Chiropractor or Ibuprofen for Back Pain? What a 2025 Study Found
Chiropractor or ibuprofen for back pain? A 2025 study of about 50,000 matched patients with new low back pain compared the two. Those who started with chiropractic spinal manipulation had a much lower rate of opioid use disorder. However, it shows an association, not proof of cause, so results vary.
Chiropractic Care or Ibuprofen
Chiropractor or Ibuprofen for Back Pain? What the Study Compared
Researchers used a large U.S. health-records network. They looked at adults with a new episode of low back pain, with or without sciatica, between 2015 and 2023. Then they followed each person for up to two years. People with serious causes of back pain, opioid use disorder, or an earlier opioid prescription were left out. After matching, each group had 24,993 patients. One group started with chiropractic spinal manipulation, and the other group received an ibuprofen prescription (Trager et al., Health Science Reports, 2025).
What the Study Found
| Outcome over two years | Chiropractic first | Ibuprofen first |
|---|---|---|
| Diagnosed with opioid use disorder | 0.24% | 1.51% |
| Long-term opioid use | 0.42% | 1.85% |
| Any opioid prescription | 30.96% | 45.00% |
In relative terms, the chiropractic group had about 80% lower risk of opioid use disorder. Their risk of long-term opioid use was 77% lower, and their risk of any opioid prescription was 31% lower. Notably, the study measured opioid outcomes. It did not compare how much pain relief each group felt.
What This Study Can’t Tell You
The results are encouraging, but they have clear limits. First, this was a retrospective study, so it can show a link but cannot prove that chiropractic care caused the difference. Second, it only included people with no earlier opioid use, so it says nothing about anyone who already takes opioids. Third, the authors say the role of spinal manipulation in reducing opioid-related harms needs further study. So when you weigh a chiropractor or ibuprofen for back pain, treat this study as one useful data point, not a promise.
What Guidelines and Reviews Say
The study notes that the CDC and the Veterans Health Administration encourage non-drug treatment for acute low back pain. In addition, a 2021 review found that clinical guidelines almost universally recommend spinal manipulation for spine pain. It may be as effective as other recommended options, such as standard medical care or physical therapy. However, the review says its effect compared with a placebo or no treatment remains uncertain because the evidence is low quality (Gevers-Montoro et al., Frontiers in Pain Research, 2021). For more on how chiropractic care compares with therapy, see our guide to chiropractic vs. physical therapy for sciatica.
When to See a Doctor First
The study left out people with serious causes of back pain, so warning signs matter. Get urgent medical care first if you have sudden leg weakness, loss of bladder or bowel control, or numbness in your groin. Also seek care for a fever or for pain after a major fall or accident. If your exam shows you need a different kind of care, Dr. Karr will tell you.
What to Expect at West Los Angeles Chiropractic®
Dr. Michael Karr, a UCLA Kinesiology graduate treating West LA patients since 1989, takes digital X-rays on your first visit. Then orthopedic tests help pinpoint the source of your pain, and he explains what he finds. If you’re deciding between a chiropractor or ibuprofen for back pain, a first visit with X-rays can help you choose. New patients pay $99 for their first chiropractic visit. We accept most PPO plans, Medicare, Workers’ Comp, and MedPay.
We’re at 11340 W. Olympic Blvd., Suite 165, on the ground floor with free parking, near the 405 and 10. We serve West LA, Santa Monica, Brentwood, Bel Air, Venice, Westwood, Beverly Hills, and Culver City. We’re open Saturdays. You can also read more on our chiropractic research page.
Frequently Asked Questions
Chiropractor or ibuprofen for back pain: which is better?
This study did not measure pain relief, so it can’t answer that. It compared opioid outcomes after starting with chiropractic care versus ibuprofen. Dr. Karr can help you choose after your exam.
Does chiropractic care prevent opioid addiction?
No. The study found a link, not a cause, and the authors say we need more research. It also only covered people with new back pain and no earlier opioid use.
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