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New Hampshire Study Concludes That Patients Who Receive Chiropractic Care are 55% Less Likely to Require Opioid Prescriptions.



OBJECTIVE:

Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to the reduced risk of adverse effects. The objective of this investigation was to evaluate the association between the utilization of chiropractic services and the use of prescription opioid medications.


Chiropractic Care Instead of Opioids?


DESIGN:

The authors used a retrospective cohort design to analyze health insurance claims data.


SETTING:

The data source was the all-payer claims database administered by the State of New Hampshire. The authors chose New Hampshire because health claims data were readily available for research, and in 2015, New Hampshire had the second-highest age-adjusted rate of drug overdose deaths in the United States.


SUBJECTS:

The study population comprised New Hampshire residents aged 18-99 years, enrolled in a health plan, and with at least two clinical office visits within 90 days for a primary diagnosis of low-back pain. The authors excluded subjects with a diagnosis of cancer.


OUTCOME MEASURES:

The authors measured likelihood of opioid prescription fill among recipients of services delivered by doctors of chiropractic compared with nonrecipients. They also compared the cohorts with regard to rates of prescription fills for opioids and associated charges.


RESULTS:

The adjusted likelihood of filling a prescription for an opioid analgesic was 55% lower among recipients compared with nonrecipients (odds ratio 0.45; 95% confidence interval 0.40-0.47; p < 0.0001). Average charges per person for opioid prescriptions were also significantly lower among recipients.


CONCLUSIONS:

Among New Hampshire adults with office visits for noncancer low-back pain, the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with nonrecipients. The underlying cause of this correlation remains unknown, indicating the need for further investigation.

