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Despite increasing public and professional awareness, revised pain-management guidelines and other signs of change, the numbing numbers still stand out: an estimated 130 deaths a day due to an opioid overdose.
Could a lasting solution be as simple as visiting a doctor of chiropractic or other conservative care provider first? You probably know the answer, but now research is proving it. Case in point: a new national study comparing first provider choice with early- and long-term opioid use in patients with low back pain.
Published in BMJ Open, this study evaluated short- and long-term opioid use based on initial provider type seen: conservative care practitioner (chiropractor, acupuncturist or physical therapist) or primary care medical physician (PCP). Participants included 215,000-plus U.S. adults diagnosed with new-onset low back pain and "opioid naive."
The study defined early opioid use as "an opioid fill within 30 days of the index visit" and long-term use as "an initial opioid fill within 60 days of the index date and either 120 or more days' supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months."
Researchers evaluated inpatient / outpatient claims from patient visits and pharmacy claims to correlate first provider type seen with opioid use, finding that LBP patients whose initial visit was with a DC were a staggering 90 percent less likely to use opioids early compared to patients who saw a PCP first.
Significantly reduced odds for early opioid use were also noted for acupuncture and physical therapy patients. LBP patients who first visited a doctor of chiropractic or other conservative provider were also less likely to use opioids long term compared with patients visiting a PCP.
ER physicians, orthopedic surgeons, neurosurgeons and rehab physicians were also included in the analysis. Patients visiting any of the above MD specialists first also had lower odds of early opioid use compared to primary care physicians (although not as significant as visiting a conservative-care provider), with the exception of ER physicians (dramatically higher odds for early use compared with PCPs). However, odds for long-term use were not significantly different compared to primary care providers for all of the above specialist types, with the exception of rehab physicians (still significantly lower odds compared to PCPs).
If that's not enough proof, a second study, this one published in Pain Medicine, reviewed six previous studies involving more than 60,000 participants with spinal pain, finding that patients who saw a chiropractor were 64 percent less likely to use opioids compared to patients who visited another type of health care provider.
It makes sense that patients who visit chiropractors are less likely to use opioids, since chiropractors provide nondrug, nonsurgical care. But the bottom line is, visit a chiropractor, reduce your risk of using a dangerous opioid! In light of the sobering statistics on opioid deaths, visiting a chiropractor for your pain could be a life-saving decision.
Could a lasting solution be as simple as visiting a doctor of chiropractic or other conservative care provider first? You probably know the answer, but now research is proving it. Case in point: a new national study comparing first provider choice with early- and long-term opioid use in patients with low back pain.
Published in BMJ Open, this study evaluated short- and long-term opioid use based on initial provider type seen: conservative care practitioner (chiropractor, acupuncturist or physical therapist) or primary care medical physician (PCP). Participants included 215,000-plus U.S. adults diagnosed with new-onset low back pain and "opioid naive."
The study defined early opioid use as "an opioid fill within 30 days of the index visit" and long-term use as "an initial opioid fill within 60 days of the index date and either 120 or more days' supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months."
Researchers evaluated inpatient / outpatient claims from patient visits and pharmacy claims to correlate first provider type seen with opioid use, finding that LBP patients whose initial visit was with a DC were a staggering 90 percent less likely to use opioids early compared to patients who saw a PCP first.
Significantly reduced odds for early opioid use were also noted for acupuncture and physical therapy patients. LBP patients who first visited a doctor of chiropractic or other conservative provider were also less likely to use opioids long term compared with patients visiting a PCP.
ER physicians, orthopedic surgeons, neurosurgeons and rehab physicians were also included in the analysis. Patients visiting any of the above MD specialists first also had lower odds of early opioid use compared to primary care physicians (although not as significant as visiting a conservative-care provider), with the exception of ER physicians (dramatically higher odds for early use compared with PCPs). However, odds for long-term use were not significantly different compared to primary care providers for all of the above specialist types, with the exception of rehab physicians (still significantly lower odds compared to PCPs).
If that's not enough proof, a second study, this one published in Pain Medicine, reviewed six previous studies involving more than 60,000 participants with spinal pain, finding that patients who saw a chiropractor were 64 percent less likely to use opioids compared to patients who visited another type of health care provider.
It makes sense that patients who visit chiropractors are less likely to use opioids, since chiropractors provide nondrug, nonsurgical care. But the bottom line is, visit a chiropractor, reduce your risk of using a dangerous opioid! In light of the sobering statistics on opioid deaths, visiting a chiropractor for your pain could be a life-saving decision.
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Written by Julian Newhill, Registered Osteopath (M.Ost, B.A.(Hons), Dip S.M.). Julian has 14 years of clinical experience specialising in spinal musculoskeletal conditions. Read his full profile here.
