In two articles evaluating early predictors of chronic work disability and the use of opioids for chronic back pain sufferers, chiropractic care was found to lead to a better outcome.

In one study, injured workers were categorized based on whether the first health care provider the worker saw for their injury was a chiropractor or not. The non-chiropractor group included primary care physicians, occupational medicine doctors, emergency room physicians and other physicians. Chiropractic care was found to be associated with lower odds of long-term disability.

With respect to drug use, as chiropractors do not have prescriptive privileges, the type of health care provider seen for the injury could be an important influence on patient opioid use. It was found that within the health care domain, the odds of long-term opioid use were substantially lower for workers who had a chiropractor as the first attending provider compared with workers who initially saw other types of providers, after adjusting for baseline pain, function, and injury severity.

In my opinion, this suggests that chiropractic care would be a better choice of treatment for work-related back pain with respect to getting an injured worker back to his or her employment while at the same time reducing dependence on opioids.

References:

  • Turner JA, Franklin G, Fulton-Kehoe D, et al. Early predictors of chronic work disability. A prospective, population-based study of workers with back injuries. Spine. 2008;33:2809–2818.
  • Opioid Use for Chronic Low Back Pain: A Prospective, Population-based Study Among Injured Workers in Washington State, 2002-2005 Gary M. Franklin, MD, MPH, Enass A. Rahman, MD, MPH, Judith A. Turner, PhD, J William E. Daniell, PhD, and Deborah Fulton-Kehoe, MPH, PhD (Clin J Pain 2009;25:743–751)