A retrospective study of outpatient and inpatient claims from 216,504 individuals 18 and older across the United States demonstrated that when compared with seeing a primary care provider as the initial provider, patients who first saw a conservative therapist (chiropractors, acupuncturists, and physical therapists), all had significantly decreased odds of both early and long-term opioid use. A growing body of evidence suggests the approaches provided by these conservative therapists (e.g. spinal manipulation, acupuncture, massage, superficial heat) are effective for reducing acute low back pain intensity and improving function.
This highlights the importance of including conservative therapists as a first line strategy to provide evidence-based nonpharmacological interventions to reduce the risks of early and long-term opioid use.
This article is available as BMJ Open https://bmjopen.bmj.com/content/9/9/e028633