Nonpharmacologic Therapy Cuts Opioid Use Disorder Risk With Low Back Pain

MONDAY, Nov. 9, 2026 (HealthDay News) -- Guideline-compliant nonpharmacologic treatment for acute low back pain (aLBP) lowers the risk for opioid use disorder (OUD) or overdose diagnosis after one year, according to a study published online Oct. 19 in JAMA Network Open. Lisa V. Doan, M.D., from New York University in New York City, and colleagues estimated the incidence of new OUD or overdose diagnosis among opioid-naive patients with Medicaid coverage initiating treatment for aLBP. The analysis included 399,500 Medicaid patients who initiated treatment for newly diagnosed aLBP (2016 through 2019).The researchers found that the cumulative incidence of OUD or overdose diagnosis was 1.4 percent at seven months and 2.3 percent at 13 months. The greatest risk was seen for initiating higher-dose opioids (>50 mg of morphine equivalent) as part of the initial treatment, increasing the risk for OUD or overdose by 146.6 percent. Similarly, compared with not initiating, initiating lower-dose opioids prescribed for more than seven days increased risk by 105.2 percent, while gabapentinoids increased risk by 101.6 percent. Lower risks for OUD or overdose diagnosis were seen with nonpharmacologic, noninterventional therapies. The largest relative risk reduction was associated with initiating versus not initiating chiropractic care, decreasing the risk by 32.8 percent. Similarly, initiating physical therapy was associated with a 31.1 percent decreased risk."Our findings support prioritizing guideline-recommended nonpharmacologic, noninterventional therapies as first-line care for aLBP," Doan said in a statement. "Pharmacologic therapies might be considered after weighing potential benefits against longer-term risks. However, we urge caution when opioids are prescribed, minimizing dose and duration."Abstract/Full Text.Sign up for our weekly HealthDay newsletter

Nonpharmacologic Therapy Cuts Opioid Use Disorder Risk With Low Back Pain

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