Should a chiropractor or ibuprofen be your first step for new back pain? A 2025 study of about 50,000 matched adults found a lower rate of opioid use disorder in the group that started with chiropractic care. However, it shows a link, not a cause. Here's what it found, and what it can't tell you.
How the Study Worked
Researchers compared two matched groups of 24,993 adults, each with a new episode of low back pain. One group started with chiropractic spinal manipulation, and the other received an ibuprofen prescription. Then they tracked everyone for up to two years. Also, people with serious causes of back pain, opioid use disorder, or a past opioid prescription were excluded (Trager et al., Health Science Reports, 2025).
The Numbers
- Opioid use disorder: 0.24% (chiropractic first) vs. 1.51% (ibuprofen first)
- Long-term opioid use: 0.42% vs. 1.85%
- Any opioid prescription: 30.96% vs. 45.00%
Notably, the study tracked opioid outcomes. It did not measure which group had less pain.
What It Can't Prove
This was a retrospective study, so it can't show that chiropractic care caused the difference. Also, it only covered people with no earlier opioid use. The authors say more research is needed. In addition, a 2021 review found that guidelines almost universally recommend spinal manipulation for spine pain, but that its effect compared with a placebo remains uncertain (Gevers-Montoro et al., Frontiers in Pain Research). So results vary from person to person.
Safety First
Get urgent medical care before any treatment if you have sudden leg weakness, loss of bladder or bowel control, or numbness in your groin. Also seek care for a fever or for pain after a major fall or accident. And don't change a prescribed medication without talking to your prescriber.
Your First Visit
Dr. Michael Karr, a UCLA Kinesiology graduate treating West LA patients since 1989, takes digital X-rays on your first visit. Then he explains what he finds and what care fits you. New patients pay $99 for their first chiropractic visit. In addition, we accept most PPO plans, Medicare, Workers' Comp, and MedPay. Also, we serve West LA, Santa Monica, Brentwood, Bel Air, Venice, Westwood, Beverly Hills, and Culver City.
Still want the full breakdown with FAQs? Read our complete guide: Chiropractor or Ibuprofen for Back Pain? What a 2025 Study Found.
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Individual results vary. This content is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before beginning any treatment program.
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