Chiropractic care reduces tramadol prescriptions for sciatica, study finds

A new study led by researchers at University Hospitals Connor Whole Health found that adults initially receiving chiropractic spinal manipulation for newly diagnosed radicular low back pain (sciatica) were significantly less likely to be prescribed tramadol over the following year compared to those receiving usual medical care.

Tramadol is a synthetic opioid that has been increasingly prescribed for low back pain in the United States (US) over the past decade. While tramadol has a lower potency compared to other prescription opioids, it still carries risks of persistent use and adverse events.

"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," said Robert Trager, DC, lead author of the study.

The retrospective cohort study, published in BMJ Open, used data from over 2,300 patient records across multiple US academic health centers. It included adults aged 18-50 with a new diagnosis of sciatica, which is characterized by radiating pain, numbness, or weakness in the leg due to a compressed nerve root.

The authors describe extensive efforts to account for differences between the chiropractic and non-chiropractic (usual medical care) cohorts. For example, the cohorts were similar with respect to age, sex, and several other factors. The researchers found that 1.3% of the chiropractic patients received a tramadol prescription over 1-year follow-up, compared to 4.0% of the patients receiving usual medical care.

As our nation continues to grapple with the opioid crisis, this study reinforces the value of offering patients evidence-based non-pharmacological alternatives for pain management."

Dr. Françoise Adan, Chief Whole Health and Well-being Officer and Director of UH Connor Whole Health

Co-author and Resident Physician at Duke University Hospital Roshini Srinivasan, MD, shared that "this work is particularly encouraging to clinicians as we continue to seek safe, effective therapies for conditions that can be complicated to manage, such as chronic low back pain and sciatica."

The researchers caution that the retrospective design has limitations and call for further research to confirm their findings. In addition, they question whether the findings might be explained by a general effect of visiting a non-pharmacologic clinician, such as a chiropractor, physical therapist, or acupuncturist.

Journal reference:

Trager, R. J., et al. (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.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
AI-based liquid biopsy technology promises early detection of cancer recurrence