How Chiropractic Care May Reduce the Need for Opioid Pain Medication 

When people experience low back pain that travels down the leg — known as radicular low back pain — relief often becomes the priority. For many, that relief is sought through medication. But growing research is exploring how non-pharmacological approaches, such as chiropractic care, may help manage pain while reducing reliance on opioid prescriptions.

Recent findings suggest that how care begins — whether through medication or manual therapy — may influence long-term outcomes for people dealing with nerve-related back pain.

What the Research Is Showing

A 2023 study published in BMJ Open examined the relationship between chiropractic spinal manipulation (CSM) and the likelihood of being prescribed tramadol, a commonly used opioid pain medication, in adults with radicular low back pain.

The study analyzed medical data from over 115 million U.S. patients, comparing those who received chiropractic spinal manipulation with those who received usual medical care alone.

The results were notable. Patients who received chiropractic care were:

• 68% less likely to be prescribed tramadol over a one-year period
  
  

• Only 1.3% of patients in the chiropractic group received a tramadol prescription
  
  

• Compared to 4% in the standard medical care group
  
  

Researchers reported that tramadol prescriptions were significantly lower in the chiropractic group, suggesting that spinal manipulation may help manage pain without the need for opioid medication.

Why This Matters for Pain Management

Tramadol is often prescribed for moderate to severe pain, but like other opioids, it carries risks — including dependency, side effects, and long-term health concerns. Reducing the need for opioid prescriptions is an important goal in modern healthcare.

The study authors suggest that the known effectiveness of chiropractic spinal manipulation in relieving radicular low back pain may reduce the need for medication by:

• Providing meaningful pain relief

• Supporting improved function

• Introducing patients to a non-pharmacological care pathway earlier in their treatment journey
  
  

In other words, addressing the underlying mechanics and nervous system involvement may change how pain is managed from the start.

A Different Pathway to Care

Rather than focusing solely on symptom suppression, chiropractic care emphasizes how the spine, nervous system, and musculoskeletal system work together. For people with nerve-related back pain, spinal manipulation may help by:

• Reducing mechanical irritation

• Supporting nervous system communication

• Improving movement and spinal function
  
  

The study highlights that patients who begin care with chiropractic treatment may be less likely to require opioid medication later — either due to direct pain relief or because they remain within a non-drug-based care model.

A Broader Perspective on Healing

This research adds to a growing body of evidence supporting conservative, movement-based approaches for managing musculoskeletal pain. It also underscores the importance of collaborative healthcare — where manual therapy, education, and medical care work together to support safer, more sustainable outcomes.

At Cafe of Life Marin, we believe care should support the body’s ability to heal and function, while minimizing unnecessary risks. Exploring non-pharmacological options can be an important part of that conversation.

Listening to What Your Body Needs

If you’re dealing with low back pain that radiates into the leg, understanding your care options matters. Early support that focuses on function, movement, and nervous system health may help reduce reliance on medications and support longer-term wellbeing.

Small, informed choices about care pathways can make a meaningful difference over time.

Research Reference:

BMJ Open (2023): Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain