Opioid Prescription Rates Plummet by 68% with Chiropractic Intervention, Study Finds

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With the opioid epidemic claiming nearly 600,000 lives since 1999,1 could alternative therapies like chiropractic care and acupuncture hold the key to safer pain management?

A recent study published in BMJ Open has found that chiropractic spinal manipulation can significantly reduce the likelihood of patients with low back pain being prescribed tramadol, a commonly used opioid.2 The study, which analyzed over 2,300 patients, found that those who received chiropractic adjustments were 68% less likely to be prescribed tramadol compared to those receiving usual medical care. The impact was seen quickly and lasted the entire year of follow-up.

"This study found that US adults initially receiving chiropractic spinal manipulation for a new index diagnosis of radicular low back pain had a reduced likelihood of receiving a tramadol prescription over 1-year follow-up compared with those receiving usual medical care," the authors concluded.2

Interestingly, the study found both groups had similar use of NSAIDs, physical therapy, and imaging - suggesting it was the chiropractic care itself that made the difference in reducing opioid prescriptions. By offering effective pain relief without drugs, chiropractic may provide a safer avenue for patients to address their back pain.

Acupuncture: More Effective than Morphine

Previous research has already demonstrated the power of acupuncture as a pain management intervention. A groundbreaking study published in the American Journal of Emergency Medicine found that acupuncture, a centuries-old practice involving the insertion of thin needles into specific points on the body, was more effective, faster-acting, and had fewer adverse effects than intravenous morphine for acute pain in emergency department patients.6

The study, conducted at a university hospital in Tunisia, included 300 patients randomly assigned to receive either acupuncture or morphine. Remarkably, the acupuncture group had a 92% success rate in pain relief compared to 78% in the morphine group. Acupuncture also provided pain relief faster and with significantly fewer side effects.

"Our study demonstrated that in patients with acute pain syndromes presenting to the ED, acupuncture is at least as efficacious and has a better safety profile than IV morphine," the researchers reported. "The results of this study suggest that acupuncture has a potential role in controlling acute pain conditions presenting to EDs and appears to be safe and effective."6

Faster Pain Relief, Fewer Side Effects

The study also found that acupuncture provided pain relief much faster than morphine. "From the 5-minute time point, the acupuncture group reported significantly larger pain decrease compared with the morphine group. This difference persisted during the entire study period," the authors noted.6

Perhaps most strikingly, the acupuncture group experienced far fewer adverse effects. "Overall, 89 patients (29.3%) experienced minor adverse effects: 85 (56.6%) in morphine group and 4 (2.6%) in acupuncture group; the difference was significant between the 2 groups," according to the study.6

A Growing Body of Evidence

These findings add to a growing body of evidence supporting the use of alternative therapies like acupuncture and chiropractic for pain management. A database compiled by GreenMedInfo.com shows that chiropractic treatment has been linked to potential improvement in up to 78 different health conditions, ranging from headaches and asthma to hypertension and fibromyalgia.7

As millions continue to struggle with pain and opioid addiction, it's clear we need a multifaceted approach that prioritizes patient safety and well-being. Overdoses claimed over 80,000 lives in 2021 alone,4 highlighting the urgent need for safer pain management options.

Integrating Alternative Therapies into Pain Management

Chiropractic care and acupuncture offer promising, non-invasive avenues to manage pain while reducing exposure to potentially harmful drugs. By integrating these evidence-based therapies into pain management strategies, we may be able to reduce reliance on risky medications and offer patients a wider range of safe, effective options for relief.

"The results of this study suggest that acupuncture has a potential role in controlling acute pain conditions presenting to EDs and appears to be safe and effective," the authors of the acupuncture study concluded. "Future studies should be performed in international populations."6

Similarly, the authors of the chiropractic study called for further research to corroborate their findings. "A prospective observational study or pragmatic trial would minimise sources of confounding and enable measurement of several key medications used for the management of LBP in tandem, such as types of opioids, gabapentinoids, benzodiazepines and non-steroidal anti-inflammatory medications," they wrote.2

A Comprehensive Approach to Pain Management

As we search for solutions to the devastating opioid epidemic, it's clear we need a comprehensive approach that includes both conventional and alternative therapies. By leveraging the power of non-drug interventions like chiropractic and acupuncture, we may be able to turn the tide on this public health crisis and offer patients safer, more effective paths to pain relief.

While more research is needed to fully understand the role of these therapies in addressing the opioid crisis, the available evidence suggests they should be considered as part of a comprehensive pain management strategy. Alongside judicious use of medications, addiction treatment, and community support, chiropractic care and acupuncture may help stem the tide of opioid overuse and abuse, offering hope for a future with less pain and fewer lives lost to addiction.

For more information on ways to approach Pain Management naturally, visit our extensive database on the subject here.

To learn more about evidence-based benefits of Chiropractic Care, visit our database on the subject here.


1. CDC. Understanding the Opioid Overdose Epidemic. Centers for Disease Control and Prevention. Published March 17, 2021. https://www.cdc.gov/opioids/basics/epidemic.html

2. Trager RJ, Cupler ZA, Srinivasan R, et al. Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data. BMJ Open. Published online May 1, 2024:e078105. doi:10.1136/bmjopen-2023-078105

3. Kuo YF, Raji MA, Chen NW, et al. Trends in Opioid Prescriptions Among Part D Medicare Recipients From 2007 to 2016. Am J Med. 2019;132(3):347-356. doi:10.1016/j.amjmed.2018.10.002

4. NIDA. Overdose Death Rates. National Institute on Drug Abuse. Published January 20, 2023. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

5. Dayanim S, Boshier J. Chiropractic Care. In: StatPearls. StatPearls Publishing; 2023. http://www.ncbi.nlm.nih.gov/books/NBK561458/

6. Grissa MH, Baccouche H, Boubaker H, et al. Acupuncture vs intravenous morphine in the management of acute pain in the ED. American Journal of Emergency Medicine. 2016;34(11):2112-2116. doi:10.1016/j.ajem.2016.07.028

7. GreenMedInfo. Chiropractic Treatment. GreenMedInfo.com. Published 2023. https://greenmedinfo.com/therapeutic-action/chiropractic-treatment

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.

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