Emergency room physicians are trying
to figure out what is optimal to offer back pain
patients who choose the ER for help. It is a dilemma
for them, especially since nearly 3 million such
patients with undifferentiated musculoskeletal low back pain choose the emergency room for help each year! (1) Unless there is
cauda equina syndrome demanding surgery or an infection, pain is the issue. How best can a Richmond ER doc help?
How can an ER doctor provide higher value care? (2) Imaging and
medication. What can the Richmond chiropractic back pain specialist provide?
Spinal manipulation and nutrients. Chiropractic has published about successful
management of back pain.
EMERGENCY ROOM: IMAGING
The ER orders a lot of
imaging. One in 3 patients who visit the emergency room
for back pain (as opposed to 1 in 4 who visit a primary care physician) gets imaging done:
simple imaging 26%, complex imaging 8.2%. (3) Today’s imaging guidelines
don’t support this as they say to hold off
on imaging for 4-6 weeks of conservative care before imaging. (4) Maybe patients
are letting the ER doctors know that they have been using
such care already? Probably not as only 34% of
patients who visit an ER tell the emergency department
physician that they get healthcare options like chiropractors,
massage therapy, acupuncture and the like. (5) What about the pain?
EMERGENCY ROOM: MEDICATIONS
Pain relief, it
seems, is what they can do. Researchers have studied
a variety of pain medication combinations ER doctors have used
to determine what is effective. What have
they discovered? Stronger pain medication options do not
offer much of a difference. Adding baclofen, metaxalone, or tizanidine to
ibuprofen doesn’t seem to up
function or pain any more than placebo plus ibuprofen by 1 week
after an ED visit for acute low back pain. (6,7) Mixing
ibuprofen and acetaminophen did not decrease pain
scores or the need for other analgesic pain meds compared with either ibuprofen
or acetaminophen alone for emergency room patients with acute
musculoskeletal injuries. (8) As a matter of fact, 48% of back pain patients
who visit an ER for their back pain continued to experience functional impairment 3 months later as well as
42% reported moderate or severe pain. 46% say
they’ve used some type of analgesic pain reliever in the last
day. There are short and long-term issues for ER patients
with low back pain. (1) This might be frustrating for ER physicians and their patients but not always
for chiropractors and their chiropractic back pain patients. The
Richmond chiropractic back pain specialist at Johnson Chiropractic is
prepared with the best of chiropractic care for
Richmond back pain relief.
CHIROPRACTIC: MANIPULATION AND NUTRIENTS
Your Richmond chiropractor understands.
Familiarity with chiropractic spinal manipulation via
The Cox® Technic System of Spinal Pain Management with the addition of
nutrition like chondroitin sulfate, glucosamine sulfate and curcurmin and
turmeric supports your Richmond chiropractor’s confidence that back
pain relief and management for many otherwise frustrated Richmond
back pain patients is possible.
Listen to this PODCAST
with Dr. Michael Schneider on The
Back Doctors Podcast with Dr. Michael Johnson who shares
the role of the primary spine physician who would be the physician
to seek out for back pain issues.
CONTACT Johnson Chiropractic
Schedule a Richmond chiropractic visit
with Johnson Chiropractic especially if an emergency department trip
hasn’t produced the pain relief you hoped.
Richmond chiropractic care has figured out a well-documented
and researched way to manage back pain.
"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER
page. Content is reviewed by Dr. James M. Cox I