Chiropractic - Effective Alternative To Surgery And Opioid Painkillers For Back Pain

The New Zealand Chiropractors' Association (NZCA) is urging people suffering from back pain to consider chiropractic care as an effective alternative to surgery and opioid painkillers. Current research and expert recommendations highlight the potential risks and limited efficacy of these traditional treatments, while emphasising the benefits of non-invasive chiropractic interventions.

NZCA spokesperson, Dr Jenna Duehr, chiropractor explains: ‘At a time when the New Zealand health service is struggling to cope, the country is wasting billions of dollars on surgical and pharmacological treatments for chronic primary low back pain (LBP) when evidence-informed recommendations on non-surgical interventions clearly supports the use of chiropractic techniques.’

According to ACC in New Zealand during 2009–2020, there were 3.3 million ACC claims for LBP with a total cost of NZ$4 billion.

Dr Jenna Duehr adds: ‘Back pain is one of the most common health issues, affecting millions of people worldwide. It can significantly impact daily activities and quality of life. Traditionally, surgery and opioid painkillers have been prescribed to manage severe back pain, but recent evidence suggests these approaches may not be the best solutions.’

The Risks of Surgery and Opioid Painkillers

1. Surgery: Australian Orthopaedic surgeon Professor Ian Harris highlighted the over-reliance on surgery in a presentation at the New Zealand Pain Society (NZPS) conference in March 2024. He pointed out that surgery is often ineffective for treating chronic pain, particularly in the neck, back, knees, and hips. Harris emphasised that surgeries like spinal fusions are expensive, potentially harmful, and often no more effective than placebo procedures (NZPS Conference, 2024).
2. Opioid Painkillers: The opioid crisis has brought to light the dangers of relying on these medications for pain management. The Centers for Disease Control and Prevention (CDC) highlights that opioid painkillers carry a high risk of addiction and overdose. Long-term use can lead to dependency, tolerance, and a range of adverse health effects, making them a less desirable option for chronic back pain management (CDC, 2021).

The OPAL trial, published in The Lancet, late last year, found no significant difference in pain severity between opioid and placebo groups for acute low back and neck pain. This study underlines that opioids should not be recommended for these conditions due to their ineffectiveness and potential adverse effects (Lancet, 2023).

Chiropractic: Effective Alternative

Chiropractic care, particularly spinal adjustments, has gained recognition for its efficacy in treating back pain without the associated risks of surgery and opioids. Key benefits include:

1. Non-Invasive Treatment: Chiropractic care involves hands-on spinal adjustments and other techniques to address joint mobility and function and improve the communication between the brain and the body via the nervous system. This non-invasive approach avoids the risks associated with surgical procedures.
2. Pain Relief and Functional Improvement: A systematic review published in the Journal of the American Medical Association (JAMA) found that spinal manipulation is associated with moderate improvements in pain and function in patients with acute lower back pain (JAMA, 2017). Chiropractic adjustments can change the brain’s awareness of the body, reduce inflammation, improve mobility and function and may reduce the risk of further injury..
3. Reduced Reliance on Medications: Chiropractic care focuses on addressing the root cause of pain rather than masking symptoms with medications. This holistic approach can reduce the need for opioid painkillers and minimize the risk of addiction and side effects.
4. Cost-Effective Care: According to a study in the Journal of Manipulative and Physiological Therapeutics, patients receiving chiropractic care for back pain incurred lower overall healthcare costs compared to those receiving conventional medical treatment, including surgery and medication (JMPT, 2016).

Dr Jenna Duehr adds: ‘The evidence is clear that chiropractors can play an important role in evidence-informed, people-centred, interprofessional and collaborative care for spinal and nervous system health. As New Zealand grapples with developing a health service fit for the 21st century we need to focus on the vital role of allied health professionals in keeping people out of the hospitals and enjoying a healthy and active life.’

References:

• Centers for Disease Control and Prevention (CDC). (2021). "Opioid Overdose Crisis." [CDC Website]
• Journal of the American Medical Association (JAMA). (2017). "Spinal Manipulative Therapy for Acute Low Back Pain: A Systematic Review and Meta-analysis." [Journal Reference]
• Journal of Manipulative and Physiological Therapeutics (JMPT). (2016). "Cost of Care for Patients with Back Pain from Chiropractic vs. Medical Treatment." [Journal Reference]
• New Zealand Pain Society (NZPS) Conference. (2024). "Presentation by Professor Ian Harris." [Conference Reference]
• The Lancet. (2023). "Opioid Analgesia for Acute Low Back Pain and Neck Pain (the OPAL Trial): A Randomised Placebo-Controlled Trial." [Journal Reference]
• American College of Physicians (ACP). (2017). "Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline." [ACP Website]
• World Health Organization (WHO). (2023). "WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings " [WHO Website]

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