Chiropractic reduces Benzodiazepine prescriptions for radicular low back pain! New evidence…

Benzodiazepines are a class of psychoactive medications that are increasingly prescribed for patients with low back pain and commonly used in patients with radicular low back pain. However, because of insufficient evidence supporting the efficacy of these medications for low back pain and the risk of serious adverse events, clinical practice guidelines discourage their use.

Benzodiazepines are a sedative-hypnotic medications that act as a central nervous system depressant, having anti-convulsant, anxiolytic and muscle relaxant properties. The primary mechanisms of this drug are to inhibit central nervous system neurotransmitters. It is hypothesized that these medications result in an analgesic effect, but adverse effects can include sedation, addiction, and increased risk of suicide. Benzodiazepine prescriptions for back pain and chronic pain in the United States are increasing at alarming rates, more than tripling between 2003 and 2015!

Previous research has identified that patients receiving care with a chiropractor for low back pain had reduced odds of receiving an opioid prescription compared with other provider types. There is limited research examining the association between allied health interventions and Benzodiazepine prescriptions but some studies have demonstrated a reduction in utilization following these interventions.

Spinal manipulation therapy (SMT) is the most common treatment provided by chiropractors and has been found to be effective for low back pain and radicular low back pain. The authors of this study hypothesize that adults receiving SMT for a new diagnosis of radicular low back pain will have a reduced odds of receiving a Benzodiazepine prescription compared with those initiating care with a non-chiropractic provider over a follow-up period of 3, 6 and 12 months.

Comment from Dr. Thistle:

“These new ‘big data’ studies are providing some compelling evidence that seeing a chiropractor for low back (with or without radicular symptoms) can help reduced the use of these prescription medications that: 1) aren’t that effective anyway, and 2) come with a lot of potential side effects.“

RESEARCH REVIEW: Association Between Chiropractic Spinal Manipulation & Benzodiazepine Prescriptions for Radicular Low Back Pain

This paper was published in BMJ Open 2022 – READ IT HERE 

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