By Kelsey Lewis, DC
The burden of spinal pain on a personal and global level cannot be understated. Spinal pain is the leading cause of disability worldwide, and because of this, researchers have taken a magnifying glass to past and current treatment strategies. Opioids were once given at high rates in hopes of managing chronic pain, much of which was spinal pain. The readily prescribed opioids lead to misuse, addiction, and disability lending to a major burden on the healthcare and social systems. High-impact research has since declared that opioids should not be used in the management of chronic pain, and that conservative care strategies are the mainstay of chronic pain treatment. Those who are disadvantaged are disproportionately experiencing chronic pain and are most affected by the opioid epidemic. This is why chiropractors at Logan University were moved to integrate chiropractic care within Federally Qualified Health Centers (FQHCs) in St. Louis that see patients who are part of this disadvantaged population. Prior to chiropractic integration, this population was unable to receive conservative pain care.
Modern pain care within an integrated facility is personalized based on the patient’s expectations, goals, and comorbidities. This means considering and addressing social determinants of health that are contributing to the person’s pain. Social determinants of health include socioeconomic status, education level, access to safe spaces to enjoy exercise, food and housing insecurity, transportation, language barriers, and more. Chiropractors facilitate care for comorbidities, including psychiatric comorbidities that are a factor in the development and persistence of their pain. In-office care can take on many forms that have the same underlying goal of improving the patient’s capacity to manage their pain and improve self-efficacy. Treatment can include education about pain, mind-body therapies, reducing fear of movement through progressive exercise, manual therapy for palliation, improving sleep hygiene, and advising on topical pain creams. These therapies alone and in isolation have shown to improve patient’s ability to manage their pain and quality of life.
Although there is still much work to be done in research and practice in managing chronic spinal pain, the chiropractors within these FQHCs are striving to meet community needs and provide access to person-centered, high quality conservative pain care to the people who are part of the disadvantaged population in St. Louis.
About Kelsey Lewis, DC
Kelsey Lewis, DC is an integrative health center clinician and adjunct faculty at Logan University. After completing her residency in integrative spine care, Dr. Lewis began practicing and educating students within integrative health centers. She is dedicated to providing high-quality, patient-centered care and student training within a diverse setting, serving those who are part of the safety-net population.