The Evidence-based Rap, or
What's Wrong With My Pain Meds?

This section is compiled by John Wiens, D.C.
Send all comments or additions to:     Frankp@chiro.org

FROM:   A Chiro.Org Editorial ~ 4–23–2011

By Frank M. Painter, D.C.

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Based on:
A Systematic Review on the Effectiveness of Pharmacological
Interventions for Chronic Non-specific Low-back Pain ~ FULL TEXT
European Spine Journal 2011 (Jan); 20 (1): 40–50

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OK, so this isn't a Rap, and I'm not Rhyming-Simon, but somebody needs to bust-a-cap on the pain-med industry, because they hold themselves to a much lower standard than they expect my Profession to maintain.

Fortunately (and, to the rescue) comes this study from the Dutch Institute for Health Care Improvement.

They actually *busted a cap*, by deciding to explore

“the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP)”.

Their article is a real eye-opener!

I say Bravo, because these drugs are medicine's sole conservative approach for managing LBP.   This Blog has previously published numerous (and recent) studies suggesting that chiropractic management for low back pain is orders of magnitude more effective for pain relief, and is also significantly more cost-effective than standard medical management. [1-8]

Now this study comes along challenging the benefits and effectiveness of medicine's reliance on drug treatments for pain management.   Our Iatrogenic Injury Page [9] clearly documents the dangers associated with these drugs (primarily death).

This European Spine Journal study reviewed 17 randomized controlled trials
for pain treatments:

NSAIDs (n = 4),
antidepressants (n = 5),
and opioids (n = 8).
Amazingly, no studies were found for muscle relaxers!

The researchers concluded that NSAIDs and opioids “seem to lead to a somewhat higher relief in pain on the short term, as compared to placebo” (aka no treatment at all!), “in patients with non-specific chronic low back pain, and that both types of medication show more adverse effects than placebo”.   (What an elegant understatement that is!)

Review of the Iatrogenic Injury Page clearly documents that tens of thousand of people die ever year from the use of NSAIDs for simple pain relief, and overdose deaths from prescribed opiates has doubled in the last 2 decades. [10]

Where are the headlines screaming about how routine medical pain-relief recommendations are killing patients in the tens of thousands???

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When will this madness stop???

The current healthcare debate has brought up basic questions about how medicine should work.   On one hand we have the medical establishment with its enormous cadre of M.D.s, medical schools, big pharma, and incredibly expensive hospital care.   On the other we have the semi-condoned field of alternative medicine that attracts millions of patients a year and embraces literally thousands of treatment modalities not taught in medical school.

One side, mainstream medicine, promotes the notion that it alone should be considered “real” medicine, but more and more this claim is being exposed as an officially sanctioned myth.   When scientific minds turn to tackling the complex business of healing the sick, they simultaneously warn us that it’s dangerous and foolish to look at integrative medicine, complementary and alternative medicine, or God forbid, indigenous medicine for answers.

Because these other modalities are enormously popular, mainstream medicine has made a few grudging concessions to the placebo effect, natural herbal remedies, and acupuncture over the years.

But M.D.s are still taught that other approaches are risky and inferior to their own training;   they insist, year after year, that all we need are science-based procedures, and the huge spectrum of drugs upon which modern medicine depends. [11]   And now, even that claim is eroding.

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REFERENCES:

1. New LBP Study Reveals Chiropractic Is Superior to PT and MD Care
   Chiro.Org Blog ~ 3–17–2011

2. Chiropractic Cost-Effectiveness
   Chiro.Org Blog ~ 3–16–2011

3. Chiropractic Goes To The Hospital
   Chiro.Org Blog ~ 3–06–2011

4. Chiropractic Treatment of Workers’ Compensation Claimants in the State of Texas
   Chiro.Org Blog ~ 2–24–2011

5. New Study Confirms That Maintenance Care Delivers!
   Chiro.Org Blog ~ 1–26–2011

6. Primary Care MDs Decline Training In Pain Management
   Chiro.Org Blog ~ 1–20–2011

7. The Cost-Effectiveness of Chiropractic Page
   

8. Patient Satisfaction With Chiropractic Page
   

9. The Iatrogenic Injury Page
   

10. Painkiller Deaths Double in Ontario
    Chiro.Org Blog ~ 12–08–2009

11. The Mythology Of Evidence-Based Medicine
    Chiro.Org Blog ~ 2–25–2011

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Since 4–23–2011