Radicular Low Back Pain and Drugs

​Lower back pain can seriously affect the quality of life, and has become the leading cause of years lived with disability worldwide when compared with other chronic diseases or disorders (1). Do you or a loved one experience low back pain? This is an important article that can make the world of difference for you.
 
“1 in 6 Australians (16%) have back problems” (2)

Radicular low back pain is a common type of back pain that involves a nerve root lesion, and is considered a type of neuropathic pain, involving radiating symptoms accompanying back pain (3). It commonly results from either disc herniation or spondylosis, with the disc herniation being either due to an acute injury or secondary to chronic degeneration of the spine (4).
Gabapentin is a common pharmaceutical that is used for neuropathic pain, and has been used for treating neuropathic symptoms of radicular low back pain (5). However there is growing evidence of the risks of taking gabapentin including abuse, misuse, dependence and withdrawal (6). Along with potential adverse effects such as somnolence, dizziness, ataxia and fatigue (7). If possible it would be better to manage radicular low back pain more conservatively. Can chiropractic help manage radicular low back pain?

In a recent research literature, 3,270 patient records were looked at retrospectively. They compared 1,635 patients who have received chiropractic care and 1,635 patients who have received usual medical care after a new diagnosis of radicular low back pain. A one year follow up was looked at after the initial diagnosis for both groups. The results from this retrospective cohort study found that the patients receiving chiropractic care for a new diagnosis of radicular low back pain had significantly lower odds of receiving a gabapentin prescription over 1 year follow up compared with those who received usual medical care (3). Though more cases need to be looked at to further substantiate these findings, early findings indicate a positive outcome for radicular low back pain management with chiropractic care, with good odds in helping a patient to lower the likelihood of having to resort to pharmaceuticals for support.


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.
 
“The more conservative approach for health is most commonly the safer approach”
 
 
 
1. James, S.L., Abate, D., Abate, K.H., Abay, S.M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A. and Abdollahpour, I., 2018. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), pp.1789-1858.
2. Australian Bureau of Statistics ABS (2019a) Microdata: National Health Survey, 2017–18.
3. 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.
4. Dydyk, A.M., Khan, M.Z. and Singh, P., 2019. Radicular back pain.
5. Morlion B. Pharmacotherapy of low back pain: targeting nociceptive and neuropathic pain components. Curr Med Res Opin 2011;27:11–33.
6. Evoy KE, Sadrameli S, Contreras J, et al. Abuse and misuse of pregabalin and gabapentin: a systematic review update. Drugs 2021;81:615–7.
7. Quintero GC. Review about gabapentin misuse, interactions, contraindications and side effects. J Exp Pharmacol 2017;9:13–21.