Chiropractic Care Reduces Opioid Prescriptions for Lower Back Pain by 68 Percent: Study

Recent research highlights how spinal adjustments can significantly reduce dependency on pain medication such as the often prescribed Tramadol.

By Sheramy Tsai
6/6/2024
Updated: 6/30/2024

Could spinal adjustments replace pain pills? Recent research suggests that chiropractic adjustments can significantly alleviate lower back pain and reduce the need for tramadol, offering a nondrug option for managing sciatica pain

Chiropractic’s Role in Curbing Medication Dependence

Millions of Americans suffer from sciatica, a type of radicular lower back pain that radiates down the leg. Often caused by compression or inflammation of a spinal nerve, sciatica can result in pain, loss of sensation, and impaired motor function. The discomfort typically follows the path of the nerve, extending from the lower back down to the calf or foot, depending on the severity of the condition.
Traditionally, Tramadol has been the main prescription for managing this pain, seen as a milder alternative to stronger opioids. However, concerns have grown about Tramadol’s long-term effects and the risk of dependency.

A recent study analyzing more than 115 million patient records from academic health centers offers new insights. Published in BMJ Open, the study shows that adults receiving chiropractic spinal manipulation (CSM) for newly diagnosed sciatica are less likely to be prescribed Tramadol in the following year than those receiving standard medical care.

This finding challenges traditional pain management strategies and highlights the potential effectiveness of CSM in providing relief without the risks linked to long-term pain medication use.

“While previous studies found a reduced likelihood of opioid prescription among those receiving chiropractic care, our study is the first to focus specifically on Tramadol,” Robert Trager, chiropractor and lead author of the study, said in a statement.

A Closer Look at the Study

The study used health records from TriNetX, an extensive database with information from 80 health care institutions. Researchers compared two groups of 1,171 patients—one group received chiropractic spinal manipulation, and the other received standard medical care. They matched the groups by age, health, and initial pain levels to ensure a fair comparison.
Over one year, patients who received chiropractic care were 68 percent less likely to be prescribed Tramadol than those who received standard medical care. This difference in prescription rates appeared early and continued throughout the year.

Additionally, the study highlighted that the use of nonsteroidal anti-inflammatory drugs, physical therapy, and lumbar imaging was similar between the two groups, further suggesting that the reduced Tramadol use was specifically associated with chiropractic care.

These results suggest that the initial treatment choice can have long-lasting effects on patients’ health. Choosing chiropractic care may provide immediate pain relief and reduce the need for pain medication, helping patients avoid the risks and side effects of opioid use.

While the study offers valuable insights, it has limitations. Key factors such as pain severity, income, and education weren’t well-represented in the data. The focus on patients from academic centers may not apply to private practice settings, and the retrospective design could leave out unmeasured variables. Further research, especially prospective studies, is needed to confirm these findings.

Tramadol: A Double-Edged Sword in Pain Management

Tramadol, a less potent synthetic opioid than morphine, is commonly prescribed for moderate to severe pain like sciatica because it’s thought to be less addictive. However, it can still lead to dependency and withdrawal symptoms similar to stronger opioids. A recent search by The Epoch Times of the U.S. Food and Drug Administration’s Adverse Events Reporting System (FAERS) found nearly 90,000 reports of problems with Tramadol, more than half of which involved drug dependence.
Tramadol’s side effects range from mild, such as nausea and dizziness, to severe, including serotonin syndrome, which can cause confusion, rapid heart rate, and respiratory depression. Additionally, its effect on norepinephrine and serotonin can trigger mood swings and mental health issues, including depression and anxiety.

Chiropractic and Pain Relief

While the recent study highlights the reduced need for Tramadol among patients receiving chiropractic care, it does not explain how chiropractic adjustments alleviate pain.
Chiropractic manipulation involves adjusting the spine to influence the central nervous system and reduce pain. According to chiropractic theory, these adjustments correct spinal alignment and relieve pressure on the nervous system, promoting the body’s natural ability to heal and reduce pain.

“Chiropractic adjustments directly correct the biomechanical dysfunctions of the spine that often contribute to pain and restricted mobility,” Bradley Rauch, an experienced chiropractor at New York Chiropractic Associates, told The Epoch Times. “By restoring proper alignment and movement, we can significantly reduce pain signals and improve overall neural function.”

As an alternative to pain-relieving drugs, the American College of Physicians recommends spinal manipulation along with exercise, acupuncture, stress reduction, heat, or massage for low back pain.

“We focus on the whole person, not just the symptoms,” Mr. Rauch said, emphasizing the holistic nature of chiropractic care. “By improving spinal health, we can enhance overall well-being and reduce the reliance on pain medications.”

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