A recent landmark study conducted by researchers at University Hospitals Connor Whole Health has unveiled compelling evidence regarding the efficacy of chiropractic spinal manipulation (CSM) in the management of sciatica. Sciatica is a common neurological condition characterized by pain that radiates along the path of the sciatic nerve, which runs from the lower back down to the legs. This condition can lead to debilitating symptoms, including pain, numbness, and muscle weakness, making effective treatment essential for affected individuals. What makes this new research particularly noteworthy is its finding that adults with newly diagnosed sciatica who received CSM were significantly less likely to encounter opioid-related adverse drug events (ORADEs) over the course of a year compared to those who received conventional medical treatment.
The ongoing opioid crisis has underscored the necessity for effective non-pharmacological alternatives for pain management. Given this context, the study’s findings spotlight the potential of CSM as a viable option that could minimize reliance on opioids, which are often associated with severe side effects, including the risk of overdose and even death. Dr. Françoise Adan, Chief Whole Health and Well-being Officer at University Hospitals, emphasized the importance of utilizing evidence-based practices in light of current public health concerns surrounding opioid prescriptions.
Published in the peer-reviewed journal PLOS One, this retrospective cohort study utilized an extensive database from the TriNetX Diamond Network, encompassing a population of over 744,000 patients. The researchers’ analysis indicated a notably low incidence of ORADEs among patients undergoing CSM, reporting only 0.09% of individuals experiencing such events within the one-year follow-up period. In contrast, the cohort that received standard medical care experienced a rate of 0.30%. The findings yield a risk ratio of 0.29, suggesting that patients receiving CSM were a staggering 71% less likely to suffer from ORADEs, highlighting its potential as a safer therapeutic intervention.
The implications of these findings transcend mere statistical outcomes. They suggest that CSM not only aids in pain relief but also plays a crucial role in preventing severe complications associated with opioid use. According to Dr. Robert Trager, the lead author of the study, previous research had pointed to a reduced likelihood of opioid prescriptions among those receiving chiropractic care. However, their investigation represents a novel approach by focusing specifically on opioid-related adverse events, thus adding critical clinical relevance to the existing body of literature.
Roshini Srinivasan, MD, who contributed as a co-author and is a resident physician at Duke University Hospital, articulated the significance of this research by stating that CSM serves not only as an effective method for pain relief but could also be a life-saving intervention. These sentiments resonate strongly in a healthcare landscape that is increasingly recognizing the imperative to seek alternatives to opioid-based therapies.
To maintain methodological rigor, the study excluded patients with prior ORADEs and those suffering from opioid use disorder. This decision warrants discussion, as it ensures that the analyzed outcomes are more likely attributed to the interventions in question rather than influenced by pre-existing conditions. Additionally, the researchers employed propensity score matching to mitigate biases by balancing critical variables such as age, sex, other substance use disorders, and various medication usage.
Despite the robust findings, the authors acknowledged limitations inherently associated with retrospective studies, such as the potential for unobserved confounding factors and constraints tied to utilizing real-world data. Nevertheless, they made a strong case that their results align with existing clinical practice guidelines that advocate for a multimodal treatment approach, incorporating spinal manipulation as an effective strategy for treating sciatica.
This study does not merely conclude with its promising findings; it also lays the groundwork for further inquiries into the mechanisms by which CSM may be contributing to reduced ORADEs. Future research could involve controlling for other variables that may explain the benefit observed, including the broader impacts of consulting non-pharmacological healthcare providers like chiropractors and physical therapists.
Moreover, the findings contribute to a growing narrative that challenges the conventional reliance on pharmaceuticals for pain management. As public health experts continue to seek solutions to the opioid epidemic, evidence indicating that CSM can effectively alleviate sciatica symptoms while minimizing the risk of serious complications represents a significant stride forward in pain management strategies.
In conclusion, the study led by University Hospitals Connor Whole Health provides robust evidence that chiropractic spinal manipulation holds promise as a safer, non-pharmacological alternative for managing sciatica symptoms. Given the rising concern over opioid prescribing practices and their associated risks, the findings advocate for the integration of CSM into the standard treatment protocols for sciatica, aligning with a paradigm shift toward holistic, patient-centered care in the management of chronic pain.
Subject of Research: Chiropractic spinal manipulation and its effects on opioid-related adverse drug events in sciatica patients
Article Title: Association between chiropractic spinal manipulation for sciatica and opioid-related adverse events: A retrospective cohort study
News Publication Date: 2025
Web References: University Hospitals Website
References: Trager RJ, Cupler ZA, Srinivasan R, Harper EG, Perez JA: Association between chiropractic spinal manipulation for sciatica and opioid-related adverse events: A retrospective cohort study. PLOS ONE. 2025, 20:e0317663. 10.1371/journal.pone.0317663
Image Credits: Credit: University Hospitals
Keywords: Chiropractic care, Spinal manipulation, Sciatica, Opioid crisis, Non-pharmacological treatment, Pain management, Adverse drug events, Clinical research.