By Ada Boneth 26 Sep, 2023
How many times have you gone to your medical doctor and been told…”In order to get better, you’re going to have to find a way to reset your nervous system so that it recoups from the stress of regular life.” Most likely…never! At most, doctors will say, “Of course stress affects your health”, as they write you a prescription for a drug. Now contrast that to a good chiropractor or other alternative health care practitioner, and you probably have been asked that question and given more natural treatments, like a great adjustment, and other recommendations to assist you with that. But what else can YOU do? Dr. Mark Hyman, one of the world’s leading Functional Medicine Doctors and 10 times New York Times Best-Selling Author, has a different opinion that is more in alignment with how I approach the human body and help it restore health and healing. As he says, “There are three things that are critical for healing: it’s what you eat, moving your body, and learning how to reset your nervous system.” And what does he recommend for resetting your nervous system…? He recommends “Tapping”, and says that “Tapping is one of the most directed and powerful ways to peel those layers away of chronic stress. It’s very effective for very difficult problems.” If you want to learn about how you can overcome illness, create long-term, lasting health, or just get over regular stress and feel better, then I highly recommend you consider “Tapping”, also called EFT. EFT or Emotional Freedom Technique was discovered well over a decade ago, and there is lots of data about it available on the web. I suggest this link for a good short explanation of Tapping and how to do it:
By Ada Boneth 26 Sep, 2023
Opioids Misuse and Addiction: How Chiropractic Can Help Thirty-five-year-old Megan presented with chronic neck and upper back pain. Megan’s pain began four years earlier, following a car accident where she injured her cervical spine and upper thoracic spine. The pain became a daily part of Megan’s routine. When she became pregnant with her first child, she was taking opioid pain medication daily, but she was able to stop during the first trimester. After her first pregnancy, Megan continued to have pain and began to retake opioids. Pregnant with her second child, Megan struggled to stop the medication. Seeking help, she found support from her husband, family and friends. However, the pain continued to rule her life, making stopping difficult. The treatment of chiropractic care—or any other complementary therapy—was never provided as an option to Megan for her chronic neck and back pain. Chronic Pain Is a Widespread Problem Megan’s story is not an unfamiliar one. News stories about the opioid addiction abound. It is a major problem throughout the U.S., and it does not discriminate. We live in a society that is in pain. According to the American Academy of Pain Management, 100 million Americans suffer from chronic pain. 1 In addition to the reports of chronic pain, opioid medications have been overprescribed. Intended for pain associated with cancer and the end stages of life, opioids are less effective in treating noncancerous, chronic pain. 2,3 The opioid crisis is not new. Its usage in the U.S. can be traced back to the late 1800s when morphine and heroin became readily available. During that time, the most commonly addicted were white females. In the early 1900s, opioids, such as heroin, were used as cough suppressants, and not much was known about the drug’s long-term effects. As usage became widespread, it became apparent that opioids were addictive. In 1914, the Harrison Narcotics Act was initiated, and a tax was imposed on anyone making, selling or importing any type of opium. In 1924, heroin became illegal. 4 In the 1980s, published articles attested to the safety of long-term heroin usage. An escalation of usage began, resulting in a significant impact on the country. A wide variety of opioids can be prescribed within the following categories: Natural Opioids like morphine, which is derived from the poppy plant Semi-synthetic like hydrocodone and heroin Fully synthetic-like tramadol or fentany l When opioid prescriptions are no longer available, many individuals begin using heroin due to its low cost and ready availability. 5 Prescription rates vary across the country. The highest overdose rates are found in West Virginia, New Mexico, New Hampshire, Kentucky, and Ohio. 6 Women are twice as likely to use prescription opioids as their male counterparts, and they tend to be between the ages of 25-54. A correlation between deaths due to opioid misuse and benzodiazepines has been found. 7 Many patients are simultaneously prescribed both drugs. One study found that women have been prescribed opioids for low back and pelvic pain during pregnancy even though the long-term effects were well known. 8 The prevalence of low back pain and pelvic pain is common and ranges between 68 and 72 percent of pregnant women. 