A new multi-institutional study, led by University Hospitals Connor Whole Health, found that adults with newly diagnosed low back pain with or without sciatica who initially received spinal manipulative therapy administered by a chiropractor were significantly less likely to be diagnosed with opioid use disorder over a two-year follow-up compared to those prescribed ibuprofen. The study suggests an association between spinal manipulative therapy and a lower risk of opioid use disorder in this population, highlighting its potential value as a first-line non-pharmacological option for low back pain amid the ongoing opioid crisis.

Published in Health Science Reports, this retrospective cohort study analyzed data from the United States’ TriNetX Research Network, including more than 49,000 matched patients from 2015 to 2025. Researchers found that only 0.24 percent of patients in the spinal manipulative therapy cohort were diagnosed with opioid use disorder within two years, compared to 1.51 percent in the ibuprofen cohort.

This translated to an 80 percent lower risk of opioid use disorder among spinal manipulative therapy recipients. Additionally, spinal manipulative therapy recipients were 77 percent less likely to experience long-term opioid use and 31 percent less likely to receive any opioid prescription compared to matched controls initially receiving ibuprofen.

“While prior studies showed that spinal manipulative therapy is associated with a lower likelihood of receiving opioid prescriptions, our study is the first to directly examine opioid use disorder,” said Robert Trager, DC, lead author of the study and Director of Chiropractic Medicine at UH Connor Whole Health.

Presented as a service to the community by: Union County Chiropractic Clinic, 110 Skyline Drive, Maynardville, TN (865) 992-7000 www.unioncountychiropractic.com