Evidence map›Paper›PMID 41404361›Full record

ReviewPain reports2026

Impact of chiropractic care on opioid use for noncancer spine pain: systematic review and meta-analysis.

Peter C Emary, Kelsey L Corcoran, Brian C Coleman, Amy L Brown, Carla Ciraco, Jenna DiDonato, Li Wang, Rachel J Couban, Abhimanyu Sud, Jason W Busse

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Pain reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Peter C EmaryMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-3044-8415
Kelsey L CorcoranCenter for Gerontology and Healthcare Research, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA.
Brian C ColemanDepartment of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA.
Amy L BrownPrivate Practice, Cambridge, ON, Canada.
Carla CiracoPrivate Practice, Toronto, ON, Canada.
Jenna DiDonatoPrivate Practice, Ancaster, ON, Canada.
Li WangMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.
Rachel J CoubanMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.
Abhimanyu SudDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Jason W BusseMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Opioids are commonly prescribed for spine-related pain; however, emerging evidence suggests that access to chiropractic care may reduce reliance on opioids. We conducted a systematic review and meta-analysis to assess the impact of chiropractic care on new or continued prescription opioid use among adults with noncancer spine pain. We searched for eligible randomized controlled trials (RCTs) and observational studies in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature up to March 20, 2025. Paired reviewers independently assessed risk-of-bias and extracted data. We performed random- and fixed-effects meta-analyses and used GRADE to assess the certainty of evidence. In total, 2 RCTs (838 participants) and 18 cohort studies (6,035,220 participants) were included in our analyses. We found very low certainty evidence that, compared with standard medical care alone, receipt of chiropractic care may reduce the odds of receiving prescription opioids by 64% (odds ratio [OR] = 0.36; 95% confidence interval [CI], 0.25-0.52; absolute risk reduction [ARR] 15%). However, we found a credible subgroup effect that earlier receipt of chiropractic services (within the first 30 days of presenting with spine-related pain) is associated with a greater decrease in the odds of receiving prescription opioids (OR = 0.33; 95% CI = 0.22-0.51; ARR = 15%) than later (≥30 days after presentation: OR = 0.73; 95% CI = 0.53-0.99; ARR = 8%; test of interaction,

Indexed as

ChiropracticMeta-analysisOpioidSpine painSystematic review

Identifiers

PMID41404361
PMCPMC12705058

What OpenQuestion holds

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Registered trials

None linked

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.