New Research Links Chiropractic Care for Sciatica to Lower Opioid Risks

What a 2025 study of more than 740,000 adults found about chiropractic spinal manipulation, sciatica and opioid side effects, and what it means for you.

By Dr Naomi Swan, Chiropractor and Co-director ·

27 April 2026

· 5 min read

Chiropractor using a spine diagram to explain sciatica and treatment options to a patient

In short

A 2025 study of more than 740,000 adults with sciatica found that people who received chiropractic spinal manipulation had a 71% lower risk of opioid-related adverse events over 12 months than those who received usual medical care. It supports chiropractic care as a sensible, conservative first option for many people with sciatica, using techniques such as spinal adjustments and flexion distraction.

When sciatica strikes, the pain can be sharp, burning, and often runs from the lower back down into the leg. For many people, this makes daily activities like sitting, standing, or even walking very difficult. Traditionally, some patients have been prescribed opioid medications to manage sciatica pain. But new research has shown that chiropractic care, specifically spinal manipulation, may not only help with symptoms but also reduce the risks linked to opioid use.

What did the sciatica study find?

A 2025 study published in PLoS ONE looked at more than 740,000 adults with sciatica. Researchers compared two groups: those who received spinal manipulation (a common chiropractic treatment) and those who received usual medical care.

The results were significant:

People who received spinal manipulation had a 71% lower risk of opioid-related adverse events over a 12-month period.
Adverse events included serious side effects such as dizziness, sedation, constipation, nausea, and in severe cases, addiction or overdose.

Why does this matter if you have sciatica?

Sciatica is more than just back pain. It is often caused by irritation or pressure on the sciatic nerve, leading to pain, tingling, or weakness down the leg. While opioids may temporarily mask pain, they do not address the underlying cause.

How do we treat sciatica at Health First Chiropractic?

Chiropractic care offers a drug-free approach. At Health First Chiropractic in Modbury North, we often use a combination of:

Spinal adjustments to improve joint movement and reduce irritation on nerves
Flexion distraction therapy to gently relieve pressure on lumbar discs
Soft tissue therapy or dry needling if muscle tension is part of the problem
Exercise and posture guidance, where it suits you, to support long-term recovery

Dr Naomi Swan using a flexion distraction table with an older patient in Modbury North — Dr Naomi Swan using flexion distraction, a gentle technique often used for disc-related pain and sciatica.

These treatments aim to improve mobility, ease pain, and support your body’s natural healing without relying on strong medications.

When to call us: leg pain that’s getting worse, or that comes with numbness, tingling or weakness, is worth having assessed promptly. New loss of bladder or bowel control, or numbness around the groin or inner thighs, needs urgent medical care, so call 000 or go to your nearest emergency department.

What does this mean for you?

The findings of this study back up what many patients in Adelaide’s north-east already know: chiropractic care can be a sensible, conservative first option for many people with sciatica. It is not about avoiding medical care when needed. It is about starting with conservative options that may reduce your reliance on medications with unwanted side effects.

References

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.

Written by

Dr Naomi Swan

Chiropractor and co-director of Health First Chiropractic in Modbury North, with over 20 years in practice and a Master of Chiropractic. Naomi is also a supervisor and examiner at the Australian Chiropractic College in Adelaide.

Meet Naomi →

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Sciatica slowing you down?

If you’re in Modbury, Modbury North, Hope Valley, Highbury, St Agnes or anywhere across the north-eastern suburbs, we’ve been looking after people with sciatica and lower back and leg pain for 20 years. We’ll find out where your pain is coming from and explain your options clearly. Every visit is one-on-one in a private room, and no referral is needed.

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Common questions

Frequently asked questions

Have another question about sciatica? Give us a call and we’ll happily talk it through.

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Sciatica is pain caused by irritation of or pressure on the sciatic nerve, which runs from the lower back through the buttock and down the leg. It often feels sharp, burning or electric, and can come with tingling, numbness or weakness in the leg. A disc bulge pressing on a nerve root is one of the most common causes.

Yes. Chiropractic care is a common conservative option for sciatica. We start with a thorough assessment to find where the nerve is being irritated, then use techniques such as spinal adjustments, flexion distraction and soft tissue work, matched to your condition and the style of care you’re comfortable with. If anything in your assessment suggests you need imaging or a medical referral, we’ll tell you.

Not without talking to your GP. This study doesn’t mean medication is never appropriate. It suggests that starting with conservative care may reduce how much you need to rely on medications with unwanted side effects. Any change to prescribed medication should be made with your doctor.

Many cases of sciatica improve over a few weeks to a few months, though it varies with the cause and how long symptoms have been present. If leg pain is severe, getting worse, or comes with numbness or weakness, have it assessed sooner rather than later.

No. You don’t need a referral to see a chiropractor, and most people don’t need a scan before their first visit. We assess you clinically, and if imaging would change your care, we’ll explain why and arrange a referral.