Low back pain is one of the most common reasons adults seek medical care, and for many, it comes with the difficult question of how best to treat it.
Traditionally, medications like ibuprofen or even stronger painkillers such as opioids have been used to ease the pain.
However, the ongoing opioid crisis has pushed researchers to find safer alternatives.
A new study offers some hopeful news in this area by suggesting that spinal manipulative therapy—commonly provided by chiropractors—may help reduce the risk of developing opioid use disorder among people with new cases of low back pain.
The study, led by University Hospitals Connor Whole Health and published in Health Science Reports, looked at more than 49,000 adults across the United States. All participants were new patients with low back pain, some with sciatica and some without, who had never been prescribed opioids before.
Researchers divided these individuals into two groups. One group received spinal manipulative therapy from chiropractors as their initial treatment.
The other group was prescribed ibuprofen without chiropractic care. Researchers then tracked both groups for two years to see how many developed opioid use disorder.
The results were striking. Only 0.24% of patients in the chiropractic care group were diagnosed with opioid use disorder within two years, compared to 1.51% of those who started with ibuprofen. This translates to an 80% lower risk of developing opioid use disorder among those who received spinal manipulative therapy.
Additionally, patients in the chiropractic group were 77% less likely to experience long-term opioid use and 31% less likely to receive any opioid prescription at all compared to those who started with ibuprofen.
Robert Trager, DC, the study’s lead author and Director of Chiropractic Medicine at UH Connor Whole Health, explained that while previous research had shown a link between chiropractic care and a lower chance of being prescribed opioids, this is the first major study to directly look at opioid use disorder as an outcome.
His team used a statistical technique called propensity score matching to ensure the two groups were similar in terms of age, gender, mood disorders, substance use history, and other risk factors for opioid addiction.
The study excluded patients who had already been prescribed opioids, had prior opioid use disorder, or had serious conditions such as cancer or fractures. This ensured that the results specifically focused on new, uncomplicated cases of low back pain.
Kristi Artz, MD, MS, Vice President of UH Connor Whole Health, noted that this research adds to growing evidence supporting non-drug approaches for managing pain.
Roshini Srinivasan, MD, a co-author and resident physician at Duke University Hospital, called the findings both encouraging and exciting because they demonstrate how chiropractic care might be part of the solution to the opioid epidemic.
Of course, the researchers acknowledged some limitations. Like all observational studies, this one relied on real-world medical records, which can sometimes have gaps or incomplete information. There’s also the possibility that other factors not captured in the data may have influenced the results.
Still, the findings line up with current guidelines from organizations like the American College of Physicians and the US Centers for Disease Control, which recommend trying non-drug approaches such as spinal manipulative therapy before turning to medications for low back pain.
This study carries an important message. For adults with newly diagnosed low back pain, starting with chiropractic care instead of medications like ibuprofen could significantly lower the chances of later developing opioid dependence.
While more research is needed to confirm these findings and better understand how spinal manipulative therapy works, the evidence so far suggests that it could be a valuable first step in treating back pain safely.
Overall, the study shines a light on how a simple, non-drug therapy could make a big difference during a time when the world is grappling with the effects of opioid addiction.
By offering an approach that avoids or reduces the need for opioids, spinal manipulative therapy may help patients manage pain more safely and reduce the risk of serious long-term consequences.
If you care about pain management, please read studies about Scientists find a new drug for chronic nerve pain and findings of Scientists find a new, less-invasive way to tackle knee pain.
If you care about pain, please read studies about Scientists find a new way to manage knee pain and findings of Promising new drug offers hope for chronic nerve pain relief.
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