ACA Petitions HHS on Chronic Pain
Written by Editor   
Wednesday, July 20, 2016 12:00 AM

At the end of June the American Chiropractic Association (ACA) petitioned the U.S. Department of Health and Human Services (HHS) to amend one of its recent rules.  Read the entire letter here.

The American Chiropractic Association (ACA) requests that the Secretary of the HHS amend the recently released “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016" as published in Morbidity and Mortality Weekly Report, Early Release / Vol. 65 March 15, 2016 ("CDC Guideline").

The draft proposal of the above referenced CDC Guideline made reference to the effectiveness of nonpharmacologic therapies including manipulation therapy in the treatment of chronic pain:  “Based on contextual evidence, many nonpharmacologic therapies, including physical therapy, weight loss for knee osteoarthritis, complementary and alternative therapies (e.g., manipulation, massage, and acupuncture), psychological therapies such as CBT, and certain interventional procedures can ameliorate chronic pain.”  However, no mention is made of manipulation therapy under the heading “Effectiveness of Nonpharmacologic and Nonopioid Pharmacologic Treatments" on page 12 of the final CDC Guideline nor anywhere else in the final rule.

The ACA therefore respectfully requests that the HHS restore the above referenced comment from the draft proposal to the final CDC Guideline. In addition, ACA requests that the portions the CDC Guideline pertaining to “Effectiveness of Nonpharmacologic and Nonopioid Pharmacologic Treatments” on page 12 and "Determining When to Initiate or Continue Opioids for Chronic Pain" p.17, be revised to reference the effectiveness of manipulation therapy in the treatment of chronic care by adding the following language: “Patients should be informed of non-pharmacological therapies for low back pain before seeking opioids. Manual-thrust manipulation, such as performed by a doctor of chiropractic, often achieves a greater short-term reduction in pain compared with common medical treatments.”

Doctors of chiropractic are well positioned to play a vital role in the conservative management of acute and chronic pain. They offer complementary and integrative strategies, as well as guidance on self-care, that can provide needed relief for many who suffer from pain. More than 33.6 million Americans sought chiropractic services in 2014. Manipulative therapy, as provided by doctors of chiropractic, has been chosen by patients time and time again as an effective and safe way to address chronic pain. The nation would therefore be well served with the inclusion of manipulative therapy, as apparently initially considered by the CDC, into the final CDC Guideline.