Chiropractic can pinpoint and address the root cause of pain allowing for long term, natural pain relief rather than just masking and numbing the pain by taking opioids and medication.
Could you please provide us with some basic background as to why and in what circumstances doctors will prescribe opioids to patients knowing they can be addicting?
Dr. Luke Stringer: It’s a really tough question, because I’m a chiropractic physician, and my scope of license is not prescribing medication. I went to school to become a chiropractor. One of the drivers was, I didn’t really want to be prescribing drugs and medication to patients.
Before we start off the whole discussion here, let’s just set a baseline. There is always a time and a place for allopathic medicine, drugs, and surgery. But I feel it can be done the wrong way around, which we’ll discuss here shortly, and it can be overdone. So, this whole podcast isn’t going to be me bashing on the medical system and how the allopathic medical system has got it wrong. But at the same time, let’s just discuss facts. And facts are that we haven’t got it right, and there is an endemic going on around this topic. So, let’s discuss it here. But basic background is the why and in what circumstance to prescribe the opioids to a patient knowing they can be addicting, that’s probably a better question for a medical doctor, let’s be honest.
But the background is what? Pain, essentially. Pain is what drives prescription medication. And what circumstances? I’m assuming if you are prescribing someone a heavy dose of opioids, then it has to be an acute episode of pain in terms of, you’ve been in a car wreck, and there’s a lot of soft tissue damage and you are really struggling to function. On the flip of that, there are some patients out there that just have chronic pain due to conditions, maybe fibromyalgia or bone on bone joint degeneration, that need the opioids to function. And then I think any doctor worth their salt, or anyone prescribing any treatment, you don’t prescribe something…same with us with chiropractic and physical therapy in our clinic, we don’t say, “Okay, you’re going to come twice a week for the rest of your life.” There’s a start point and an end point.
So, if we’re going to be prescribing anything from chiropractic care to physical therapy to prescription, and obviously it’s, “Okay, you’re going to take this, this amount of times, for this amount of time,” then we’re going to do a re-evaluation. And at the re-evaluation, then obviously we should have seen improvement to the point where we don’t need the opioids and we can get them on something less strong, and/or we’re making referrals for images and specialists who then obviously evaluate that person further so they don’t have to be leaning on the opioids as a crutch to just functioning.
Opioids are derived from opium, and as we all know that stuff’s extremely addicting. It’s a manmade synthetic substance, so I think some say on the addiction scale it’s at the top. So unfortunately, it’s no surprise that patients that take them feel great and then can’t function without them, unfortunately.
What are some reasons why patients who are considering surgery visit a chiropractor?
Dr. Luke Stringer: We have many patients coming in, and we’re typically the end of the road. Patients are coming in and they’re 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.” That’s pretty typical for what we see in the clinic.
But before we get there, I feel like surgery, we’ll split it up. Surgery is needed in acute situations. You slip, you’re out on a run, you slip, roll your ankle, you fracture your leg, the bone is poking out of your leg, you need surgery. You’re not going to come see a chiropractor. Or, you’re playing high level sports, you spin, you blow your ACL out. Well, that needs surgery in order to perform at that high level. So, typically patients are coming in to see us not in that acute type of situation. It’s more chronic.
A couple of cases we’ve had recently, spinal pain, dominantly in the low back, they’ve tried physical therapy, tried the prescription medications, it’s failed. And the surgeon’s like, “Okay. Then obviously we need to perform surgery”. So, can we walk it back a little bit? I feel like we should try conservative care before we get to the surgery, because we always have that option of surgery. And if you have it, then you’ve had it. And unfortunately, 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.
I will have a patient come in and we will say, “Look, 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. Maybe we can do that without the use of drugs and/or surgery. Great.”
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, the physical therapy. And then, unfortunately, they’re conditioned, due to degenerative changes or disc damage, they unfortunately don’t have an option. Or they have an option, but they obviously lean towards surgery.
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 in concerned with for surgery. Neck pain is number three. So, that’s another common area that we see patients for. And it’s typically always based around poor alignment, degenerative changes, disc issues that compress nerves that create a lot of pain for that patient. And they just struggle to function.
From a technical standpoint, how does chiropractic care alleviate pain naturally?
Dr. Luke Stringer: Chiropractic care is all based on that premise, the body’s innate ability to function without intervention. So, we’ll focus this around a summarization. Every joint in your body, spinal or extremity, is designed to move freely and stably. So, let’s say we have a trauma. We get rear-ended, and the neck shoots forward, we get ligament damage in the neck, and the joints shift out of alignment, and they’re compressing joint or nerve roots in the neck, generating pain. So, if we can take that patient through a conservative plan, so no drugs, no surgery, but again, there’s time and a place for that, 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. So, we’re talking about the neck from the head, and then obviously stabilizing those joints, so when they move, they move with stability. That’s essentially how chiropractic care can alleviate pain without intervention.
What specific types of pain are chiropractors the most successful in alleviating?
Dr. Luke Stringer: It’s a bit of an open-ended question. Some chiropractors like to say they can fix this better than this, or this type of pain is easier to treat than another type of pain. But pain in general, it could be acute pain, so that’s pain that came in immediately to four weeks. You’ve got subacute pain, that six to twelve week mark, you’ve got chronic pain, three months. Pain can range from nerve pains, that’s sharp, stabbing, burning, numbness, tingling. You can have more musculature pain, dull, stiff, achy. All those four are under the umbrella of neuromuscular skeletal pain, and chiropractors can take care of neuromuscular skeletal pain.
I wouldn’t say there’s a specific type of pain that chiropractors are better at treating than others. Now, there are conditions that are more difficult to treat than others. For example, sciatica is a tough one to treat, or low back disc herniations are more difficult to treat than, say, just an acute episode of neck pain. But anything that falls in the neuromuscular skeletal pain that’s driven from that system, a good chiropractor should be able to comfortably take care of that for you.
If someone has become addicted to opioids, in what ways can a chiropractor help them to try to fight that addiction?
Dr. Luke Stringer: Great question. We actually have a big tub at the front of our clinic that we ask our patients to dump their prescription meds in when they don’t need them anymore. And that tub gets full pretty quick. But why are you taking the opioids? You’re taking the opioids to assist you with managing your pain. When you come to see a chiropractor, they’re not addressing a symptom of pain like the opioid is. “You’ve got neck pain, here’s a drug, take it.” They’re addressing the root cause of it. So, that’s where you would perform a detailed history. “When did it start? How did it start? How does it feel? How does it impact your life?” 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.
It could be structural misalignment, it could be just poor joint function, it could be compensation in the muscles that surround a joint, it could be degenerative changes. All those clinical factors, diagnoses dictate types of treatment. But, if you can clinically address what’s driving the pain, so, for example, we have a 50% reduction in our low back curve that’s putting compression on the third nerve root. We’re losing disc height, and then that’s referring pain down into the knee. And that’s why you’re 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?
So, chiropractic is just essentially 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, you’re offering more of an objective long term, natural improvement than obviously just bandaiding it by taking some meds and just numbing the pain.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.