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Acupuncture Gets Medicare Assist For Treating Chronic Low Back Pain

Acupuncture Gets Medicare Assist For Treating Chronic Low Back Pain

There is exciting news for people suffering from chronic low back pain who have experienced relief from acupuncture and are opposed to turning to risky pharmaceuticals and surgery. Dr. Rick Lambert, Medical Director at Montvale Health Sport + Spine in Montvale, NJ, is pleased to report the decision from the Centers for Medicare & Medicaid Services (CMS) made earlier this year: Medicare will cover acupuncture treatments for chronic low back pain (cLBP) under the provisions of the Social Security Act.

The CMS, noting the prevalence of seniors 65 and older who range from 13 to 50 percent of the population of communities large and small across the United States, has concluded that “the public health implications of this information are immense.” This presents the potential of having great impact on what is statistically the cause of most chronic low back pain, especially when aging and advanced aging are factors. It is classified as pain with “no identifiable systemic cause,” which means that the cause does not emanate from any discernible illness or injury. It is categorized as nonspecific. If that seems ambiguous, even mysterious, consider that it is one of the enigmas for millions of Americans who lack a diagnosis for the specific source of this often disabling pain.

For example, Medicare-approved coverage for acupuncture treatment for cLBP does not include association with any of the following causes:

  • injury
  • surgery
  • pregnancy
  • diseases that are infectious, metastatic (from transient cancerous cells) or resulting from inflammation

Chronic pain is often difficult to assess, even though it is one of the leading reasons for people seeking medical care. Yet the pain is real to those affected by it. According to the CMC, chronic pain is defined as any lasting 12 weeks (three months) or longer and may also be diagnosed in some cases as “being present six months or more in the past year.”

Does it interfere with basic lifestyle activities? Can it be defined as a disability? Does the pain reach a certain level of severity? These are among the questions that may be posed for Medicare coverage, and highly qualified specialists like Dr. Lambert will be called upon to make such diagnoses or provide treatment based on referral from another physician.

It is clear that low back pain is among the most common— if not the most common— healthcare issues among adults of all ages in this country. The CMC, consulting sources like the Center for Disease Control and Prevention (CDC), reports that low back pain is experienced by 25 million people in this country. Furthermore, it continues to remain “the leading cause of years lived with a disability.”

Dr. Lambert, who is board certified in acupuncture, received his basic medical training at the NYU School of Medicine and followed up studying internal medicine at the Thomas Jefferson University Medical Center in Philadelphia. For more comprehensive information see www.cms.gov and enter “acupuncture” in the search field.

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