Pawtucket Times

She’s got your back, literally

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

- 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.

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 ?? 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.
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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