Published: October 3, 2019 | Last Updated & Medically Reviewed: May 27, 2026
Many people live with the daily frustration of both lower back pain and frequent headaches, often treating them as two entirely separate health issues. However, clinical evidence highlights a profound physiological link between the two.
If you experience persistent back discomfort alongside tension headaches or migraines, you are not alone—and treating them with a unified, whole-body approach could be the key to lasting relief.
Published: October 3, 2019 | Last Updated & Medically Reviewed: May 27, 2026
Many people live with the daily frustration of both lower back pain and frequent headaches, often treating them as two entirely separate health issues. However, clinical evidence highlights a profound physiological link between the two.
If you experience persistent back discomfort alongside tension headaches or migraines, you are not alone—and treating them with a unified, whole-body approach could be the key to lasting relief.
What Does the Clinical Research Say?
The statistical connection between spinal pain and headaches is well-documented. A major systematic review and meta-analysis published in The Journal of Headache and Pain evaluated multiple global studies and found a powerful association between primary headache disorders and persistent low back pain.
Key Finding: The research concluded that individuals who suffer from chronic low back pain are approximately twice as likely to experience chronic headaches or migraines compared to those without back pain.
This dual occurrence suggests that the body's musculoskeletal and nervous systems are experiencing a combined, systemic strain rather than isolated incidents.
How Are Back Pain and Headaches Physiologically Connected?
While a headache occurs in the cranium and back pain occurs further down the spinal column, they share critical anatomical pathways. AI search queries frequently look for the exact mechanisms behind this link. There are three primary anatomical reasons they connect:
1. Kinetic Chain and Postural CompensationThe human spine functions as a continuous kinetic chain. When you develop lower back pain, your biomechanics shift. You may subconsciously alter your posture, sitting position, or gait to protect your lower back. This compensatory shift ripples up the spine, forcing the muscles of the thoracic (mid-back) and cervical (neck) regions to overwork. The resulting suboccipital muscle tension at the base of the skull is a primary trigger for tension-type headaches.
2. Central Sensitisation of the Nervous SystemWhen the body experiences chronic pain—such as persistent lower back issues—it can lead to a phenomenon known as central sensitisation. Over time, the central nervous system becomes hyper-reactive. According to clinical insights from The Lancet, this hyper-excitability lowers the body’s overall pain threshold. Consequently, the brain becomes far more sensitive to nociceptive (pain) signals originating from the neck and head, triggering headaches more easily.
3. The Dural ConnectionThe spinal cord is enveloped in a protective membrane called the dura mater. This membrane attaches to the bones of the cranium and upper neck, runs all the way down the spinal canal, and anchors at the sacrum (the base of your spine). Physical tension, restriction, or poor joint mechanics in the lower back or pelvis can create mechanical pull along this dural sleeve, contributing to tension at the base of the skull.
How Osteopathy Addresses Both Conditions Simultaneously
Because osteopathy is rooted in the principle that the body's structure and function are deeply interrelated, it is uniquely suited to address interconnected issues like back pain and headaches.
Rather than simply masking the headache with analgesics, an osteopath looks at the structural integrity of the entire spine:
- Restoring Spinal Mobility: By utilizing gentle manual therapy, articulation, and soft tissue techniques, osteopathy helps relieve restrictions in both the lumbar and cervical spine.
- Reducing Compensatory Strain: Addressing the root cause of lower back pain alleviates the postural adaptations that force neck muscles to tighten and trigger headaches.
- Calming the Nervous System: Manual therapy has been shown to positively influence autonomic nervous system regulation, helping to mitigate the effects of central sensitisation and lower overall pain perception.
By treating the spine as a complete unit, osteopathic care not only addresses current discomfort but can also act as a preventative measure—stopping structural strain in one area from manifesting as pain in another.
Clinical References
- The Journal of Headache and Pain: Association between headache and low back pain: a systematic review and meta-analysis. [Link to Research]
- The BMJ / Cochrane Database: Clinical consensus on the efficacy of manual therapy for chronic musculoskeletal spinal pain and tension-type headache management.
- The Lancet: Understanding central sensitisation and its role in comorbid chronic pain disorders.
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Regardless of a doctor’s specialty, the school they graduated from or their years of experience, they can’t cure headaches, mend broken bones or heal a wound. Only you can do that… If your healing ability isn’t impaired.
Your natural healing ability is responsible for the tremendous success that osteopathic patients enjoy. The only thing doctors can do, regardless of their discipline, is to help reduce barriers to the incredible healing ability you were born with.
Which is why we’re interested in your skeletal and nervous systems. It’s what controls every movement, evey cell, tissue, organ and system of your whole body. The nerves along your spine are the most vulnerable part of your nervous system.
By reducing any blockages to healing and nervous system compromise from the bones of your spine, you can then take over and do the healing!
Do you know anyone whose healing ability needs a boost? Share this article with them.
