Chiropractic and Opioid Prescription

​One of the most important causes of disability globally is low back pain (1). It has been increasing in all age groups over the last few decades (2). Do you or a loved one experience low back pain? This is an important article that could make the world of difference to you.
 
“The age standardised prevalence estimate for low back pain is 10.5% in North America.” (3) This means that 10 out of every 100 people will get significant LBP.
 
Due to limited effectiveness of common medical therapies which include the use of nonsteroidal anti-inflammatory drugs, opioids, spinal fusions, and epidural steroid injections (4-6). It is recommended by clinical practice guidelines that evidence-based nonpharmacological treatment options should be the first-line therapy considered. Including exercise, superficial heat, spinal manipulation, massage, cognitive behavioural therapy and others (7). In the emergency department, more than two thirds of older patients with a lumbar spine condition received opioid analgesics (8). Is chiropractic care a treatment option that may help reduce the need to use opioids?
 
In recent research literature, they looked at Veterans Health Administration health record data, the study sample included patients who had a visit for low back pain in a Veterans Health Administration primary care provider between 2015 and 2020. The patients included in the study hadn’t had care for low back pain for more than 18 months prior to the visit. The study looked at new opioid prescriptions within 365 days after this initial visit. From the results it was indicated that there was a significantly lower risk for receipt of an opioid prescription among chiropractic care users in the follow up of 365 days later (9). The study indicates a positive correlation with the use of chiropractic care and reducing the risk of having to turn to opioids to help manage low back pain.
 
If you want to find out if chiropractic may help manage low back pain for you or your loved ones, have a chat with one of our chiropractors to see how they can assist.

“It is important to try a more conservative evidence-based nonpharmacological treatment option first as it is the recommended clinical practice guidelines”
 
 
 
 
 
 
1.Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet 2018;391:2356–67.
2. Global Health Group Data Exchange http://ghdx.healthdata.org/gbd-results-tool accessed Nov 15, 2020). 
3. Ferreira, M.L., De Luca, K., Haile, L.M., Steinmetz, J.D., Culbreth, G.T., Cross, M., Kopec, J.A., Ferreira, P.H., Blyth, F.M., Buchbinder, R. and Hartvigsen, J., 2023. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(6), pp.e316-e329.
4. Deyo RA, Mirza SK, Turner JA, Martin  BI. Overtreating chronic back pain:time to back off? JAmBoardFam Med. 2009;22(1):62-68.
5.Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA. Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis. Pain Physician. 2016;19(3):E365-E410.
6. Machado GC, Maher CG, Ferreira PH, Day RO, Pinheiro MB, Ferreira ML. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Ann Rheum Dis. 2017;76(7):1269-1278.
7.Qaseem, A., Wilt, T.J., McLean, R.M., Forciea, M.A. and Clinical Guidelines Committee of the American College of Physicians*, 2017. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 166(7), pp.514-530.
8. de Luca, K., McLachlan, A.J., Maher, C.G. and Machado, G.C., 2023. Australian emergency department care for older adults diagnosed with low back pain of lumbar spine origin: a retrospective analysis of electronic medical record system data (2016–2019). BMC Emergency Medicine, 23(1), p.17.
9. Lisi, A.J., Bastian, L.A., Brandt, C.A., Coleman, B.C., Fenton, B., King Jr, J.T. and Goulet, J.L., 2025. The Impact of Chiropractic Care on Opioid Prescriptions in Veterans Health Administration Patients Receiving Low Back Pain Care: Lisi et al. Journal of General Internal Medicine, 40(16), pp.3973-3981.