Spinal Manipulation and Acupuncture: Safer Alternatives to Opioids for Pain Relief

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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 But chiropractic is not the only alternative therapy showing promise in reducing reliance on risky pain medications.

Acupuncture: An Ancient Solution to a Modern Crisis

Acupuncture, a centuries-old practice involving the insertion of thin needles into specific points on the body, has been shown to be a powerful pain reliever. A groundbreaking study published in the American Journal of Emergency Medicine found that acupuncture 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.

Chiropractic Care: 78 Potential Health Benefits

Chiropractic care, which involves manual adjustment of the spine, has been associated with numerous health benefits beyond just pain relief. According to a database compiled by GreenMedInfo.com, 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

The recent BMJ Open study adds to this body of evidence, suggesting that chiropractic care can significantly reduce the need for opioids like tramadol in patients with low back pain.2 By offering effective, drug-free pain management, chiropractic and acupuncture may provide safer alternatives for the millions of Americans struggling with painful conditions.

A Multifaceted Approach to Pain Management

While more research is needed to fully understand the role of alternative 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, non-drug approaches like chiropractic and acupuncture may help stem the tide of opioid overuse and abuse.

As we search for solutions to the devastating opioid epidemic, it's clear we need a multifaceted approach that prioritizes patient safety and well-being. By integrating evidence-based therapies like chiropractic and acupuncture into pain management, we may be able to reduce reliance on risky medications and offer patients a wider range of safe, effective options for relief.


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

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