Oregon Lower Back Pain Guidelines: Try Chiropractic First

New guidelines recommend chiropractic as only non-drug intervention for first four weeks of care.

The new State of Oregon Evidence-Based Clinical Guidelines for the Evaluation and Management of Low Back Pain recommends spinal manipulation as the only non-pharmacological treatment for acute lower back pain.  And as we’ve mentioned on our previous posts, pain-killers can do more than kill pain.  Read on.

The amended guidelines, have been adopted by the Oregon Health Authority where changed when The Oregon Chiropractic Association (OCA) repeatedly gave written and oral testimony that the original draft guidelines placed too much emphasis on drugs and surgery.

The OCA provided fellow Health Evidence Review Commission members with scientific clinical journal articles validating the efficacy of chiropractic spinal manipulation for back pain, with an emphasis on flexion-distraction technique research. This evidence-based input resulted in a much-improved final version now recommending continued conservative management, intensive interdisciplinary approach,” rather than leading a path which led only to surgery or other invasive procedures.

With the risk versus benefit favoring spinal manipulation over the use of pharmacologic therapy including “first-line medications,” e.g., acetaminophen or non-steroidal anti-inflammatory drugs, it was a landmark decision for the agency dealing with how to treat acute low back pain guidelines, the process of which has not been refuted by any subsequent research or guidelines; and which states that spinal manipulation both relieves pain and restores function, while pain medications (NSAIDs and analgesics) relieve pain but do not restore function.

It was also noted that the risk-to-benefit ratio favored less invasive spinal manipulation over drug therapy, including the recommended first-line medications acetaminophen and NSAIDs, and most certainly over narcotic medications. We did so using the following sobering facts:

Acetaminophen (e.g., Tylenol), is the leading cause of acute liver failure in the United States, resulting in approximately 140,000 poisoning cases, 56,000 ER visits and approximately 100 deaths each year. Oregonians were unknowingly taking more than one product that contained acetaminophen, increasing the likelihood of unintentional overdoses and poisoning. Non-steroidal anti-inflammatory drugs (NSAIDs) are the second leading cause of peptic ulcers, resulting in more than 100,000 hospitalizations at an estimated $2 billion in additional health care costs and 17,000 deaths yearly in the U.S. – NSAID use is also associated with cardiovascular mortality, particularly in the elderly. These associations also exist for Celebrex and non-selective NSAIDs such as ibuprofen and naproxen.

Oregon’s narcotic statistics reveal that between 1997-2007, hydrocodone sales increased by 280 percent, oxycodone by 866 percent and methadone by 1,293 percent, and resulted in 700 poisoning deaths from 2003-2007, with the increasing availability of these narcotics closely

Pages: 1 2

Leave a Reply

Your email address will not be published. Required fields are marked *