Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events

Journal of Manipulative and Physiological Therapeutics . 2018

Over the past few years, there has been a dramatic shift in the guidelines for treating spine pain. Groups such as The American Geriatrics Society, The Institute of Medicine, and the American College of Physicians have recommended a progressive, evidence-based, non-pharmacologic approach to care.

This study found the drug classes (acetaminophen, NSAID’s, opioids) most often prescribed for low back pain have a high correlation to those most associated with adverse drug events (ADE). While no causal relationship was established between chiropractic utilization and risk of ADE; the findings showcased a stunning reduction in ADE’s for those patients who had received chiropractic care within the previous 12 months.

“Many patients who are prescribed analgesic medications have low back pain; among US adults prescribed opioids, 59% have reported having back pain.”

 “Chiropractic care of low back pain is both safe and effective; a recent systematic review and meta-analysis found that for treatment of acute low back pain, spinal manipulation, as performed by chiropractors, provides a clinical benefit equivalent to that of NSAID’s, with no evidence of serious harms.”

 “The adjusted likelihood of an adverse drug event occurring in an outpatient setting within 12 months was 51% lower among recipients of chiropractic services as compared to non-recipients.”