Low Back Pain: America vs. Canada | Portland, OR
What happens in America when you get low back pain? It's an important question because it's the number 2 reason people go to see the doctor, after the common cold. Of course, the common cold also includes "Covid," too.
And also accounts for billions of dollars in disability payments, lost wages, and decreased productivity. It can be a tremendous strain on the economy; not just in medical bills and at the job site, but also insurance costs, liability Legal Work, and can stress the fabric a family life. If low back pain is the most common generator of chronic pain in Portland, and chronic pain is one of the leading causes of suicide, we have to wonder how many families have been torn apart by the effects of a single car accident, workplace injury, or simply 30 years of disuse.
Low Back Pain in Portland OR
When your country has a nationalized healthcare plan, it has an extra incentive in taking all of these things into consideration. The strain of the medical industry is a strain on the entire country. It is also a Measure by which a people cares for itself and a measure of the amount of accountability a national leader might have to its people. All of these facts were taken into consideration and were the motivating factors for the country of Canada in trying to figure out what to do about the low back pain epidemic. The goals were simple: what's cost-effective, what can people access for care, who can properly manage low back pain cases, and, God for bid, what actually works for the long term and not just the short term.
Before the reveal, we should talk about what happens in the United States and what used to happen in Canada. Most people have a primary care physician. When you get back pain, most people will try to ignore it. When that doesn't work, nonsteroidal anti-inflammatory drugs, NSAIDs, as well as some minimal home treatments like heat or ice and stretching, are often employed. We see a lot of patients who spend thousands on a new bed only to feel minimal difference, if not feel worse. And then it's off to the doctor. Many patients will receive a prescription for, or advice to take, the exact same anti-inflammatory drugs and home procedures that they had been trying to that point. After that, more intense medication's are usually on offer. Since the opioid epidemic has reached near biblical proportions, most doctors are very wary of prescribing them, but many still do. Many times, patients are then sent for x-rays which reveal nothing of interest to the medical doctor or, queue the doom and gloom music, "degeneration" or "arthritis" is discovered.
Then, if the patient is really persistent, they often receive MRIs showing much of the same, are given injections of steroids and/or painkillers which sometimes provide temporary relief but have also caused increases in pain, including burning that takes weeks to subside. If you get a particularly nonconservative surgeon, or it seems like they have tried everything, surgery will be suggested to remove bone spurs, replace worn discs, or fuse segments in the hopes that the pain will subside. More and more well-versed medical doctors are referring patients for some kind of physical care earlier on in this cavalcade of procedures. Many insurance companies have looked at the data and insist on some kind of physiotherapy prior to authorizing surgeries. But for too long, physical therapy has come after the surgery to strengthen the post surgical area. Rarely, do patients get a referral to a chiropractor at all, much less early on.
If I had a dollar for every patient that came in and said "I've tried everything…"
Canada wanted to avoid this. So the conclusion of the MANGA report, instructing doctors and citizens alike, was not just that chiropractors should be utilized for low back pain; chiropractors were entrusted to be the *Portal of Entry Physicians* for low back pain. Chiropractic first. Before you ask for Imaging, before you accept a prescription for Tylenol, and as early on in the onset of low back pain as possible. And then if you're still not getting better, the chiropractor will make the referrals and generate the next plan of attack.
That is because their well funded and non-biased study found what chiropractors have known for years: chiropractic is the most cost-effective, safe, whole-patient-based, and effective treatment for low back pain, in modern medicine.
When I graduated from Chiropractic school 15 years ago, they were many Canadian students who had enrolled because of their own good experiences and where encouraged by how integrated and accepted Chiropractic was in the Canadian main stream. Maybe that's why those polls tend to find them happier with their healthcare than Americans; and happier in general.
Maybe it's time we caught up to our neighbors in the north.