SIOUX CITY | Chiropractic care isn't as easy of a pain fix as opening a bottle of pills, according to Brad Chicoine.
The Sioux City chiropractor said new patients may make multiple trips a week to the BAC Clinic of Chiropractic & Spine Rehabilitation, 1501 Nebraska St., for spinal manipulations, be asked to overhaul their diets and partake in homework.
"I've seen patients and I don't think they know how they feel because they've been taking opioids," he said. "In between the opioids, they take Tylenol or the NSAIDs. It's sad."
As the prescription opioid epidemic rages across much of the country, many states are cracking down on doctors who over-prescribe pills and are promoting other ways to manage pain. According to the Centers for Disease Control and Prevention, opioids -- including prescription opioids, heroin and fentanyl -- killed more than 33,000 people in 2015.
Iowa Gov. Kim Reynolds proclaimed September as Drug-Free Pain Management Awareness Month to raise public awareness about nonpharmacologic options, such as chiropractic care, to safely and effectively relieve acute, subacute and chronic pain.
During the 41 years he has been in chiropractic practice, Chicoine said he has seen "remarkable" changes in the symptoms of patients with chronic pain who receive chiropractic care, but he said it takes time.
"We have to teach people how to become healthy, rather than just alleviate pain. Just because the pain's gone, doesn't mean that the person is OK," he said. "We like to look for the cause of pain and treat the cause, which we feel are biomechanical or physiological problems in the body."
According to a Gallup and Palmer College of Chiropractic study of Americans, which was conducted from February through March 2017, 78 percent of Americans said they prefer to address their physical pain in other ways, before taking pain medication prescribed by a doctor. The study found that 23 percent of Americans said prescription medication is "not very safe," while 8 percent said it was "not safe at all."
"If someone's hurt their lower back and they're taking pain pills, they don't have any way of finding out whether it's out of alignment," Chicoine said. "They're taking pain pills and they don't feel the pain -- that's when they blow discs."
Chiropractic uses adjustments to correct misalignments in the body, which create pressure or abnormal movements in the joints of the spine. It's a natural, noninvasive form of health care that doesn't involve the use of drugs.
"If there is an abnormal movement or a locking up effect, the joint no longer moves correctly or the way that it was designed to move," he explained. "Through manipulation or correcting those misalignments, it will allow nerve flow or nerve pressure to return to normal."
In addition to manipulation of the spine, Chicoine said he uses various modalities at the BAC Clinic to treat patients, such as laser therapy; massage therapy; acupuncture; physiotherapy, which includes ultrasound and electrical stimulation; and non-surgical decompression, which puts motion into the lower spine and allows nutrients, oxygen and water to return to the discs.
Chicoine said headaches, neck, arm and lower back pain, shoulder problems, and numbness and tingling in the hands and feet are some of the most common ailments that bring patients to his office.
Since medical care has been around a lot longer than chiropractic care, Chicoine said patients typically seek out medical care first, but he said research shows that more and more patients are moving further away from the medical model of care to try to alleviate structural problems.
"If they've been to a chiropractor before, they'll seek chiropractic care first, especially if they've had a good experience with it," he said of patients. "If they have not had a good experience with it or if their medical doctor chooses not to refer the patient to a chiropractor, the medical doctor will try his specific modes of treatment, which may be, first of all, pain-relieving medications."
Patients visiting the BAC Clinic for the first time, can expect to be examined and receive X-rays to determine the extent of their soft tissue damage. A standard protocol of manipulation follows.
"If it's acute or subacute or if it's a chronic, longstanding problem, we may use a different technique," Chicoine said. "It really depends on symptomatology and exam findings."
The severity of the patient's condition will also influence how often they need to receive treatment. Chicoine said some patients need to come in three or more days a week at first. When their pain lessens and their condition improves, he said appointments begin to taper off. Patients who've responded well to chiropractic care usually return regularly for maintenance appointments, according to Chicoine. He said most insurance companies, as well as Medicare and Medicaid, cover chiropractic care, but benefits are capped.
"It's not like a broken bone, where you set the bone and it welds back together again. We're dealing with joints that have to keep moving in the body," he said. "Once they're been injured, they will develop scar tissue, which is not as elastic as the connective tissue that was there before. Therefore, the joint can lock up again. Some patients need more care than others."
Chicoine said advising patients on diet and nutrition is also an important part of the treatment process, especially for patients with autoimmune diseases. He suggests vitamins, nutrients and minerals to patients and urges them to stay away from acidic substances, including soda, coffee, tea, alcohol and energy drinks.
"Today's world, we're in the processed everything as far as nutrition goes. We're eating foods that are very acidic to our bodies," he said. "You better be counter-balancing that with some neutral fruits and vegetables. The more acidic we become, it's kind of like a horror movie. You throw acid on somebody and they melt away -- it's the same with our joints."