Opioids for Sciatica? The Science PROVES Chiropractic is Better! | #478

Foreign hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode we have some fantastic brand new research that we're going to evaluate which is all about how chiropractic can reduce opioid related adverse events. This is massively actionable, it is a timely topic and it is something that you can utilize in all, all of your marketing, all of your conversations to help people understand that there are better alternatives than opioids out there. We're gonna dive into it and those talking points, clinical pearls and much more. Before we get started, I wanna say a few words about neck care. The best objective assessment of the cervical spine on the market. Reliable assessments and exercises for neuromuscular control, proprioception, range of motion and sensory motor integration. You can click on down below in the show notes. Check out neckcare@neckcare.com but today's podcast we're exploring a big question and that is can chiropractic care reduce the risk of opioid related adverse drug events in patients with sciatica? Have you ever seen a patient with sciatica? Probably today. And many people out there are still being recommended opioids that have sciatica. That, that is a massive problem. This study continues to plant the flag of the solution and this study says yes. And the numbers are super compelling. When I say yes, I mean chiropractic care can reduce that risk. So let's start with the big picture. Opioids have long been a go to treatment for musculoskeletal pain, including sciatica, despite limited non existent evidence so supporting any sort of effectiveness whatsoever. High harms, low effectiveness. Where's the Hippocratic oath? I do not know. But it is a massive problem. Opioids, as you are very well aware, come with massive risks. Addiction, dependency, overdose, death. And the latest data from the CDC shows that opioid related deaths in the US reached 25 per 100,000 people in. In 2021. Interesting number there, 2021, because we know that there was some effect of what went on with COVID and how opioid prescriptions, let's say, evolved. There was a sharp decrease in opioids being prescribed for spine related pain prior to the pandemic. While everybody goes lockdown mode, nobody can get the care and the many people can't get the care and treatment that they need. And pretty much as you've probably heard me say, all of those gains disappeared. And that is a travesty. Because the opioid crisis Basically has been driven by medical guidelines. Now, those guidelines have now discouraged opioid prescriptions, but we know many patients are still being prescribed these drugs every single day. And if I'm blunt about it, you listening right now? People in your community today were prescribed opioids for, for spinal complaints that were non emergent and not referred into your practice. That is a massive problem and it is resulting in death, it's resulting in disease, process, it's resulting in addiction, fractured families. And that's real, that's not extrapolating and taking it too far. It is the facts. And the more that we can get out there and tell the message of who we are and what we do, the better our communities will be. And a byproduct of that, your practice will be healthier as well. So what are the alternatives to opioids? Well, chiropractic, it's been deemed safe, effective, and of course it's drug free. And this study continues to provide us with the data necessary to back up those claims. So this study was produced in 2025, hot off the press. I'm gonna drop a link down in the show notes if you wanna check it out. It's titled association between Chiropractic Spinal Manipulation for Sciatica and Opioid Related adverse events. It's a retrospective cohort study. Retrospective cohort study is great. The other super interesting thing about the title of this, they said if you picked up on this chiropractic spinal manipulation. So this is super specific to literally what you do because they're calling out that the chiropractor was involved. Now we know spinal manipulation is a hallmark, spinal adjustments are hallmark of what we do as chiropractors. But spinal manipulation can sometimes be performed by other providers as well. So when they focus in on the chiropractic component, that's really important. It should perk up your ears because it's directly relevant to who you are and what you do. So in this study, they looked at over 744,000 patients diagnosed with sciatica. A lot of people. And these patients are split into two primary groups. Group number one were those who received chiropractic spinal manipulation. Group number two was those who received usual medical care, but no chiropractic. They tracked these patients not for a day, not for a week, not for a month, but for a full year, to see who experienced an opioid related adverse drug event, or ORAD as they called it here, opioid related adverse drug event. And the results were absolutely stunning, meaning patients who received Chiropractic care had a 71% lower risk of opioid related adverse events compared to those who received usual medical care, a 71% lower risk. That is astronomically high. Less than 1/10 of 1% of patients in the chiropractic spinal manipulation group experienced an ORAD, compared with 3/10 within the medical care group. So you were more than three times as likely if you received usual care to have an adverse event to opioids. And if you were in the chiropractic end, you had a 71% lower risk. Now, additionally on top of that, chiropractic patients were 32% less likely to be prescribed an opioid in the first massive. Now if you're thinking, well, of course they were less likely to be prescribed considering we're non prescribing, that's correct. But it's important to also highlight the fact that this indirectly highlights efficacy, meaning if somebody was still in abject pain with sciatica, it's very likely they'd go on to try to find another avenue. So it's not only that we are non prescribing physicians, which I think I take massive amounts of pride in, but the second component to that is we're able to help people so they don't go and want that script, which is that's a like double benefit, so to speak.

