Drugs Versus Chiropractic Treatment For Back Pain

The typical go-to for most people who suffer from back pain is medication. Whether that is Over-the-Counter (OTC) NSAID’s (Non-steroidal Anti-Inflammatories) like Tylenol, Robax, Advil, Motrin, etc, or prescription meds like Benzodiazepine and even Opioids.

Sounds pretty easy to just poping a pill to get out of trouble and move on with your day. In fact, there is fairly good research out there that these meds may help in the short term. You know, get you over those rough patches but I think most of us inherently understand that this pain control strategy probably isn’t the wisest choice in the long term.  Any GI or Kidney specialist will caution you against prolonged use of NSAID’s because of the negative side effects of prolonged drug use. And it goes without saying that the stronger prescription stuff such as muscle relaxers (e.g. Benzodiazepine), nerve pain meds (e.g. Neurontin, Gabapentin) or the big guns (i.e. Opioids). We don’t need to go there in much detail today.

Despite best efforts to develop effective treatment approaches, back pain remains the number one cause of disability in the world. If you’re in doubt, you can check out these researchers who confirmed what we have known for years.

So, let’s explore some options to medication for helping relieve your back pain.

So, if we accept that, then we need to move on to what treatment(s) are high value? That means, best bang for your buck.

 

One article showing the burden of disease of back pain in Australia. This mimics the WHO’s Global Burden of Disease Databases.

One article showing continued Opiod use after ED visits

One article showing chiro better than Bensos

Once article showing 56% less opiod use in seniors if they see a chiro for back pain

It is pretty easy to say “Don’t Take Drugs” but seriously? If you’re in huge pain, what are the alternatives?

Let’s have a look at what Mr/Ms. Science says…

These scientists looked at approximately 9000 people between the ages of 18 – 49 who experienced a new episode of back pain and sciatica. They compared those that received Chiropractic treatment (Spinal Manipulation also known as adjustments) versus those that did not and followed them for one year to see how the two groups did.

They watched for how many people followed up with their Doctors to request ongoing Medication, in the form of muscle relaxers (Benzodiazepine) for pain control at the 3, 6, and 12-month points. The assumption was that if early treatment was effective, then the need for ongoing pain management would be reduced over the next year.

Turns out, the group that received the Chiropractic treatment were far less likely to require ongoing pain meds over the next year versus the group that didn’t. One can infer from this that if you see a chiropractor for spinal manipulation (adjustments), soon after you experience back pain or sciatica, your pain will settle much better reducing your need for ongoing pain meds over the next year.

Good question. The most common condition for which Opioids are prescribed is back pain. If your pain is so severe that you feel you need to go to the ED (Emergency Department), the ED’s staff’s priority is to make sure your pain isn’t caused by potentially really serious stuff like cancer, infections, fractures or a severely-herniated disc resulting in Cauda Equine Syndrome. Serious conditions like this are referred to as Red Flags and fortunately are very rarely the cause of back pain. So, if you are at the ED and the staff determines your pain is not due to a Red Flag condition, then the job becomes to give you something to help your pain and send you home. Often, this involves the prescription of strong pain medication called Opioids.

The problem with that is that these scientists showed if you get some Opioids at the ED, chances are really good you will still be using those Opioids a month later…bad news! It is no secret how bad Opioid addiction is so we really need to figure out a better way.

These scientists looked at almost 56,000 Medicare recipients who were diagnosed with spinal pain. These were older patients (seniors), which is perhaps an even more important group to look at because we know, seniors are a vulnerable population with high rates of co-morbidity and polypharmacy. That is facy talk for lot’s of other health issues and using multiple medications – very complex patients that are quite tricky to try and help.

They compared those that underwent chiropractic treatment versus those that did not and then looked at who were most likely to fill an Opioid prescription over the following year for ongoing pain management.

Those that received chiropractic treatment for spinal pain were 56% less likely to fill an Opioid prescription over the next year versus those that didn’t see a chiropractor.

Given the potential negative side effects of Opioids, this is a pretty compelling argument to seek chiropractic treatment for back pain instead of just popping a pill. Especially if you are a senior.

These two studies showed that seeking chiropractic care for helping you relieve your back pain was associated with significantly less need to rely on heavy pain medications like muscle relaxers (Benzodiazepine) and Narcotics (Opioids). Previous studies have found that chiropractic care is associated with decreased use of opioids, but have not focused on older Medicare beneficiaries, a vulnerable population with high rates of co-morbidity and polypharmacy.

What does it all mean? Seeing a chiro means less back pain with fewer side effects. A healthier option. Don’t forget that getting the initial part of the pain under control is great but you also need to think about how to keep yourself feeling good. I describe some strategies on that in this article.

As always, if you have any experiences (good or bad) about chiropractic treatment for back pain, feel free to reach out. I’ll do my best to reply.

1. https://chiromt.biomedcentral.com/articles/10.1186/s12998-022-00415-7
2. https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13979
3. IwAR1PcSTeszqcLN6WgeGQy66vmMiEfp25J5Iwy6WFESa5k926eeggLD
4. https://pubmed.ncbi.nlm.nih.gov/18619768/