Chiropractic care reduces tramadol prescriptions for radicular low back pain!

Close up of man taking in pill and another hand holding a glass of clean water

A growing body of evidence suggests seeing a chiropractor can help keep radicular back pain patients off prescription drugs like benzodiazepines, gabapentin, opioids in general and now, tramadol (a synthetic opioid) specifically!

Tramadol is an atypical, synthetic opioid that is often prescribed for low back pain. Previous studies have found that individuals with low back pain receiving spinal manipulation are less likely to be prescribed an opioid. However, no study has specifically focused specifically on the use of tramadol. 

Tramadol stimulates opioid receptors and inhibits norepinephrine and serotonin reuptake. As a result of the overuse of opioids in the United States and elsewhere, tramadol may be prescribed in place of stronger potency opioids as it is often perceived as a safer alternative, with fewer and less severe adverse events. Several major clinical practice guidelines for low back pain do not provide recommendations for or against tramadol prescription.

Considering the recent increase in tramadol prescribing for low back pain, the current study aimed to examine the association between receipt of spinal manipulation and tramadol prescription among adults with a new diagnosis of radicular low back pain. The authors hypothesized that adults receiving spinal manipulation would have a reduced likelihood of tramadol prescription relative to those receiving non-chiropractic medical care over a 1-year follow-up period.

This week’s Research Review: “Chiropractic Spinal Manipulation Reduces Tramadol Prescription for Radicular Low Back Pain

This paper was published in BMJ Open (2024)

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