It may come as a surprise to some that one of the most common conditions for which opioid pain medications are prescribed is pain in the lower back. However, with the rise of the opioid epidemic, experts have been prompted to reassess how best to treat lower back pain. Thus, non-drug treatments are being considered as a first line of defense.
Opioid pain medications come with a high risk of serious side effects. According to the Centers for Disease Control and Prevention, as many as 1 in 4 people who receive prescription opioids for non-cancer related pain also struggle with addiction.
A safer approach
In 2017, the American College of Physicians (ACP) updated its back pain treatment guideline to recommend first using non-drug treatments for chronic lower back pain before prescribing pain medications. Research shows non-drug treatments such as spinal manipulation, physical therapy, massage, or acupuncture provide may people with relief, along with a low risk of side effects. The ACP says opioids should be a last resort because of the high risk of serious side effects.
Likewise, the Department of Defense/Veterans Administration’s 2017 guideline for lower back pain promotes the use of spinal manipulation and other nondrug options.
The patient summary states that, “Complementary medical treatments like acupuncture, spinal manipulation therapy, and yoga are helpful for many people.”
Research continues to support that non-drug treatments are not only effective, but also can help people avoid or reduce opioid use. A review of studies published in the March 2020 issue of Pain Medicine found that patients with spinal pain who received chiropractic care received fewer opioid prescriptions.
Similarly, a 2019 study in the British Medical Journal found that patients who saw a chiropractor as their initial provider for back pain had 90 percent lower odds of both early and long-term opioid use.