Reduced likelihood of gabapentin prescription in US adults receiving chiropractic spinal manipulation for low back pain

A new study conducted by researchers at University Hospitals (UH) Connor Whole Health sheds light on potential benefits of chiropractic care for adults with radicular low back pain (i.e., sciatica).

The study, published in BMJ Open, entitled "Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using U.S. data," investigated the relationship between chiropractic spinal manipulative therapy (CSMT) and the prescription of gabapentin, an off-label treatment for radicular low back pain.

The researchers hypothesized that adults under 50 years of age receiving CSMT for newly diagnosed radicular low back pain would have reduced odds of being prescribed gabapentin over a one-year follow-up period. Using a retrospective cohort study design, the research team analyzed data from a large U.S. health care network comprising millions of patient records.

The CSMT cohort had significantly lower odds of receiving a gabapentin prescription compared to the usual medical care cohort. The odds ratio was 0.53 (p<0.0001), indicating a meaningful reduction in gabapentin use among patients who received chiropractic care for radicular low back pain.

"We are excited by the implications of our findings, which suggest that chiropractic care could offer benefits to managing low back pain and lead to greater concordance with clinical practice guidelines with respect to medication prescribing," said lead author Robert J Trager, DC, from UH Connor Whole Health. "While chiropractic spinal manipulation is already recommended for low back pain, this study re-affirms its utility and sheds light on its other potential pain management benefits."

As the medical community continues to seek ways to improve patient care, studies like this one contribute valuable insights into the potential benefits of CSMT for low back pain. With this study, the authors build on their previous work, which showed that recipients of CSMT were less likely to be prescribed a benzodiazepine, and other studies, which showed a similar finding with opioids.