Sciatica has a way of making itself the center of attention.
That burning, shooting, electric pain traveling from your lower back into your buttock and leg can turn sitting at your desk, driving through Boston traffic, or simply putting on your shoes into a daily challenge.
For years, medications—including opioids—have sometimes been used to manage severe sciatic pain. But a major 2025 study published in PLOS ONE raises an important question: Could starting with chiropractic care help some patients reduce their exposure to opioids?
The results are worth paying attention to.
Researchers found that adults with sciatica who initially received chiropractic spinal manipulation were about 32% less likely to receive an oral opioid prescription during the following year compared with matched patients receiving usual medical care.
This Wasn’t a Small Study
We’re not talking about 20 people and somebody’s cousin with a bad back.
Researchers used a massive U.S. healthcare database containing information from more than 200 million patients. After carefully matching patients to make the groups as comparable as possible, researchers analyzed 372,471 chiropractic patients and 372,471 usual-medical-care patients with sciatica.
That’s nearly 745,000 matched patients.
The researchers then followed what happened over the next year.
The Opioid Difference Was Significant
Patients who initially received chiropractic spinal manipulation had a relative risk of 0.68 for receiving an oral opioid prescription compared with the usual-medical-care group.
Translated from research-speak into English: the chiropractic group had approximately a 32% lower relative risk of receiving an opioid prescription.
That’s particularly interesting because opioids come with well-recognized risks. The study discusses adverse effects ranging from dizziness and sedation to more serious concerns such as dependency, overdose, and respiratory depression.
Nobody wants their sciatica treatment to create a second problem.
What About Serious Opioid-Related Problems?
This is where the research becomes even more interesting.
The study’s primary outcome was actually opioid-related adverse drug events, including serious problems such as poisoning and overdose.
Over one year, these events occurred in:
· 0.09% of chiropractic patients
· 0.30% of usual-medical-care patients
That produced a relative risk of 0.29, meaning the chiropractic group experienced about a 71% lower relative risk of these opioid-related adverse events.
The researchers suggested that this difference was likely related, at least partly, to the chiropractic patients’ lower probability of receiving opioids in the first place.
Pretty simple concept: less exposure to a medication means fewer opportunities to experience its adverse effects.
Why Consider Chiropractic for Sciatica?
Sciatica typically occurs when a nerve root in the lower spine becomes irritated, often producing pain that travels into the leg.
Chiropractic spinal manipulation is a hands-on treatment directed toward the joints of the spine. Importantly, the researchers noted that spinal manipulation is recommended in multiple clinical practice guidelines as part of the management of sciatica when appropriately indicated.
At Charles Street Family Chiropractic, our goal isn’t simply to make your symptoms temporarily quieter.
We want to determine why you’re hurting.
Depending on your diagnosis, examination, and imaging findings, your treatment program may incorporate:
· Chiropractic spinal manipulation
· Non-surgical spinal decompression
· Therapeutic exercise
· Soft-tissue therapy
· Postural rehabilitation
· Home exercise recommendations
Not every person with sciatica requires the same treatment—which is why the examination comes first.
Does This Prove Chiropractic Prevents Opioid Use?
No—and that’s an important distinction.
This was a retrospective observational study, not a randomized clinical trial. Researchers used sophisticated statistical matching to account for differences between the groups, but observational research cannot prove that chiropractic treatment directly caused the reduction in opioid prescriptions or adverse events.
What the study does show is a very large and statistically significant association.
And this isn’t an isolated finding. The authors noted that previous studies have also found chiropractic spinal manipulation for spinal pain to be associated with lower opioid and gabapentin prescribing.
Looking for Sciatica Treatment in Boston?
If you’re suffering from sciatica, a herniated disc, radiating leg pain, numbness, tingling, or chronic low back pain, medication isn’t necessarily your only option.
At Charles Street Family Chiropractic, Dr. Chris Quigley evaluates patients from Boston, Beacon Hill, Back Bay, Cambridge, Brookline, Somerville, Newton, Quincy, and throughout Greater Boston who are looking for conservative approaches to low back and sciatic nerve pain.
If you’re searching for a Boston chiropractor for sciatica, non-surgical sciatica treatment in Boston, or herniated disc treatment without surgery, an evaluation can help determine whether chiropractic care is appropriate for your condition. Call us today at 617-720-1992 to schedule an evaluation to see if we can help. Put our over 40 years combined experience to work for you.
The Bottom Line
This enormous 2025 study found that patients with sciatica who initially received chiropractic spinal manipulation had a 32% lower relative risk of receiving an oral opioid prescription and a 71% lower relative risk of an opioid-related adverse drug event during the following year compared with matched patients receiving usual medical care.
That doesn’t mean you should stop an opioid or any other prescribed medication without talking with your prescribing healthcare provider.
But if you’re facing sciatica and would prefer to explore conservative treatment options, chiropractic care should be your first call.
At Charles Street Family Chiropractic, the goal is straightforward: identify what’s causing your pain, treat the problem conservatively when appropriate, and help you get back to living your life.
Preferably without your sciatic nerve running the show.
Reference
Trager RJ, Cupler ZA, Srinivasan R, Harper EG, Perez JA. Association Between Chiropractic Spinal Manipulation for Sciatica and Opioid-Related Adverse Events: A Retrospective Cohort Study. PLOS ONE. 2025;20(1):e0317663. doi:10.1371/journal.pone.0317663.
