This article is one of a series covering back pain — causes, symptoms, and the treatments we use at Back and Body Medical in Midtown Manhattan. For the complete overview, see the full guide:
→ Back Pain Treatment in New York City — The Complete Guide
Current research finds that 52% of all opioid prescriptions are for patients with low back pain. 2 million Americans suffer from opioid use disorder, and 47,000 died from opioid use in 2017. In light of this epidemic, the high cost of diagnostic tests, invasive treatments, and the low level of satisfaction with his care, Boston university school of public health researchers seek to find a better option for low back pain management. What they found is interesting. A patient’s initial choice of healthcare provider plays a major role in their prospects for a successful outcome. This is not only for the patient, but the insurance company as well.
A major healthcare insurance carrier decided to send their policyholders a notice which promoted initial care for low back pain with a chiropractor or a physical therapist. The carrier says that by sending these notices, it is expected that the use of spinal imaging tests will be reduced by 21%, spinal surgeries by 21% and opioid prescriptions by 19%. This leads to lower costs for plan participants and employers.
The American College of physicians also agree with this recommendation, that non-surgical and non-drug care should be the initial course of treatment for a low back pain patient. Here is some research on the effectiveness of these non-surgical and non-drug approaches for managing low back pain:
- A 2020 study found that 22% of patients who initially visited their primary care doctor (PCP) for low back pain received a short-term opioid prescription.Those who first consulted with a PT or DC were 85-90% less likely to require an opioid prescription.
- A 2015 study found that patients who initially received care from a DC were more satisfied with their care than those who visited a PCP first, and the overall treatment costs were lower.
- In 2013, researchers analyzed data from Washington state worker’s compensation cases. They found that 43% of workers with a back injury who initially consulted with a surgeon ended up having surgery. Only 1.5% of those who first received chiropractic treatment eventually had a surgical procedure for their back pain.
- A study published in 2019 found that low back pain patients were less likely to see DC/PTs vs. PCPs when the insurance plan had more restrictions on DC/PT visits (higher co-pays, deductibles, participation in programs such as a health savings account).
Clearly through this research, conservative treatment approaches such as chiropractic care and spinal manipulation should be the first recommendation for patients who suffer from low back pain. It should even be the recommendation for patients with other musculoskeletal conditions. Ultimately, this leads to a reduced use of harmful opioids, and as we can see there will be plenty of cost savings for patients and insurance. Come and see yesterday if you are experiencing any low back pain or other musculoskeletal conditions.
Do you have pain or discomfort? Reach out today! Through chiropractic, physical therapy and other treatment options, we have many options to help you. Schedule an appointment today or call us (212) 371-2000

Dr Shan Sivendra MD is the founder and medical director of Back and Body Medical in Midtown Manhattan. A board-certified medical doctor, certified acupuncturist, and Director of House Physicians at St. Barnabas Medical Center, Dr Sivendra has been practicing in New York since 1995.
He completed his residency in Internal Medicine at Saint Barnabas Medical Center (affiliated with Mount Sinai School of Medicine) and received the Resident Research Award for three consecutive years.
Dr Sivendra has a background spanning internal medicine, pain management, and conservative spine rehabilitation, and was licensed in both the US and the UK.
At Back and Body Medical, he leads a multidisciplinary team of chiropractors, physical therapists, and acupuncturists dedicated to helping patients recover from pain without surgery or unnecessary medication.
Further Reading: Back Pain
