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Changing Beliefs about Pain - Neuroscience Education

An Article Review

Dynamic Chiropractic Feb 2020, VOL 38, #2

 

I opened up my latest edition of Dynamic Chiropractic and was very intrigued by this article. I just had to do a review!

 

Chronic pain is now at epidemic proportions in the western world. In the US alone, the CDC estimates 50 million Americans are suffering from chronic pain.  Low back pain being the biggest piece of the chronic pain pie. To make matters worse, 20 million Americans are experiencing “high-impact chronic pain.” High impact meaning it limits how much a person is able to work. Chronic pain in the US alone is costing upwards of $560 billion each year! That's a lot of zeros.

 

To compound the issue of chronic pain, for the last few years the majority of this chronic pain was treated with opioids. Opioid therapy became one of the medical standards when managing musculoskeletal pain. Living in the Midwest of the US, I have heard personal stories from folks about how the majority of their little town was almost decimated due to prescribed oxycontin. 

 

The cycle becomes once the MD is no longer able to prescribe the opioid then in many cases the patient will turn to the “street pharmacy” and get heroin. 

 

A personal friend of mine, had this exact experience with her former husband.  She came home (to their family home) and had found that her husband had committed suicide. 

 

She feels he was not able to cope with the oxycontin/heroin addictions. He had originally been prescribed oxycontin for low back pain. I know that the police force in my area has been trained and now carries ‘Narcan’ with them at all times.  Narcan is the nasal spray that helps saves a person’s life when they are over-dosing on a narcotic.

 

According to the CDC…

 

“70,237 drug overdose deaths occurred in the United States in 2017. The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).

 

In 2017, the states with the highest rates of death due to drug overdose were West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000).1”

 

All that to say, the medical community is starting to admit that maybe (just maybe), opioids should be reduced in their frequency and distribution to patients. 

 

As it turns out, if you read the medical literature they aren’t even that effective in treating musculoskeletal pain. There are more effective drugs (with less side effects) and other modalities which treat chronic pain way better like pain neuroscience education.

 

What is it?

Pain neuroscience focuses on teaching patients in pain how to change their beliefs regarding pain. They get different educational sessions including neurobiology and neurophysiology of pain and how the central nervous system processes and handles pain.


 

Clinical trials/research are showing pain reduction at 3, 6 and 12 months markers plus improved function at the area which has pain and better mental health!

 

In the clinical trials, researchers have been putting together the neuroscience education with non-pain continent exercises and are seeing some very good results when it comes to chronic low back pain.

 

Here’s the kicker, they have seen that the typical patient with chronic pain who has been on opioid treatment reports no change in pain after two years of opioid “therapy.”  After entering a neuroscience education program, the average patient’s pain is reduced by 54.2%! Thats immense!

 

As someone who lives in Ohio (the second highest opioid crisis state), I hope the medical community starts taking modalities like this (and chiropractic) seriously. Currently, there is a tidal wave of opioid abuse and addiction which is destroying lives, families and the cities they live in.

Kassandra Schultz D.C