UPFRONT | Roundup PATIENT CARE Take 5 Self-care yields better outcomes for chronic pain The National Pain Strat-egy, released this year by the U.S. Department of Health and Human Services, places strong emphasis on self management and patient education as critical path-ways for improving treat-ment of chronic pain, espe-cially back pain. At the recent American Pain Society’s (APS) An-nual Scientific Meeting, researchers representing the Veterans Affairs (VA) and Nor th American Spine Foundation discussed im-plications of the National Pain Strategy for improving pain management and re-ducing disability. The VA estimated in one study that 44 per cent of soldiers in an Army infantry brigade reported chronic pain three months after re-turning from tours of duty in Afghanistan and Iraq – double the rate among civil-ians. The North American Spine Foundation says spi-nal disorders have increased by 300 per cent in the last 50 years and now rank as the number-one cause of disability in the United States and in the military. Robert Kerns, professor of psychiatry, neurology and psychology at Yale Univer-sity, spent 38 years practic-ing in VA health care. He reported in a panel pres-entation at the APS meeting that the VA’s stepped-care model to help veterans bet-ter manage pain through standardized pain assess-ments, alternative therapies, patient education and self-care is succeeding in reduc-ing opioids use. “The proportion of VA patients receiving high doses of opioids has de-creased significantly in the last four years concurrent with greater use of non-drug alternative pain thera-pies,” Kerns said. He cited better self-man-agement and patient educa-tion as examples of new ways the VA is working to improve pain care for veter-ans, and believes the Na-tional Pain Strategy’s strong advocacy of self-care will provide more educational resources and greater incen-tives to help physicians empower patients to be-come more proficient at managing and coping with their pain. In his panel presentation, Michael Reed, executive director, North American Spine Foundation, ad-dressed the importance of emphasizing function to prevent or minimize disabil-ity in people with spinal disorders. “The current treatment paradigm addresses pain first and function second, but it should be reversed,” said Reed. “The pendulum may have swung too far forward in addressing pain and not function, so we need to emphasize both in balance.” Reed reported that the financial impact – direct medical costs, disability payments, lost work time costs and patient costs – as-sociated with spinal disor-ders currently are estimated at more than $600 billion a year in the United States alone and Social Security disability payments are ap-proximately $40 billion. NUMBER CRUNCHING Who wants to be a millionaire? The Canadian Men’s Health Foundation commissioned a study that examines the financial burden cost by unhealthy lifestyle. According to the calculations, men could be millionaires if they quit smoking, alcohol and unhealthy eating. Amount of money an unhealthy male could lose over his lifetime 8.6 MILLION 26.4% Canadian males who smoke cigarettes Canadian male adults who are overweight or obese 66.6% 79 years life expectancy of a typical Canadian male www.canadianchiropractor.ca 6 Canadian Chiropractor July/August 2016
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