Expand Programs & Options for Chronic Pain Prevention

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Overview

This objective focuses on taking proactive steps to prevent people from having chronic pain to begin with. If far fewer people were experiencing chronic pain, there would be far fewer people being prescribed opioids, and that would mean fewer chances for people to become dependent or develop and OUD. And, with fewer prescriptions, there would be fewer opioid pills in a community that might be diverted or misused.

Promising Practices for Health Plans to Support Chronic Pain PREVENTION

Health plans play an essential role in supporting improvements in chronic pain prevention because they determine what gets paid for. The following are recommended practices for Health Plans:

 

Add or expand coverage for chiropractic services for chronic pain prevention

Research shows that up to 80% of the population will experience back pain at some point during their lives.
  A recent global survey of health conditions identified back pain as the single most disabling condition worldwide.
  It is also the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
  American College of Physicians (ACP), the largest medical-specialty society in the world, updated its back pain treatment guidelines to support a conservative approach to care.

  In March 2016, the Centers for Disease Control and Prevention released updated guidelines for prescribing opioids that also promote the use of non-pharmacologic alternatives for the treatment of chronic pain. In 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognized the value of non-drug approaches to pain management by adding chiropractic and acupuncture to its pain management standard.

 A study based on Washington state workers found that 42.7 percent of people who visited a surgeon first for work-related back pain eventually had surgery, compared to only 1.5 percent of those who visited a chiropractor first.
 

 

 

Accelerating Physical Therapy Treatment of Low Back Pain to Avoid the Need to Prescribe Opioids

Back pain can worsen to a chronic condition if left untreated, which often leads to costly procedures and opioid dependency. In fact, lower back pain is one of the most common conditions treated with opioids. Bethlehem, Pa.-based St. Luke's University Health Network has a new Comprehensive Spine program (August 2018) to ensure patients with lower back pain get timely access to physical therapy services before the condition worsens and requires surgery or pain medications. St. Luke's program is designed to prevent the development of chronic back pain among patients by addressing the issue sooner with physical therapy.

Add or expend coverage for acupuncture services for chronic pain prevention

This would be for early treatment of pain-related conditions BEFORE they turns into chronic pain.
 

Add or expand coverage for health education or mindfulness as a way to prevent chronic pain

This should focus on health education and mindfulness as approaches to prevent the onset of chronic pain.
 

Train case managers in chronic pain prevention

This would involve early detection of symptoms or risk factors that, if left uncheck, would likely lead to chronic pain.
 

Support research on strategies for chronic pain prevention

Everyone wins with smart upstream prevention. Research is needed to guide investments in that type of prevention. Why wait until a person is dealing with chronic pain if it can be prevented.
 

Inspiring Examples of Chronic Pain PREVENTION

 

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Sources

 

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1. Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin, 2007; May;25(2):353-71.
2. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016 Oct 7; 388:1545–1602.Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med, 2017;166(7):514-530.
3. Hart LG, et al. Physician Office Visits for Low Back Pain: Frequency, Clinical Evaluation, and Treatment Patterns from a U.S. National Survey. Spine, 1995; 20:11–9
4. Machado GC, et al. Non-steroidal Anti-inflammatory Drugs for Spinal Pain: A Systematic Review and Meta-analysis. Annals of the Rheumatic Diseases. Published online first, Feb. 2, 2017; doi: 10.1136/annrheumdis-2016-210597
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