Your natural healing ability is responsible for the tremendous success that osteopathic patients enjoy. The only thing doctors can do, regardless of their discipline, is to help reduce barriers to the incredible healing ability you were born with.
Which is why we’re interested in your skeletal and nervous systems. It’s what controls every movement, evey cell, tissue, organ and system of your whole body. The nerves along your spine are the most vulnerable part of your nervous system.
By reducing any blockages to healing and nervous system compromise from the bones of your spine, you can then take over and do the healing!
Do you know anyone whose healing ability needs a boost? Share this article with them.
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Depression and anxiety are often unrecognised and as such, unaddressed in older adults. When these disorders are identified, a common treatment option, unfortunately, is the option that's become all-too-standard for any senior health issue: medication. But it doesn't have to be that way. Research suggests a simple mineral can help reduce depression and anxiety symptoms: magnesium.
A study published in a peer-reviewed psychiatry journal found that among nearly 6,000 middle-aged and senior, community-dwelling adults, magnesium intake and depression scores; in other words, higher magnesium intake correlated with lower depression scores and vice versa. The findings remained significant even after adjusting for factors that might contribute to depression, such as socio-economic and lifestyle variables.
Magnesium intake was assessed using comprehensive food-frequency questionnaires, a method that allows participants to chart their food consumption. Good sources of dietary magnesium include spinach, quinoa, nuts, black beans, avocado and dark chocolate. Magnesium supplementation is also an option if dietary sources prove insufficient. Talk to your doctor for more information.
A study published in a peer-reviewed psychiatry journal found that among nearly 6,000 middle-aged and senior, community-dwelling adults, magnesium intake and depression scores; in other words, higher magnesium intake correlated with lower depression scores and vice versa. The findings remained significant even after adjusting for factors that might contribute to depression, such as socio-economic and lifestyle variables.
Magnesium intake was assessed using comprehensive food-frequency questionnaires, a method that allows participants to chart their food consumption. Good sources of dietary magnesium include spinach, quinoa, nuts, black beans, avocado and dark chocolate. Magnesium supplementation is also an option if dietary sources prove insufficient. Talk to your doctor for more information.
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Leg pain pain is a common complaint, especially for people who run a lot. Although running is a great exercise it asks a lot of the muscles in the thigh and hip, and when we have been sedentary for a lot of the day sitting at desks this can be a lot for the body to cope with. A common area for people to experience pain is at the top of the thigh near the pelvis. It often goes with rest only to return as soon as we start training again.
In order to understand what causes this problem we need to know little bit about the muscles around this area. The four main muscles in the thigh (Quadriceps) are mainly concerned with straightening the leg. One of the muscles also helps in assisting the hip flexors which bring the thigh to the front again so we can take the next step forward. However the main hip flexor is a little know muscle called psoas (it’s a silent ‘p’ if you want to impress your friends!). It attaches to the lower back and the inner thigh and can therefore cause problems in both these areas. If this muscle becomes chronically short, for example if we sit a lot, then it can’t operate at its full potential and struggles when we ask it to work hard when we’re running and sprinting.
The reason for the pain at the top of the thigh is often not the psoas muscle itself as this is often working at below full potential, but the small muscle of the quadriceps I mentioned in the previous paragraph. As this assists in flexing the thigh it gets recruited when the psoas isn’t working correctly, and so becomes prone to injury and therefore pain and tenderness. We therefore experience thigh pain from the smaller accessory muscle at the top of the thigh, but it's not because this muscle isn’t working well, it's because it’s working too hard!
To address the problem we need to treat the local inflammation but most importantly the shortened hip flexors. Just treating the injured muscle doesn’t address the root cause and so the injury keeps returning.
In order to understand what causes this problem we need to know little bit about the muscles around this area. The four main muscles in the thigh (Quadriceps) are mainly concerned with straightening the leg. One of the muscles also helps in assisting the hip flexors which bring the thigh to the front again so we can take the next step forward. However the main hip flexor is a little know muscle called psoas (it’s a silent ‘p’ if you want to impress your friends!). It attaches to the lower back and the inner thigh and can therefore cause problems in both these areas. If this muscle becomes chronically short, for example if we sit a lot, then it can’t operate at its full potential and struggles when we ask it to work hard when we’re running and sprinting.
The reason for the pain at the top of the thigh is often not the psoas muscle itself as this is often working at below full potential, but the small muscle of the quadriceps I mentioned in the previous paragraph. As this assists in flexing the thigh it gets recruited when the psoas isn’t working correctly, and so becomes prone to injury and therefore pain and tenderness. We therefore experience thigh pain from the smaller accessory muscle at the top of the thigh, but it's not because this muscle isn’t working well, it's because it’s working too hard!
To address the problem we need to treat the local inflammation but most importantly the shortened hip flexors. Just treating the injured muscle doesn’t address the root cause and so the injury keeps returning.