9, 10 For chronic pain in pregnancy, the American Pain Society guidelines 11 suggested that women be counseled regarding the risks and benefits of opioid therapy, with the recommendation that there should be little to no use during pregnancy. The American College of Obstetricians and Gynecologists makes numerous recommendations to minimize opioid use and highlight nonpharmacological options for chronic pain. 12 For those who are addicted, abrupt discontinuation of opioids during pregnancy can lead to preterm labor, fetal demise, or fetal distress. Opioid agonist therapy with methadone or buprenorphine is the standard recommendation. Infants exposed to opioid use may develop neonatal abstinence syndrome (NAS), which was first described in the clinical literature in the 1970s. In 2012 alone, 21,000 infants were diagnosed, a five-fold increase from the previous 12 years. There is a high correlation between opioid exposure and death from birth to five years of age. 13, 14 Opioid exposure tends to be accidental, such as a child accidentally ingesting a pill or being stuck by a heroin needle. Since infants and small children have a low body mass, even a small amount of exposure can have long-term and damaging effects. Exposure tends to decline before it starts to elevate beginning at age 12 and increasing until ages17-18, where it plateaus. Opioid use in adolescents is much different than in the younger counterparts, as it tends to result from leftover prescriptions found in medicine cabinets. 13, 14 The Role of Chiropractic Chiropractic can often help with chronic pain as an alternative to medications. Typically, after a regimen of chiropractic treatment, patients are able to reduce or eliminate unnecessary medications. Also, we can frequently help patients avoid unnecessary surgeries. Our community has drug drop boxes for opioid disposal, drug take-back programs, and testing programs. Also drug lock boxes are available. Check with your local pharmacist and city hall. References 1 Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011. 2 Trescot AM, Glaser SE, Hansen H, Benyamin R, Patel S, Manchikanti L. Effectiveness of Opioids in the Treatment of Non-Cancer Pain. Pain Physician. 2008; 11. 181-200. 3 Chou R, Deyo R. Devine B. The Effectiveness and Risks of Long Term Opioid Treatment in Chronic Pain. Agency for Healthcare Research and Quality. September 2014 4 Kolodny A, Courtwright D, Hwang C, Kreiner P, Eadie J, Clark T, Alexander G. The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction. Annual Review of Public Health. Vol 36 (2015) pp559-574 5 Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers – United States, 2002-2004 and 2008-2010. Drug Alcohol Depend. 2013;132(1-2):95-100. 6 CDC https://www.cdc.gov/vitalsigns/opioid-prescribing/ 7 American Society of Addiction Medicine. Opioid Addiction Fast Facts(2016) https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf 8 Maeda A, Bateman BT, Clancy CR, Creanga AA, Leffert LR. Opioid Abuse and Dependance During Pregnancy: Temporal Trends and Obstetrical Outcomes. Anesthesiology 2014. Dec;121 (6):1158-65 9 Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol 2004;104(1):65–70 10 Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine 2005;30(8):983–991 11 American Pain Society Guidelines:Guideline for the Use of Chronic Opioid Therapy in Noncancer Pain: Evidence Review: http://americanpainsociety.org/uploads/education/guidelines/chronic-opioid-therapy-cncp.pdf 12 Committee on Obstetric Practice American Society of Addiction Medicine August 2017: American College of Obstetricians and Gynecologists https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Opioid-Use-and-Opioid-Use-Disorder-in-Pregnancy 13 Patrick S and Schiff D. A Public Health Response to Opioid Use During Pregnancy. American Academy of Pediatrics. Pediatrics. Vol 139/Issue 3 (2017) 14 Allen J, Marcel C, Spiller H, Thiphalak C, Hodges N, Smith G. Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000-2015. Pediatrics. Vol 139. No 4(2017)
By Ada Boneth 25 Jul, 2023
The sciatic nerves are the largest and longest nerves of the body, reaching about the size of your thumb in diameter, and running down the back of each leg. When these nerves are irritated or affected by the inflammation of nearby soft tissues, doctors refer to this as sciatica
By Ada Boneth 25 Jul, 2023
Not sure if you are sitting efficiently and appropriately at your computer desk? Watch this video and make adjustments as needed!
By Ada Boneth 25 Jul, 2023
Below is a link to mental health resources in San Mateo County from Melissa Platte. Melissa is a fellow member of my San Mateo Rotary club and the director of San Mateo nonprofit mental health agencies. www.smccontractors.org
By Ada Boneth 25 Jul, 2023
Something Simple to Give Your Immune System A Boost Here’s the link. Once you’ve gotten the hang of it, it’s pretty quick, just a few minutes, to do a daily drainage routine. If you feel under the weather, I suggest two times per day, morning and evening. Otherwise once per day is sufficient.
By September 3rd, 2021 30 May, 2023
