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As More Patients Embrace Chiropractors For Pain Relief, So Do Health Insurers

FPS Groningen

Bob Jones of Trumbull County has recurring pain from an old injury, but he isn’t going to be getting opioids. He never wanted them anyway, and found his own solution for pain relief. 

That includes visits with chiropractor Patrick Ensminger.

“All I do is take the joint to its normal end range, which is about there,” Ensminger tells Jones. “And I apply a little additional push. And you felt a little bit of a pop or click there. And then we do the same procedure on the other side.”

“That felt good,” Jones responds. “And no medication. That’s a good thing.”  

The number of prescriptions doctors are writing for opioid pain killers is down, and not just because they’re pulling back in the face of the addiction crisis.

Ensminger says chiropractic treatment is increasingly popular with patients like Jones because it works by stopping musculoskeletal and nerve pain from happening, as opposed to blocking, masking or altering perceptions of pain, as drugs do.

“The chiropractic role is to provide a valid, evidence-based, effective and an alternative to opioid prescribing,” Ensminger says.

Nationally the number of opioid prescriptionswritten over the last five years has dropped nearly 9 percent, and in Ohio, it’s down almost 29 percent.

Patients like Jones are turning to chiropractic treatment because of concern over the addiction risks with opioids. However, chiropractic and other non-traditional practices are also becoming more mainstream among insurance providers, as well.

As a practical matter, drug-based pain treatment doesn’t work for people like professional driver Tony Robins.

“With my occupation, I cannot be on any kind of prescription medication because I have to operate company equipment,” Robins says. “And also, the side effects, when I did take some after some surgeries I had, there would be no way I could stay on those and go back to work.” 

Credit American Chiropractic Association
Health-care providers increasingly try to measure the benefits and risks of opioids and alternatives.

Until recently, alternative pain treatment has typically not been available from tradition healthcare providers. But Patrick Ensminger, who is also president the Eastern Ohio Chiropractic Society, says that based on recent conversations with Mercy Health, Ohio’s largest hospital system, changes are coming.

“Mercy group has taken it upon themselves to work pro-actively towards a referral, or even in-patient, program to offer chiropractic services to provide alternatives to opioids,” Ensminger says.

Frank Beck, the head of dental services at Mercy Health, is leading the hospital organization’s task force on pain. He says the change not only recognizes the need for alternative paint treatment options, but also that different kinds of pain need different approaches. 

“If they’re dental, they get shipped down here,” Beck says. “If they’re musculoskeletal, we have a physical rehabilitation medicine institute, where the chiropractic piece is going to fit in. So as we look at the alternatives to opioids, there’s a whole bunch. Acupuncture is one as well. “ 

As a whole, the healthcare industry also taking steps to expand alternative pain treatment options. The Joint Commission – the national hospital accreditation organization – now requires considering alternative treatments before prescribing opioids. So do many states.

“In the state of Ohio, there are four bullet points: a chiropractor, acupuncturist, and behavior, or cognitive therapist,” says Bobbie D’Amato, CEO of a medical billing and coding service based in Youngstown. “They have to reach out to before they’ll be put on opioids.”

D’Amato says some states are being more aggressive. West Virginia recently passed a law requiring health insurers to cover a minimum of 20 visits to alternative treatment providers for patients needing pain relief.

In Ohio, a group of major health insurers participating in a state task forcereleased a list of recommendations this month for battling the opioid crisis. Their list includes increasing coverage of non-drug pain treatment.

And University Hospitals will be holding a symposium in September focusing on non-pharmacological approaches to pain management.