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With my parents’ help I walked out of the San Manuel Hospital, unsteady after a week of doctor prescribed bed rest. I had hurt my back jumping off the house, and now the promise of a popsicle and a family visit was the only bright spot in this long-gone medical treatment for back pain, common in 1956.
Thirty years later in the back pain field, we have a “Knowledge Opinion Leader” (read a respected, well-paid physician), promoting to doctors and the public the synthetic heroin drug Oxycontin as a “wonder of nature”, having high effectiveness for pain control with “less than 1% chance of addiction”. These drugs then became the go-to med for even common low back pain, instead of being mostly reserved for end of life care. I am compelled to point out that the pain relief market is much larger than hospice demands. Five states are now suing the manufacturer for false advertising.
Now, with 91 Americans dying from overdose daily, the American College of Physicians has issued guidelines calling for increased use of non-drug, hands-on treatments like chiropractic, physical therapy, yoga, massage, acupuncture, and the like. They say opioids should never be the first-line choice for pain.
This is great, but late, news. In 1994, the U.S. Agency for Healthcare Policy and Research reviewed low back pain care and recommended spinal manipulation as one of a few first tools for this common condition. It advised waiting on surgery and other invasive actions. Political pressure quickly grew from surgeons, who feared loss of insurance coverage should their service be shown to be no better than non-surgical remedies. This pressure dovetailed with a “reduced government” approach by a new Republican House, and in 1995 the Agency’s name and function was changed, with “Policy” removed from both its title as well as its role.
New low back pain guidelines were then released, advising short-term opioids, Ibuproben (shown recently to raise heart attack risk within first days to month of use) and Tylenol (which new studies show doesn’t help with low back pain, is a liver risk, and flattens emotions in the patient). Spinal manipulation was not mentioned.
One lesson to learn, or perhaps more accurately “re-learn”, is that this problem appears to have been motivated by money only. When we realize the TV and media most of us watch are run mostly on ad dollars from drug companies and, at election time, politicians, it is clearer why we don’t get the full story until it is too late.
John Huntington is a local business owner in Oracle. He is a chiropractor with many years in the community. He writes a health related article in Pinal Nugget.
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