Low Back Pain and Meds

​Low back pain is one of the leading cause of disability worldwide and it affects about 570 million people globally (1,2). Do you or a loved one experience low back pain? This is an important article that can make the world of difference to you.
 
“About 39% of the adult population will have low back pain in any given year” (3)
 
A common type of low back pain which is characterised by radiating pain into the lower extremity, and may or may not be with corresponding neurological deficits (eg. weakness, sensory loss) is radicular low back pain. It is low back pain that involves a nerve root lesion (4), depending on severity it can affect the overall quality of life, so it’s important to have it addressed appropriately. Though more conservative approaches involving non-pharmacological therapies are recommended as a first approach in line with current evidence based clinical guidelines (5), pharmacological options are still regularly recommended early on.
 
In a recent research literature, researchers did a retrospective cohort study using US data to look at the likelihood of tramadol prescription in adults with radicular low back pain. Tramadol is an atypical, synthetic opioid that is comparatively lower in potency, which is increasingly being prescribed for low back pain in the US (6). Globally, it is the most consumed opioid in terms of MME (morphine milligram equivalent) per 1000 inhabitants per day (7). From this retrospective cohort study, they looked at 1171 patients per cohort, and it was found that the adults that were receiving chiropractic spinal manipulation for radicular low back pain had a reduced likelihood of receiving a tramadol prescription over a 1-year follow-up (8). Though more studies and cases needs to be looked at to further substantiate these findings, the findings so far are pointing towards a positive outcome with chiropractic spinal manipulation as a conservative first approach to manage radicular low back pain in adults.
 
So if you want to find out if chiropractic care 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 better to try more conservative care before pharmacological or invasive procedures where appropriate”
 
 
1. Wu, A., March, L., Zheng, X., Huang, J., Wang, X., Zhao, J., Blyth, F.M., Smith, E., Buchbinder, R. and Hoy, D., 2020. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Annals of translational medicine, 8(6).
2. Abbafati, C., Machado, D.B., Cislaghi, B., Salman, O.M., Karanikolos, M., McKee, M., Abbas, K.M., Brady, O.J., Larson, H.J., Trias-Llimós, S. and Cummins, S., 2020. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.
3. Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., Woolf, A., Vos, T. and Buchbinder, R., 2012. A systematic review of the global prevalence of low back pain. Arthritis & rheumatism, 64(6), pp.2028-2037.
4. Trager, R.J., Cupler, Z.A., Srinivasan, R., Casselberry, R.M., Perez, J.A. and Dusek, J.A., 2023. Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data. BMJ open, 13(7), p.e073258.
5. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:514–30.
6. Coyne, K.S., Barsdorf, A.I., Currie, B.M., Poon, J.L., Maziere, J.Y., Pierson, R.F., Butler, S.F., Schnoll, S.H., Farrar, J.T., Fisher, H.J. and Franks Jr, M.J., 2021. Insight into chronic pain in the United States: descriptive results from the Prescription Opioid Misuse and Abuse Questionnaire (POMAQ) validation study. Current Medical Research and Opinion, 37(3), pp.483-492.
7.Jayawardana, S., Forman, R., Johnston-Webber, C., Campbell, A., Berterame, S., de Joncheere, C., Aitken, M. and Mossialos, E., 2021. Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study. EClinicalMedicine, 42.
8. Trager, R.J., Cupler, Z.A., Srinivasan, R., Casselberry, R.M., Perez, J.A. and Dusek, J.A., 2024. Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data. BMJ open, 14(5), p.e078105.