A new study published in JAMA Network Open experts found the use of gabapentinoids — medicines widely used to treat neuropathic pain — increased the risk of hip fractures, especially in older patients who were frail or had kidney disease. Often seen as a safer alternative to opioids, the gabapentinoid drugs gabapentin and pregabalin are antiepileptic drugs that are considered as first-line treatments for the management of neuropathic pain.

Patients had 30 per cent increased odds of suffering a hip fracture within two months of being dispensed a gabapentinoid medication. The link between gabapentinoids and hip fractures existed across different age groups but the odds of hip fracture was higher among patients who were frailer or had chronic kidney disease, so these should be important considerations when deciding when to prescribe gabapentinoids.

The study highlights that caution is needed before prescribing gabapentinoids, especially for people who are prone to falls and fractures. The findings highlight the importance of assessing each patient’s risk before prescribing gabapentinoids.

Chiropractic care can help manage neuropathic pain without opioids or gabapentinoids by focusing on spinal adjustments to alleviate pressure on nerves caused by misalignments in the spine, potentially reducing pain and improving nerve function; this approach often includes techniques like spinal manipulation, soft tissue mobilization, stretching, and sometimes electrical stimulation or ultrasound therapy to further ease discomfort and inflammation.
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