A recent study discovered a significant association between chiropractic spinal manipulative therapy (CSMT) and a decrease in the use of gabapentin in the treatment of radicular low back pain (rLBP) amongst adults under 50. Researchers carried out this retrospective cohort study in the U.S., tapping a network of over 122 million patients’ medical and pharmacy records from 2017 to 2023.
The study cohort consisted of 1,635 adults with a new diagnosis of rLBP, divided between those receiving CSMT and those under usual medical care. The findings revealed a significant reduction in the odds of gabapentin prescription in the CSMT cohort over a year-long follow-up period. In many cases, the reduction in gabapentin use can be traced back to the effectiveness of the CSMT in reducing pain and improving the patient’s overall quality of life.
The research suggests that early CSMT intervention might influence the treatment pathway for rLBP, potentially reducing the need for certain prescription medications.
“…several clinical practice guidelines do not recommend gabapentin for the treatment of LBP or rLBP, including those of the American Family Physician (2017).”
“Gabapentin prescription was less frequent in the CSMT cohort over the 1-year follow-up after rLBP diagnosis both before and after propensity matching. After matching, 4.6% of patients in the CSMT cohort and 8.3% in the usual medical care cohort had received a gabapentin prescription.”
“Accordingly, our findings add to growing evidence that receipt of CSMT early in the care pathway for new onset LBP/rLBP could lead to greater concordance with these guidelines with respect to medication prescribing practices. In addition, our findings are consistent with some authors’ recommendations that patients with LBP/ rLBP should initiate treatment with non-pharmacological providers such as chiropractors.”
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