Amit Shah, the chief medical officer at CareOregon, once had a patient so beset with chronic pain that his initial goal was just to get her to walk to the mailbox. Once she could do that, he wanted her to walk a little farther each day until she could make it around the block.
It isn’t news that the medical community is grappling with how to reduce dependence on prescription painkillers. As the opioid epidemic remains front and center, some places are experimenting with alternative therapies such as acupuncture, massage, and yoga. Oregon is pioneering the practice, mandating not only that insurance providers cover these therapies but also that they are given priority over prescriptions.
Oregon’s emphasis on alternative therapies originated with CareOregon, a nonprofit that contracts with the state’s Medicaid and Medicare programs. Several years ago, it funded its own non-medication pain clinic in a small coastal town, offering physical therapy, peer-group support, and behavioral health services to patients with chronic back pain. The results were encouraging.
Studies of alternative therapies for chronic pain — particularly back pain — aren’t conclusive. Research on the effectiveness of acupuncture and yoga in alleviating chronic pain is spotty at best, and chiropractic care and massage have been shown to work well only for short episodes of back pain. Still, Pfeifer and her team think these therapies have promise, and Medi-Cal, California’s Medicaid program, now covers acupuncture and chiropractic services.
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