Pain can be challenging to manage. Every year, more than 11 million Canadians suffer from pain directly related to back and other musculoskeletal conditions. According to the World Health Organization, musculoskeletal conditions are the second largest contributor to disability worldwide. Chronic pain is associated with the poorest quality of life as compared with other chronic diseases. Healthcare practitioners and Canada’s health system struggle with safe and effective pain management. And, there are significant gaps in accessing appropriate and effective pain management options within the current healthcare system in Canada. As the national association representing Canada’s chiropractors, the Canadian Chiropractic Association (CCA) supports a better approach to pain management. An approach that includes prompt access to and integration of chiropractic care across the country.
Too often, pharmacological and invasive treatments (including opioids) are the first-line of treatment used to manage acute and chronic non-cancer pain. Notably, low back pain is one of the primary causes for over-use of prescribed opioids. Greater access to non-pharmacological alternatives through prompt triage and referral would decrease invasive treatments and the pressure to prescribe opioids. Interprofessional collaboration that integrates chiropractors into innovative models of healthcare can lead to improved patient outcomes and satisfaction, and a reduced reliance on opioids by healthcare professionals for pain management.
Systematic reviews and clinical practice guidelines do not recommend the initiation of opioid therapy for chronic non-cancer pain. Rather, evidence supports use of self-management strategies and conservative care including chiropractic as first-line treatments to help manage pain and improve function.
The wait times for publicly-funded pain clinics in Canada can be up to or greater than one year, with the majority of Canadians having limited access to proper care. Yet, referrals to first-line treatment options for managing musculoskeletal conditions, such as community-based interprofessional primary care clinics, rarely include chiropractors. Incorporating chiropractors as part of the pain management team will improve health outcomes and overall quality of life, as well as reduce the burden on healthcare systems.