She’s got your back, lit­er­ally

Lo­cal chi­ro­prac­tor help­ing pa­tients be free of pain... and painkillers

Pawtucket Times - - FRONT PAGE - By JOSEPH FITZGER­ALD jfitzger­ald@woonsock­et­call.com

NORTH SMITH­FIELD – Fifty-three-yearold Cindy B. of Prov­i­dence was born with a con­gen­i­tal lig­a­ture de­fect that for most of her adult life has re­sulted in an end­less cy­cle of chronic low back pain, failed treat­ments, and some­times even dis­abil­ity.

“The spasms and pain in my lower back would get so bad I couldn’t even stand up,” she says. “I was al­ways hunched over and looked like an old woman.”

Ev­ery two months like clock­work, the pain would be­come so bad she had to be driven to the emer­gency room, where doc­tors would pre­scribe the same treat­ment ev­ery time: An in­jec­tion to con­trol the spasms, mus­cle re­lax­ants, and Per­co­cet, a pre­scrip­tion painkiller.

A re­cov­er­ing al­co­holic and drug ad­dict, Cindy loathed the idea of hav­ing to take pre­scrip­tion opi­oids, fear­ing they would trig­ger a lapse in her ad­dic­tion re­cov­ery.

“I’ve been sober and drug-free for five years and nar­cotics to man­age my pain was re­ally not an op­tion for me,” she says. “But noth­ing was work­ing and it (spasms) would keep hap­pen­ing no mat­ter what I did.”

Cindy says she was be­ing set up for an end­less cy­cle of pain and then treat­ment with pre­scrip­tion painkillers un­til her in­sur­ance com­pany sug­gested she look into other pain man­age­ment op­tions.

That’s when she met Dr. Denise A. Franzese, D.C., a John­ston-based chi­ro­prac­tor, who Cindy says changed her life. She be­gan see­ing Franzese two years ago for a com­bined treat­ment of back,

shoul­der and neck ma­nip­u­la­tion, elec­tri­cal mus­cle stim­u­la­tion, and Biofreeze and mas­sage ther­apy.

The re­sults, she says, have been noth­ing short of a mir­a­cle. Not only have there been less emer­gency room visits – and thus fewer opi­oids – but her qual­ity of life has im­proved dra­mat­i­cally.

“In the two years I’ve been see­ing Dr. Franzese I’ve had only two back spasms,” she says. “I feel so much bet­ter and my qual­ity of life is so much bet­ter.”

That kind of out­come doesn’t sur­prise Dr. Su­san M. Don­ahue, D.C., a North Smith­field chi­ro­prac­tor who is try­ing to raise aware­ness of the chi­ro­prac­tic pro­fes­sion's role in pre­vent­ing and man­ag­ing chronic pain and help­ing wean peo­ple off pre­scrip­tion painkillers.

A De­struc­tive Treat­ment

“Amer­ica's opi­oid epi­demic is not af­fect­ing just the poor and work­ing class, but all seg­ments of so­ci­ety,” says Don­ahue, whose prac­tice is lo­cated at 63 Ed­die Dowl­ing High­way. “Ad­dic­tion crosses the bound­aries of wealth and so­cial sta­tus, af­fect­ing peo­ple from all so­cioe­co­nomic groups.”

In­ad­e­quate pain man­age­ment, cou­pled with the epi­demic of pre­scrip­tion opi­oid overuse and abuse, has taken a se­vere toll on the lives of tens of thou­sands of peo­ple in the United States. Ac­cord­ing to the Cen­ters for Disease Con­trol and Pre­ven­tion, as many as one in four pa­tients who re­ceive pre­scrip­tion opi­oids long term for non-can­cer pain in pri­mary care set­tings strug­gles with ad­dic­tion. Ev­ery day, more than 1,000 peo­ple are treated in the ER for mis­us­ing pre­scrip­tion opi­oids.

Deaths in­volv­ing opi­oids have quadru­pled since 1999; in 2014 alone, more than 14,000 peo­ple died from over­doses in­volv­ing the drugs. That same year, another 2 mil­lion peo­ple abused or were de­pen­dent on opi­oids.

