Racial and Ethnic Differences in Receipt of Nonpharmacologic Care for Chronic Low Back Pain Among Medicare Beneficiaries With OUD

Key Points

Question  Are there racial and ethnic differences in receipt of physical therapy (PT) or chiropractic care for chronic low back pain (CLBP) among people with opioid use disorder (OUD)?

Findings  In this cohort study of 69 362 Medicare beneficiaries with CLBP and OUD, 10.2% received PT or chiropractic services within 3 months. Black or African American and Hispanic persons had lower odds of chiropractic care compared with non-Hispanic White persons.

Meaning  In this study, PT and chiropractic care use was low overall and racial and ethnic inequities in utilization and time to chiropractic care were observed, underscoring the need for equitable and multimodal pain management among people with OUD.

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Complementary Alternative Medicine: A Culturally Centered Approach to Managing Chronic Pain from One American Indian Community

Abstract: This evaluation explored the benefits of Complementary Alternative Medicine (CAM) within a reservation-based, State-certified outpatient treatment provider. The three CAM strategies provided were massage, acupuncture, and chiropractic therapies. The evaluation team worked with a peer recovery support specialist and tribal evaluation intern to co-create a one-page, eight-question, fixed-response instrument based on previous work in the community. Surveys were collected by the peer support specialist post-session with individuals receiving CAM therapies. Surveys assessed self-reported impacts, reasons for attending CAM sessions, and mental, physical, spiritual, and emotional health before and after CAM sessions. Paired t-tests were used to examine significant differences in mean scores before and after CAM sessions. A total of 40 participants completed the survey between March 2021 and March 2022. The evaluation found a significant increase in the mean scores for all measured self-reported health ratings: physical, spiritual, emotional, and mental. The greatest increase observed was for physical health (M = 5.32, SD = 2.53) and physical health after (M = 8.38, SD = 1.60) based on self-report data; t(78) = 6.46, p = .0001. CAM sessions positively influenced participants; 83% (n = 33) reported being more hopeful about their overall health and wellness. The holistic approach demonstrated promising results and potential benefits of CAM on overall wellness and belonging. Further research is needed to explore how CAM may be implemented as a culturally centered approach to managing chronic pain often associated with opioid use disorder.

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