Nonpharmacological pain treatments, including chiropractic, are receiving increasing attention, especially given that 59% of US adults who were prescribed opioids reported having back pain. Furthermore, the Institute of Medicine recommends nonpharmacological therapies as effective alternatives to pharmacotherapy for patients with chronic musculoskeletal pain and the American College of Physicians’ clinical guidelines recommend nonpharmacological treatment as the first-line treatment for back pain.

 

Some early evidence shows that the use of nonpharmacological treatments (including chiropractic) for musculoskeletal pain has an influence on opioid use. For instance, a recent study reported that among patients treated for spinal pain, expenditures for opioid therapy decreased as expenditures for manual care (chiropractic and physical therapy) increased, as did costs for spinal surgery and spine care overall. Another study involving 1,702 neck pain patients reported that those who received chiropractic (DC) care were less likely to be prescribed opioids within one year of their first visit. Several other studies have reported similar findings (references included in the Review).