Kevin Pearce: Maybe 10 years ago we did a study across a lot of primary care practices
in Kentucky about what they're commonly seeing, and low back pain was in the top 5 things
that they would see on a day-to-day basis.
Keisa Bennett: The evidence shows more and more that it's a very complex process that
we don't understand amongst the nerves and the muscles and all the parts of the person's
body and including your mental and emotional health.
The treatments that we have as medical providers are frustratingly ineffective, and many of
them are dangerous.
Bill Elder: Not every person with chronic low back pain receives opioid medications,
but it has become a huge public health and personal health problem.
These medications sensitize the person to pain.
The longer you take them, the more you need.
These medications usually bring increased suffering in the long term.
Keisa Bennett: There's lots of reasons that we all wish there were better and more evidenced-based
treatments to really help people with the pain we understand that they're having.
VO: A pilot research study at the University of Kentucky examined what would happen if
primary care providers referred patients with chronic low back pain to free alternative
therapies.
The study recruited primary care providers, and clinical massage therapists, in urban
and rural practices in Central Kentucky.
Bill Elder: Guidelines exist for treatment of chronic low back pain and those guidelines
recommend the use of these alternative therapies.
However, they haven't been demonstrated in real-world practice.
We want to know if there are going to be side effects, we want to know if patients will
accept them, we want to know how they work over a longer term.
Those are important questions that this study will get to.
Kevin Pearce: What would happen if you were able offer your patients massage therapy or
a guided relaxation therapy program and they didn't have to pay for it?
A lot of people may say "well so what," because in the real world they would have to pay for
it, but the way research progresses, is when these things are tested in the right context,
if they are proven to be effective, payers come along behind and begin to pay for these
things.
Keisa Bennett: Many of our patients, and particularly those that need it the most, often live month
to month and it's something they feel they can't spend money on.
Bill Elder: This study offers these therapies at no cost, taking money out of the equation.
Kevin Pearce: It's sort of a first step toward what makes sense to cover for insurance companies,
or what people are willing to pay for out of pocket.
VO: The study of 100 patients looked at two alternative therapies.
Progressive Muscle Relaxation, or PMR, is something patients could do at home, with
audio instructions guiding them through tensing and relaxing different muscle groups.
Lee Ball: Our body, if we stop and listen, will whisper to us, "This is an issue."
And if we keep ignoring it, it gets to where it screams to us.
And then is often when we do something about it.
For the older population who thinks that aches and pains have to be part of growing older,
this can maybe help them see, in addition to maybe some exercise and other things, a
piece of what could help them not have to accept pain as part of their aging process.
Katie Stewart: So from a long-term perspective, they're breathing a little easier, they're
sleeping better, so all these systems, your immune system and your nervous system are
finally resting, instead of firing the whole time.
And so what this study says is you can send real-world complicated people, which are people
we see every day, into a massage setting and for the most part, they're gonna get something
out of it and it's gonna be beneficial, and they're going to feel better and they're going
to be "yes, I liked massage."
Bill Elder: This was a real-world study with real-world results because we were able to
engage our community partners, physicians and massage therapists, across the region.
While the PMR findings were less than expected, we had quantifiable, positive outcomes with
massage therapy.
In our next study we will examine which patients benefit most from these treatments.
We hope to bring new treatment options that will relieve suffering in Kentucky.