According to the U.S. Geological Survey, approximately 71 percent of the earth’s surface is composed of water. Similarly, 60 to 70 percent of the average adult human body is composed of water. If you’re a 120-pound female, you’re made of at least 72 pounds, or 36 quarts, of water. If you’re a 175-pound male, you’re carrying around at least 105 pounds, or 52 to 53 quarts, of water. In either case, that’s a lot of liquid. But that water isn’t in your body for ballast. It’s there for work. Water provides the medium in which all our physiological processes take place. In other words, water makes our lives possible. This makes sense when we consider that the proportion of water on earth and in our bodies is approximately the same. Water is the conduit that makes things happen. From the perspective of complex biological organisms, without water there are no organs, no tissues, and no cells. And if there are no cells, there is no life. Thus, water is essential to our survival. But our internal supply of water is dynamic. We use up more or less water depending on our activities. Of course, being more physically active causes more water to be consumed in metabolic processes such as releasing energy from ATP adenosine triphosphate) molecules.1 Rebuilding ATP supplies requires water as well. Additionally, your kidneys maintain dynamic control over the amount of water in your blood as one of the primary means of regulating blood pH, which must be in a very narrow range of 7.35 to 7.45. Even minor deviations from optimal pH levels can result in symptoms such as fatigue, headache, increased heart rate, muscle pain, and jaundice. Maintaining sufficient water intake is as important a requirement for good health as is regular exercise, a healthy diet, and obtaining necessary rest. The question naturally arises, how much water should I drink each day? Drinking sufficient water takes a little bit of effort, but there is a big payoff. In fact, the recommendation to drink more water is possibly the most important nutritional advice one could receive. If one is not drinking enough water, any other nutritional improvements will have less of an impact. Specifically, take your body weight and divide it in half. That’s the number of ounces of fluid you need per day. You can use water, juice, soup, herbal teas, anything which is mostly fluid. Because they are “diuretics” or eliminate fluid from your body, alcohol and caffeinated beverages don’t count as part of your daily fluid. In fact you have to add fluid to make up for their deleterious effect. Example: I weigh 122 pounds. 122 x 1/2 = 61, i.e. I need 61 oz of fluid per day. If I have a cup of caffeinated coffee for breakfast, now I need 69 oz. of fluid today. If I have a glass of wine with dinner, then I need to add another 8 oz. To make up for it (78 total for today). Hikers and those living or working at altitude know that by the time you feel thirsty (or your mouth feels dry), it’s too late. (2,3) Over the past few months, I’ve noticed a lot more of my friends, patients and loved ones complaining about pain in their neck, back, and joints. And it makes sense… with everyone staying home, people just aren’t moving around as much these days. So…I did a little research and came up with a quick routine to help improve joint comfort and better mobility. It only takes about 30-seconds to do, but it will make a HUGE impact on how you feel all day long. All you need is an empty glass and the alarm on your phone. Every time you sit down — whether it’s to work, to watch a show, or to simply read through your emails — set an alarm for 30 minutes. When the timer goes off, walk to the kitchen and get a drink of water. DON’T just keep a glass of water next to you (I’ll tell you why in a second…) First, I’m going to explain WHY you’re getting water: Believe it or not, a lot of joint and back pain is actually due to dehydration . In-between each vertebra is a disk that acts as a cushion for your spine. The inner layers of these disks are filled with water…and when we bend our spines to sit, the disks compress and some of that water leaks out. This isn’t a problem if you’re properly hydrated; those disks will simply get refilled by your body. But if you don’t drink enough water, that won’t happen…and your vertebrae will be left grinding against each other, causing you an extreme amount of stiffness and pain. It’s estimated that roughly 70% of Americans don’t drink enough water — which means there’s a good chance you’re dehydrated without even knowing it. By reminding yourself to drink more water, you’ll decrease back pain and improve your overall health. So… Why not just keep a glass of water next to you? You won’t be surprised when I tell you: Humans just weren’t meant to sit around a house all day! As strange as it sounds, moving around is one of the best ways to decrease back and joint pain. In fact, a 2011 study conducted in Minneapolis showed that people who sit less also experience much less back and neck pain. Researchers challenged sedentary workers to stand up more frequently — reducing their sit-time by 66 minutes a day. After 7 weeks of this, participants reported 54% less back and neck pain. When it comes down to it, you and I weren’t designed to sit for more than 30 minutes at a time. When you sit down for hours and hours at time, it’s a recipe for back and joint pain. By setting an alarm and making yourself get up to drink a glass of water, you’ll give your body two of the most important tools it needs to keep your joints healthy and happy. 1. Graham MJ, et al: Low-Volume Intense Exercise Elicits Post-exercise Hypotension and Subsequent Hypervolemia, Irrespective of Which Limbs Are Exercised. Front Physiol 2016 May 31. doi: 10.3389/fphys.2016.00199 2. Thornton SM: Increased Hydration Can Be Associated with Weight Loss. Front Nutr 2016 Jun 10. doi: 10.3389/fnut.2016.00018 3. Johnson EC: Hormonal and Thirst Modulated Maintenance of Fluid Balance in Young Women with Different Levels of Habitual Fluid Consumption. Nutrients 2016 May 18. doi: 10.3390/nu8050302
