Chiropractic Treatment Linked to Lower Opioid Dependency in Low Back Pain Patients

A recent comprehensive study conducted by researchers at University Hospitals Connor Whole Health has revealed significant findings regarding the treatment of low back pain. The research indicates that patients diagnosed with low back pain who initially received spinal manipulative therapy from chiropractors exhibited a markedly lower risk of developing opioid use disorder, particularly when contrasted with those who were prescribed ibuprofen for pain management.

The study, published in Health Science Reports, analyzed data from the TriNetX Research Network, encompassing over 49,000 patients in the United States between 2015 and 2025. The results showed that only 0.24% of patients who opted for chiropractic spinal manipulative therapy were later diagnosed with opioid use disorder within two years. In contrast, the diagnosis rate among those taking ibuprofen was significantly higher at 1.51%, indicating an 80% reduction in the risk of opioid-related issues for the chiropractic treatment group.

Furthermore, the findings suggested that individuals receiving spinal manipulative therapy were also 77% less likely to engage in long-term opioid use and 31% less likely to receive any opioid prescriptions compared to their counterparts who were prescribed ibuprofen. According to the lead researcher, the evidence underscores the importance of nonpharmaceutical pain management strategies in addressing the ongoing opioid crisis.

The research specifically targeted opioid-naive adults aged 18 and older experiencing new episodes of low back pain, deliberately excluding those with prior opioid use or serious medical conditions such as cancer. Participants were divided into two groups: one receiving spinal manipulative therapy and the other given ibuprofen. Advanced statistical techniques were employed to ensure both groups were comparable in terms of demographics and potential risk factors for opioid use disorder.

The Vice President of UH Connor Whole Health emphasized the ongoing commitment to investigating nonpharmacological treatments aimed at reducing opioid reliance for common pain conditions. Co-authors of the study highlighted the importance of expanding the evidence base for chiropractic care, particularly as a viable alternative in managing pain amidst the opioid epidemic.

Despite the promising results, the authors acknowledged certain limitations inherent in observational studies, such as the potential for residual confounding and the reliance on electronic health records, which may lack comprehensive data. Nonetheless, the findings align with clinical guidelines from reputable organizations advocating for nonpharmacological approaches, including spinal manipulative therapy, as first-line treatments for low back pain.

Future research is encouraged to delve deeper into this area to ascertain whether the observed benefits are directly attributable to spinal manipulative therapy, or if they stem from broader factors like the dynamics of patient-provider relationships within nonpharmacological treatment settings.