Chiropractic for Sciatica

Radicular low back pain, or pain that radiates from the low back down the back of the leg, is known as sciatica. Too often, medical doctors prescribe gabapentin, an anti-convulsant / anti-epileptic medication used as an off-label treatment for sciatica.

Chiropractic spinal manipulation is your best option for treating sciatica, since the usual cause is a pinched / inflamed spinal nerve. New research also shows that patients with sciatica improve under chiropractic care to the point that they are less likely to need gabapentin, underscoring chiropractic’s effectiveness.

Researchers found that among adults under age 50 with newly diagnosed radicular low back pain, patients who received chiropractic spinal manipulative therapy were significantly less likely to be prescribed gabapentin over a one-year follow-up period. Compared to patients who did not receive chiropractic SMT (and who received standard medical care instead, including medication), patients who visited a chiropractor were 53 percent less likely to need gabapentin in the following year. Findings appear in BMJ Open.

Not surprisingly, gabapentin’s off-label use is not supported by research, according to the study authors, who state that “systematic reviews in 2018 and 2022 demonstrated clear evidence of lack of its effectiveness for [radicular low back pain]. Additionally, there is growing evidence of its risks including abuse, misuse, dependence and withdrawal. … Several clinical practice guidelines do not recommend gabapentin for the treatment of LBP or rLBP, including those of the American Family Physician (2017). Evidence supporting the use of gabapentin for LBP is considered inconclusive by guidelines from the North American Spine Society (2020), Global Spine Care Initiative (2020) and Veterans Affairs/Department of Defense (2019 and 2022).”

(By the way, previous research also suggests chiropractic spinal manipulative therapy reduces the odds of needing a prescription for opioids or benzodiazepines (neither of which are recommended for acute low back pain or radicular LBP, either, according to the study authors.)

Not the first time a medication has been prescribed – either for an intended or off-label use – despite the potential for more harm than good. But that leads us to the clear takeaway for anyone with sciatica, particularly if their medical doctor has recommended or prescribed gabapentin (or another medication): go to a chiropractor instead!