Not Yet RecruitingNot Applicable

The Effect of Chiropractic Care on Opioid Use for Chronic Spinal Pain: A Feasibility Study

Canada24 participantsStarted 2026-04-01

Plain-language summary

The investigators will conduct a pilot cluster randomized controlled trial (RCT) of chiropractic care added to usual medical care, versus usual medical care alone, for adult patients prescribed opioid therapy for chronic non-cancer spinal pain at four community health centers (CHCs) in Canada. These centers provide services to communities and vulnerable populations with high unemployment rates, multiple co-morbidities, and high rates of chronic musculoskeletal disorders that are commonly managed with prescription opioids. The investigators hypothesize that a full-scale (definitive) cluster RCT on the impact of chiropractic care on prescription opioid use for chronic non-cancer spinal pain will be feasible within the Canadian CHC context.

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: Clusters * CHC in Canada * Roster of ≥ 3,500 patients * One or more opioid-reducing strategies implemented as part of their standard medical services (e.g., chart audits, tracked performance metrics related to high dose prescribing) Participants * Adult patients (aged ≥ 18 years) * Diagnosis of chronic non-cancer spinal pain (i.e., back or neck pain of ≥ 12 weeks' duration, not associated with cancer) * Actively receiving one or more opioid prescriptions (minimum dose of 50 mg MED, dispensed over a period of at least 3 consecutive months) * Interested in reducing their opioid dose * Cognitive ability and language skills required to complete the outcome measures * Provision of informed consent Exclusion Criteria: Clusters • CHCs that employ chiropractors or have currently established chiropractic programs Participants * Individuals already receiving chiropractic care * Opioid-naive (or \< 90 consecutive days of opioid prescription) at baseline * Total active opioid dosage of \< 50 mg MED at baseline * Actively receiving treatment for opioid use disorder (e.g., methadone, naloxone) * Spinal neoplasms or other 'red flag' diagnoses (e.g., fractures, infections, inflammatory arthritis, or cauda equina syndrome) * Anticipated problems with the participant being available for follow-up (e.g., incarceration, or planned incarceration) * The participant is or may be enrolled in a competing trial * Prior enrolment in the ACCESS-DC trial * Other reason to exc…

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Participant Enrolment

Timeframe: From start of enrollment up to 26 weeks (or study end)

Treatment Allocation

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up

Refinement of Data Collection Methods

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up

Compliance with the Protocol

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up

Trial details

NCT IDNCT06160947

SponsorMcMaster University

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2027-12-31

Contact for this trial

Peter C Emary, DC, PhD

001-519-653-1470 emaryp@mcmaster.ca

View on ClinicalTrials.gov More Back Pain trials

Plain-language summary

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

What they're measuring

Participant Enrolment

Timeframe: From start of enrollment up to 26 weeks (or study end)

Treatment Allocation

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up

Refinement of Data Collection Methods

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up

Compliance with the Protocol

Timeframe: Baseline, 6-, 12-, 18- and 26-week follow-up