Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast.
In this week’s news: We’ll Be Looking At –
- Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain
- And Finally, a Story about Dose-response and efficacy of spinal manipulation for care of cervicogenic headache
For HealthBeat …. This is Dr. Todd Eglow!
Welcome to HealthBeat Podcast #627 recorded March 23, 2018
HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.
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And Now for some news ….
Opioid vs Non-opioid Medications on Pain-Related Function in Patients With Chronic Back Pain
Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronic pain.
A recent study was published in the NEJM to compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects.
Both interventions (opioid and nonopioid medication therapy) followed a treat-to-target strategy aiming for improved pain and function. Each intervention had its own prescribing strategy that included multiple medication options in 3 steps. In the opioid group, the first step was immediate-release morphine, oxycodone, or hydrocodone/acetaminophen.
For the nonopioid group, the first step was acetaminophen or a non-steroidal anti-inflammatory drug. Medications were changed, added, or adjusted within the assigned treatment group according to individual patient response.
The primary outcome was pain-related function (Brief Pain Inventory [BPI] interference scale) over 12 months and the main secondary outcome was pain intensity (BPI severity scale).
The study concluded that treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.
Discuss manipulation and related non-opioid therapies for LBP with your Qualified Chiropractor.
Surf to our Show Notes for Links – https://jamanetwork.com/journals/jama/article-abstract/2673971
Dose-response and efficacy of spinal manipulation for care of cervicogenic headache
The optimal number of visits for the care of cervicogenic headache (CGH) with spinal manipulative therapy (SMT) is unknown.
A recent study was published in the Spine Journal to identify the dose-response relationship between visits for spinal manipulative therapy and chronic cervicogenic headache outcomes; to evaluate the efficacy of spinal manipulative therapy by comparison with a light massage control.
Participants were randomized to 4 dose levels of chiropractic spinal manipulative therapy: 0, 6, 12, or 18 sessions. They were treated 3 times per week for 6 weeks and received a focused light-massage control at sessions when spinal manipulative therapy was not assigned.
The study concluded that there was a linear dose-response relationship between spinal manipulative therapy visits and days with cervicogenic headache.
For the highest and most effective dose of 18 spinal manipulative therapy visits, cervicogenic headache days were reduced by half, and about 3 more days per month than for the light-massage control.
Surf to our Show Notes for Links – http://www.thespinejournalonline.com/article/S1529-9430(18)30077-9/fulltext
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For Chiropractic OnLine Today’s HealthBeat, This has been
Dr. Todd Eglow.