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So couple quotes from the study that I thought were really impactful was quote, adults with sciatica who initially received chiropractic spinal manipulation had a lower risk of an ORAD compared to matched controls not initially receiving chiropractic spinal manipulation, likely explained by a lower probability of opioid prescription. Next. It's just such a powerful statement because it means choosing chiropractic first doesn't just reduce pain. It can, as we've just said, it can actually help patients avoid these dangerous and unnecessary opioids altogether. So there's some takeaways here that are really, really important. And here's the thing. I know sometimes these studies can almost sound redundant. It's like chiropractic taking care and helping people with low back pain. It's like, I've heard it already. You have, but the market tells us most people haven't. So it's really important for you not to tune out and be like, yeah, I know, I know we can help with low back pain. I know we can help with headaches. I know we can help with this. I know we reduce medications. Can we get onto something else? The answer is no, because people are still being prescribed opioids en masse and people who have low back pain are still getting advanced interventions in mass. That means we have not done the completed job yet. The study is there not to do the job for us. The study is there to empower us with the information, to then market, to communicate and to ensure that we're doing everything we can to help our community live the healthiest life possible. And most of the time that's going to involve coming into your office at some point in their life. So don't tune out on this stuff. Please keep listening, please keep paying attention, please keep leaning in. Because these studies are so critically important. And some of the takeaways, again, chiropractic care is not just about pain relief. It's actually about safer health care choices. Excuse me. And this study adds to a massive body of continually growing evidence that early, early chiropractic intervention can help patients avoid opioids and the risks of that. That doesn't mean go try everything else and if nothing else works, go see the chiropractor, which sometimes has been the case. Oh, I get the people referred in when they're the worst of the worst. They've gone through everything else. That can be super helpful, don't get me wrong. But you know what, it's even better being the first referral choice and being able to help people avoid interventions that actually set them back as opposed to moving forward. I think another big takeaway again is it's time to share this type of message loud and clear. Many people at this point, it's not unknown that opioids are risky, but probably they have no clue that chiropractic care and what you do is actually a evidence based, research supported, it's the best solution. So getting out there and telling that message and that goes into using this data in your patient education and in your marketing. So, so when patients walk into your practice with sciatica, it's important that they understand by choosing your practice first, you're reducing your risk of opioids and you can weave that into your messaging in a variety of different ways, whatever is most elegant for you. But let people know even if they're coming in for sciatica and let's say they were not at risk. However you want to define that for going and getting an opioid, it's important to make it clear that that they're reducing that risk so that they can tell their friends, they can tell their colleagues and you have to be able to take the information and connect it. I always think of it like the old saying journey of a thousand miles starts with one step. If you expect the patient to jump from step one in knowledge to step 10, you lost them, you have to go step one, two, three, four and the amount of knowledge you have as a provider, you are blinded to the lack of knowledge with your patients. So just be clear, be direct, help them understand the benefits in totality of what you're offering. And again, medical doctors, they need to hear this too. Working to strengthen your relationships with other healthcare providers. MDDO whatever it might be Arnp, PA by showing them this research and highlighting that chiropractic should be the first line treatment for sciatica and back pain can can again not only help your business, but it also helps the people in your community live a better life. That's what we do at the MD connection via the evidence based chiropractor for a lot of docs around the world. As I always say, if you're listening to this and you join the program, you'll hear me say this on our implementation call, which is the program, it works 100% of the time when implemented and 0% when not implemented. So if you're interested in building relationships with other healthcare providers, head over to the evidencebasedchiropractor.com, check out the MD connection. It's, it's super affordable. It's paint by numbers and it works. Which those are all things that I like. So with this study there are some limitations. It's of course observational, not causal. That means that just because somebody gets chiropractic adjustments, it doesn't cause fewer orads, it's just associated. Of course, it's also important to know that about 9% of the usual medical care group ended up getting chiropractic care during the follow up period. That means the true difference might be even bigger if more people started with chiropractic first, tying into what we discussed just a few minutes ago. So there's important components to this one. Chiropractic care obviously plays a crucial role in reducing Opioid reliance. It's an opportunity for you to get out there and educate your patients and colleagues about this type of research. And I'm gonna say we, you have a responsibility to be part of the solution to the opioid crisis that only happens to through clear communication. Step one is you understanding this. So thank you so much for tuning in and listening to this podcast. Step two is taking action on it and that's really where the rubber meets the road. So wrapping things up. This study found that chiropractic care significantly reduces the risk of opioid related adverse events. Patients who received chiropractic for sciatica were less likely to be prescribed opioids in the first place. And this is a message that we should be sharing with patients, medical professionals, maybe even policymakers as well. So my challenge is to take this and utilize it, to share it with your patients, to use it in your marketing, and to have conversations with other healthcare providers in your community about the role that you play. And that's the most important aspect of this. Who we are and what we do is better positioned now than ever in the past. And I hope that that continues to be true. But there is a preponderance of research supporting the care that you deliver. And this isn't like a tight race like you know, this is not like, well, you could do this or this and you know, chiropractic won by the skin of its teeth. Not at all. Opioids cause harms. Anybody that provide, anybody that's providing them, I'm gonna say specifically for non emergent spinal pain. It's a conversation for another day, but they should be held to task on that. That's not your or my responsibility. But what is our responsibility is to ensure the people in our community know the truth about what's going on and the best options so they can be empowered to make the best decisions. And ultimately you are the one responsible for that. So if you have any questions about that, hit me up. Of course, Jeff. The evidencebasedchiropractor.com if you have not left a rating or review for this podcast, I would love it if you would take a moment and do so. That just helps more people find out about the podcast. And additionally, I want to wrap by saying a few words about Turncloud minimalist design without being sparse. And they've stripped away everything that's non essential, making everyday function simpler. And they've created an intuitive application where no one needs a user manual. So you've been frustrated with your EHR or you just want to check out what's out there, hop on a call with them turncloud.com connect with their team. Super affordable, super easy to use. If those things sound good to you, check out turncloud.com, i'll drop a link down in the show notes. Other than that, thank you so much for being a chiropractor. Have a fantastic week in practice and I will talk to you soon.

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