Solv­ing the prob­lem may seem ob­vi­ous – to stop opi­oid abuse, stop pre­scrib­ing opi­oids. But when you dis­cuss the ad­dic­tion prob­lem with doc­tors, many say they don’t have much choice when it comes to pre­scrib­ing opi­oids. Over-the­counter drugs like Tylenol and Advil aren’t ad­dic­tive, but they also aren’t use­ful for treat­ing all types of pain. Opi­oids, on the other hand, are very ef­fec­tive at treat­ing chronic and neu­ro­pathic pain.

Opi­oids af­fect chan­nels within the brain that in­crease the lev­els of dopamine and sero­tonin in the brain. This means that the sen­sa­tion of pain de­creases as it’s in­ter­rupted by the sen­sa­tion of plea­sure – but that feel­ing of plea­sure can be ad­dic­tive.

“It can take only three days to be­come ad­dicted to a pre­scrip­tion painkiller,” Don­ahue says.

Don­ahue says opi­oids fre­quently are pre­scribed for acute and sub­a­cute low back pain, How­ever, the long-term ben­e­fits of chronic opi­oid ther­apy re­main un­cer­tain. Epi­demi­o­logic stud­ies have sug­gested that long-term use does not re­sult in im­prove­ment in func­tion or qual­ity of life, and in a fair num­ber of patents re­sults in worse pain, worse re­ported health, lower level of ac­tiv­ity and un­em­ploy­ment, higher health­care uti­liza­tion and poorer qual­ity of health

A Non-Phar­ma­co­logic Al­ter­na­tive

For­tu­nately, Don­ahuee says, safer non-phar­ma­co­logic op­tions like chi­ro­prac­tic care can help.

Chi­ro­prac­tic care is a hand­son, non-in­va­sive and drug-free ap­proach doc­u­mented to be ef­fec­tive in the acute and chronic neuro-mus­cu­loskele­tal pain en­vi­ron­ment, yield­ing im­proved clin­i­cal out­comes, re­duced costs and high lev­els of pa­tient sat­is­fac­tion.

Like Don­ahue’s 75-year-old pa­tient, John F., who suf­fered with de­bil­i­tat­ing lower back strain caused by years of liv­ing a seden­tary lifestyle. John had been treated with heavy-duty painkillers, but was look­ing for a more holis­tic treat­ment that didn’t in­volve drugs.

Don­ahue used ice ther­apy and ex­er­cise, which worked won­ders on Jack’s spinal discs, soft tis­sues and lig­a­ments.

“Not ev­ery ache and pain de­serves a pill,” she says.

Where opi­oids only mask the pain, doc­tors of chi­ro­prac­tic ap­proach the prob­lem highly ed­u­cated and trained in the struc­ture of the hu­man body. And they use hands-on tech­niques to help en­hance flex­i­bil­ity, mus­cle strength and range of mo­tions.

“When it comes to chronic back in­juries we re­ally need to eval­u­ate the cur­rent pain-man­age­ment sys­tem and take a closer look at non-drug al­ter­na­tives,” Don­ahue says. “What we’re say­ing is that maybe there doesn’t have to be just one treat­ment plan and that chi­ro­prac­tic and other non-drug al­ter­na­tives can be the first or­der of busi­ness in­stead of pills for a more func­tional and bet­ter out­come.”

And it’s not just Don­ahue sound­ing the clar­ion call for chi­ro­prac­tic as an im­por­tant first line of de­fense against pain and ad­dic­tion. There is a grow­ing body of re­search that val­i­dates the ef­fec­tive­ness of chi­ro­prac­tic ser­vices, lead­ing many re­spected health care or­ga­ni­za­tions to rec­om­mend chi­ro­prac­tic and its drug-free ap­proach to pain re­lief.

Ear­lier this year, the Amer­i­can Col­lege of Physi­cians up­dated its guide­lines for the treat­ment of acute and chronic low back pain to rec­om­mend first us­ing non­in­va­sive, non-drug treat­ments be­fore re­sort­ing to drug ther­a­pies.

