into our clinic and we are typically the end of the road for them. They come in saying, “Okay, I’ve been recommended surgery on my spine. I don’t want to get it, so here I am to see you. Fix me or I’m getting surgery.” We try conservative care before surgery, because we always have that option of surgery. And if you have it, then you’ve had it. And unfortunately, for spinal surgery, the research is not great. 72 to 80% of the time, you feel the same or worse. And if you’ve had one, you’re five times more likely to have another spinal surgery. That’s just the facts of it.
Our wheelhouse is neuromuscular skeletal pain. Low back pain is the number one missed cause for work in America. That’s typically what patients are coming for to avoid surgery. Typically, the pain is based around poor alignment, degenerative changes, or disc issues that compress nerves. We say to our patients, “Let’s start conservatively. Our goal here is to reduce your pain, improve joint function, stabilize and strengthen a joint, take pressure off the joint, the disc, the nerve, and get you to the point where you can physically load that joint and function to a capable level”. We put patients through our care plan, and if they respond to the treatment and they obviously hit their goals and their objective, it’s great. They don’t need surgery. But, there are going to be patients that fail treatment from the aspect of the conservative model, the chiropractic and the physical therapy. And then, unfortunately, due to degenerative changes or disc damage, they lean towards surgery.
If we can clinically address what’s driving the pain, so, for example, we found a 50% reduction in their low back curve that’s putting compression on the third nerve root. They are losing disc height, and then that’s referring pain down into their knee. And that’s why they are taking the opioid. Okay, well, if we can get that joint moving so it’s functioning better, we can improve the alignment of the spine. So, we shift the body weight from the front of the disc to the back of the disc. That’s going to create better loading into the joint that allows the disc fluid to go forwards away from the nerve root, not back onto it, which was generating the pain. We break down a soft tissue that’s gone into spasm, and then we stabilize that tissue in that joint. Then, why would that patient need to continue on the opioids?
Chiropractic care is all based on the premise that the body has an innate ability to function without intervention. Every joint in your body, spinal or extremity, is designed to move freely and stably. If we can take patients through a conservative plan, so no drugs, no surgery, with the premise on reducing scar tissue, improving joint mobility and alignment, and then improving spine alignment, in doing so, we’re going to reduce inflammation, and improve how the spine is loaded. We are stabilizing those joints, so when they move, they move with stability. That’s how chiropractic care can alleviate pain without intervention.
So, chiropractic is just a way, if done correctly, that we can pinpoint the root cause of the issue and address the root cause of the issue. And by doing that, we are offering more of an objective long term, natural improvement than obviously just bandaiding it by taking some meds and just numbing the pain.