Recently, a health maintenance organization affiliated with the University of Pittsburgh School of Medicine, developed landmark guidelines for chronic low back pain management. The University of Pittsburgh Medical Center (UPMC) Health Plan says that as of Jan. 1, 2012, people that are candidates for spinal surgery must first determine medical necessity. It lists chiropractic care as a viable alternate for the treatment of low back pain, something the professionals at ChiroCarolina® in Charlotte, NC, have seen firsthand in the course of their careers.
Because spine surgery rates are soaring, the health plan says that “prior authorization to determine medical necessity” is needed; this includes confirmation the candidates have “tried and failed a 3-month course of conservative management that included physical therapy, chiropractic therapy, and medication.” Additionally, patient’s opting to have surgery must have graduated from UPMC’s Health Plan’s low back pain health coaching program. This cutting edge program uses a web-based system to help people “understand pros and cons of surgery and high-tech radiology.” This policy is groundbreaking because it is the first program in the country that has implemented these guidelines putting chiropractic care at the forefront of low back pain treatment. When the health care plan stated the reasons for the change, it stated,”We feel strongly that this clinical initiative will improve the quality of care for members who are considering low back surgery, and that it will facilitate their involvement in the decision-making process.” At ChiroCarolina® in Charlotte, NC, patients experiencing low back pain can find the relief they need using conservative treatment methods that don’t involve spine surgery or medication. With the soaring prices of medical treatment, health care plan providers as well as their clients are seeking alternatives to costly traditional medical intervention. Chiropractic care is fast becoming a reliable and effective alternative for patients seeking relief of low back pain. Managing chronic low back pain conservatively Here are suggestions, including chiropractic care, listed by the UPCM’s health plant for managing chronic low back pain:
- Use RICE (rest, ice, compression and elevation)
- Screen for “yellow flags” and psychosocial factors and use behavioral interventions where possible with other treatment options
- Help patients understand self-management techniques using ability assessment and education, especially on return to work and usual activity function
- Starting and graduating from the University of Pittsburgh Medical Center’s Health Coach’s Low Back Pain Program. The patient would also need to participate in other programs including weight loss, exercise, cutting back on smoking, and treating depression and/or stress.
- Referral to a physical therapist or an experienced chiropractor for things like manipulation/mobilization and stabilization exercises. This is before advanced imaging is to be done.
- There should be detailed documentation of the amount of conservative treatment of chiropractor/physical therapy.
Gerald Clum, DC, former president of the World Federation of Chiropractic and Life Chiropractic College West, and current executive committee member of the Foundation for Chiropractic Progress, stated his support of the new guidelines, stating, “The UPMC should be congratulated for its leadership is establishing policies to assure that the least invasive and most likely to be successful care strategies, including chiropractic care, are applied for a meaningful period of time before surgical considerations are made. This decision is both an important recognition of the value of chiropractic care in the acute low back pain environment as well as a recognition of the clinical and economic downsides to spinal surgery in this situation.” The University of Pittsburgh Medical Center’s Health Plan covers recipients in 15 counties in Pennsylvania and integrates 20 hospitals, 400 doctors’ offices and outpatient sites. If you have chronic low back pain, the experienced doctors at ChiroCarolina® in Charlotte, NC, can help. Contact them today for an appointment, and find out how quickly you, too, can find relief from your low back pain!