In March 2016, the Cen­ters for Disease Con­trol and Pre­ven­tion, in re­sponse to the opi­oid epi­demic, re­leased guide­lines for pre­scrib­ing opi­oids that also pro­mote non­phar­ma­co­logic al­ter­na­tives for the treat­ment of chronic pain.

In 2015, the Joint Com­mis­sion, the or­ga­ni­za­tion that ac­cred­its more than 20,000 health care sys­tems in the U.S. (in­clud­ing ev­ery ma­jor hos­pi­tal), rec­og­nized the value of non-drug ap­proaches by adding chi­ro­prac­tic and acupunc­ture to its pain man­age­ment stan­dard.

A More Holis­tic Ap­proach

Don­ahue be­lieves pa­tients and health care providers should first ex­haust con­ser­va­tive forms of pain man­age­ment, when ap­pro­pri­ate, be­fore mov­ing on to riskier, po­ten­tially ad­dic­tive treat­ments such as opi­oids.

And while she’s not look­ing to cre­ate an ad­ver­sar­ial re­la­tion­ship with the med­i­cal com­mu­nity – which many be­lieve is partly to blame for over­dose deaths re­lated to the pain med­i­ca­tions – Don­ahue be­lieves there needs to more move­ment away from the cur­rent sys­tem of treat­ing the symp­toms and not the per­son.

“I think there’s a time and place for ev­ery­thing, but we need to work to­gether,” says Don­ahue, who earned her Doc­tor of Chi­ro­prac­tic from New York Chi­ro­prac­tic Col­lege in 2005.

A 1981 graduate of Wil­liam E. Tol­man High School in Paw­tucket, Don­ahue ran chi­ro­prac­tic prac­tices in Woonsocket and Prov­i­dence be­fore open­ing her North Smith­field prac­tice four years ago on Ed­die Dowl­ing High­way.

Don­ahue be­lieves that when your body is in a state of home­osta­sis, or bal­ance, all of its var­ied sys­tems func­tion prop­erly to re­pair or re­verse in­jury or disease. As a chi­ro­prac­tor, she takes a holis­tic ap­proach to pa­tient care, one that fo­cuses on a pa­tient's to­tal well­ness, or well-be­ing, in­stead of spe­cific dis­eases or ail­ments.

This in­tri­cate phys­i­o­log­i­cal and bio­chem­i­cal in­ter­re­la­tion­ship among var­i­ous parts of your body – in­clud­ing its spinal, mus­cu­loskele­tal, neu­ro­log­i­cal, and vas­cu­lar sys­tems – is what chi­ro­prac­tors ded­i­cate them­selves to ex­plor­ing and treat­ing, with spe­cial at­ten­tion to nu­tri­tion, ex­er­cise, and healthy emo­tional and en­vi­ron­men­tal re­la­tion­ships.

Lifestyle coun­sel­ing is a crit­i­cal part of what chi­ro­prac­tic care in­volves – from pro­vid­ing ad­vice on lift­ing tech­niques, sleep, pos­ture, ex­er­cise, and nu­tri­tion and diet, to er­gonomic work en­vi­ron­ments and sports and recre­ational in­jury pre­ven­tion.

“Ex­er­cise and other kinds of phys­i­cal ac­tiv­ity can go far in keep­ing your body strong and healthy, able to fight disease and ward off in­juries from pulling, push­ing and lift­ing,” Don­ahue says. “A healthy and fit body also gen­er­ally re­cov­ers faster from in­jury and pain.”

For Prov­i­dence’s Cindy B., who re­ceives treat­ments from Dr. Franzese twice a month, turn­ing to chi­ro­prac­tic care for re­lief of her pain has been the best thing she ever did.

“My ad­vice for any­one look­ing into chi­ro­prac­tic care is to be proac­tive in your treat­ments and to get se­ri­ous about mak­ing lifestyle changes be­cause do­ing that only ben­e­fits the chi­ro­prac­tic treat­ments,” she says.

Don­ahue

Photos by Ernest A. Brown/The Times

Chi­ro­prac­tor Su­san Don­ahue is do­ing her best to keep her pa­tients pain-free and, more im­por­tantly, painkiller-free.

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