ArticleHealth science reports2025
Association Between Spinal Manipulative Therapy for Low Back Pain With or Without Sciatica and Opioid Use Disorder: A Retrospective Cohort Study.
Article in Health science reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Clarifying statistical methods in a TriNetX analysis of statins and osteoporosis in CKD patients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
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- Association Between Spinal Manipulative Therapy for Low Back Pain With or Without Sciatica and Opioid Use Disorder: A Retrospective Cohort Study.Health science reports · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Background and Aims: Previous research suggests patients receiving spinal manipulative therapy (SMT) for low back pain (LBP) are less likely to be prescribed opioids. However, the clinical implications of this finding are unclear. We tested the hypothesis that opioid-naïve adults receiving SMT for LBP are less likely to develop opioid use disorder (OUD) compared to matched controls prescribed ibuprofen over 2 years follow-up. Methods: We queried a United States data resource (TriNetX) for patients age ≥ 18 years with a new episode of LBP with/without sciatica from 2015 to 2023 (allowing for up to 2 years of follow-up to 2025), excluding those with serious pathology, OUD, and opioid prescription. We divided patients into cohorts: (1) SMT and (2) ambulatory ibuprofen prescription, using propensity matching for OUD risk factors. Our primary outcome was the risk ratio (RR) of OUD. We secondarily explored the RR for long-term opioid use, and opioid prescription RR and mean count. Primary analyses conducted in TriNetX and R used logistic regression for matching, standardized mean difference to assess between-cohort balance (threshold of ≤ 0.1), and contingency tables for RRs, using a significance threshold of Results: 24,993 patients remained per cohort following matching. Comparing the SMT cohort to ibuprofen cohort, there was a significantly lower incidence and risk of OUD [95% CI] (0.24% vs. 1.51%; RR = 0.20 [0.15, 0.28]; Conclusion: Adults receiving SMT for new LBP had a lower risk of OUD compared to matched controls prescribed ibuprofen. These findings corroborate guidelines recommending first-line SMT for LBP. The role of SMT in mitigating opioid-related harms requires further investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.