By September 2nd, 2021 30 May, 2023
Not sure what to do with all those extra plastic bags? How about you make your own lumbar support pillow! It’s easy, environmentally friendly, and can save your back.
By Wednesday, September 1st, 2021 30 May, 2023
Recumbent stationary bikes provide an excellent way to condition, improve cardiovascular function, and burn fat. Even for people who have bulging or herniated discs, they are usually a safe form of exercise. When pedaling the legs should not have to be wider than the position they would normally be. The pedal at its highest point should come no higher than ½ inch below the front of the seat (use a level to determine the height). You can add a firm foam pad to lift your buttocks if necessary. It may put less strain on the hips, knees, and back to lift higher than ½ inch. When the foot is fully extended there should still be ideally 7 degree bend in the knees. (5 degrees is absolute minimum), or else undue strain will be placed on the knees. All American Fitness (in San Jose) has a smaller bike for shorter people (5′ 4” and shorter): Body Guard. Their products and service are excellent, so I highly recommend going there for your sports equipment needs. It’s crankcase is 2” less than Precor and Lifecycle (3.5”) which helps put less stress on a short person’s body.
By Saturday, February 27th, 2021 30 May, 2023
1) Regular chiropractic care Research shows that removing or reducing nerve pressure boosts organ function. Because the spleen and liver are the backbone of our immune system, this means that regular Chiropractic treatments help boost our immune systems. Because the nerves also control vasoconstriction and vasodilation, keeping the spine and nervous system in balanced harmony also improves circulation, which is crucial for the normal function of every cell in our bodies. 2) Decrease fear levels. Research shows that the more you’re in fear the lower your immune functioning is. If you do a quick search online you’ll get hundreds of articles on the correlation between fear and lowered immune function specifically related to the pandemic. How do you decrease fear? Refocus your attention on positive things in your life like the beautiful day, the fact that you have your health, your family, your pets. Consider a media fast – disconnecting for a day, several days, a week, or if that’s too difficult try a half a day. Media outlets are television, news, radio, social media, and the internet. You might be surprised how much better you feel 🙂 Practice gratitude – make this a daily practice. Before bed write down five things that you are grateful for on this day. Pay attention to what you’re letting into your mind and heart – the body thrives with peace, calm, and positivity. You have the power to create this with a little extra attention and intention! 3) Feed your body healthy whole foods. The nutrition we put into our body helps it run – when you put in high quality nutrients, the better your body functions, the stronger your immune system is and the better you feel. Eat the rainbow – make sure you’re getting a large variety of veggies and some fruits – it’s a great way to get antioxidants Eat whole grains – these provide fiber and nutrients Eat healthy fats like avocados, coconut oil, raw organic nuts, and olive oil decrease inflammation and are essential for the body. Eat clean healthy proteins to give your body the building blocks for functioning. 4) Move and rest your body. Getting exercise regularly has been challenging for us during the pandemic however, It is still incredibly important that you are moving your body in some way and then getting the rest your body needs to repair. Walks, stretching, jumping jacks, etc. Just move! Try exercising for 1 minute each hour – you’d be surprised how effective it is Get 7-8.5 hours of sleep every night 5) Connect with friends and loved ones. This is essential! And I know it’s challenging. Social isolation is detrimental to your well-being including your immune system. Reach out to your friends and family – make the effort Create or find a group of friends to connect with – create your pod If you don’t have a pet consider getting one – they love you unconditionally! Get outside and connect with nature – nature has so many living beings and it’s healing! Be of service for an elderly neighbor, a friend that needs help, or an organization. 6) Make sure you’re getting your basic nutrients! Research has shown that vitamins D, C, and zinc are helpful. I’ve also added vitamin A because it boosts T-cells which help to fight infections! Vitamin C – 1g 3x daily Vitamin D – 5000 IU daily Zinc – 30mg daily Vitamin A – 10,000 IU daily Incorporate these basic immune system boosters into your daily life to support your immune system, create a healthy and calm mental emotional environment, and feel good that you are taking your health into your own hands! This article was originally published by Dr. Laura Enfield and has been edited for our website.
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