Durable Medical Equipment helps Chronic Pain Patients.
By Kelli M. Donley, MPH
“Conservative care” is a term often heard at pain specialists’ offices. Ideally, pain physicians want to be able to treat their patients and eliminate all pain in the most minimally invasive method. There should be no rush to procedures, unless the pain is acute.
Most patients, however, have chronic or ongoing, nagging pain. Conservative care plans for such pain may include changing a patient’s diet, encouraging lifestyle changes and chiropractic appointments. one of the many tools chiropractors have to help chronic pain patients is DME -or durable medical equipment. Think support braces for the back.
“DME is designed to support an area to reduce mechanical stress, and promote healing,” says Chance Moore, DC. “DME can help muscle spasm, muscle tears, spinal disc injuries, knee ligament tears or sprains and a variety of other conditions.”
Moore regularly prescribes DME to patients to help with chronic pain. “TENS and lumbar spine bracing are the most commonly prescribed DME for pain,” says Moore. “We treat many conditions on any given day, but the most frequent area we treat is the lumbar spine – or lower back. When the structures of the lumbar spine are injured the brain sends messages to the surrounding musculature to contract.
This can result in muscle spasm. bracing of the lumbar spine supports the area to reduce muscle spasm and speed healing. TENS is a great device that reduces the perception of pain. TENS can be used almost anywhere on the body.”
While Moore has seen great results from DME with patients, Kim Rowe, a DME representative with Desert Medical, says braces may provide temporarily relief but not a cure. “Many patients think that a spine or knee brace will completely heal them and eliminate their pain,” says Rowe. “This is far from the truth. The idea behind bracing a pain patient is to help increase their daily activity levels while minimizing pain. For example, if wearing a spine brace can help a patient sit or stand longer without having to take a pain pill or lie down, then it is successful. by wearing a brace, your underlying problem is still there, the brace will help support the injured area while you are undergoing treatment.”
Moore says while working with a patient on a treatment plan, DME provides necessary literal support. Many patients have an improved quality of life thanks to these tools. “I have seen great results,” says Moore. “Some patients come into the office unable to stand due to the severity of a muscle spasm. The immediate support that a lumbar brace can provide will reduce the muscle spasm and can allow the patient to walk out of the office and perform their activities of daily living.”
Rowe says as a bracing consultant, she enjoys working with patients to find the right DME to help with their pain. “I specialize in all types of bracing: spine, knee, shoulder, neck, ankle, hip, etc.,” she says. “Daily, I fit orthopedic and pain patients for many different ailments and injuries. Spine and knee braces are by far most commonly prescribed by physicians and healthcare providers. but, if you show me where your pain is, I can find a brace for it!”
During such a meeting with a bracing consultant, patients will also learn how to wear, remove and care for the brace. Patients should ask how long they are to wear the brace and what to look for if the brace
isn’t working. Typically, DME is covered by insurance.
“Before fitting our patients for a brace, we make sure to notify them of their remaining deductible amount and co-pay benefits,” says Rowe. The patient should know exactly what he/she will owe before being fit.” As with any treatment, there are risks. However, Moore says the risks for injury with DME are minimal.
“TENS is a great treatment as long as the patient does not have any electrical implanted devices,” says Moore. “over-reliance of bracing causes weakness and dependence on the brace. It is important to not overuse the brace and when appropriate engage in a supervised stretching and strengthening program.
If a patient is suffering from chronic back pain and is interested in first exhausting all conservative care treat- ment options before surgery DME is a smart option to consider. Your pain physician should be able to discuss DME options and schedule a bracing consult.