Spinal Manipulative Therapy for Low Back Pain Tied to Lower Risk for Opioid Use Disorder

FRIDAY, Oct. 10, 2025 (HealthDay News) — Adults receiving spinal manipulative therapy (SMT) for new low back pain have a lower risk for developing opioid use disorder (OUD) compared with matched controls prescribed ibuprofen, according to a study published online Sept. 19 in Health Science Reports.

Robert J. Trager, D.C., from University Hospitals Cleveland Medical Center, and colleagues conducted a retrospective cohort study using a U.S. data resource (TriNetX) to assess whether opioid-naïve adults receiving SMT for low back pain are less likely to develop OUD over two years versus control patients prescribed ibuprofen. The analysis included 24,993 adult patients per cohort who were diagnosed with a new episode of low back pain with or without sciatica from 2015 to 2023.

The researchers found a significantly lower incidence and risk for OUD (0.24 versus 1.51 percent; relative risk [RR], 0.20), long-term opioid use (0.42 versus 1.85 percent; RR, 0.23), and opioid prescription (30.96 versus 45.00 percent; RR, 0.69) for SMT recipients. Similarly, SMT recipients also received fewer opioid prescriptions.

“It is equally encouraging and exciting to demonstrate a growing evidence base for chiropractic care contributing potential solutions to pain in the context of the opioid epidemic,” coauthor Roshini Srinivasan, M.D., from Duke University Hospital in Durham, North Carolina, said in a statement.

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