Chiropractic manipulation effective for back pain

Chiropractic manipulation therapy is not routinely recommended as the initial treatment for low back pain, but a research review suggests this approach may work as well as interventions that doctors typically prescribe first.

Research published in the British Medical Journal analysed data from 47 studies involving a total of 9,211 adults. The authors reported that spinal manipulation eased lower back pain as much as exercise, non-steroidal anti-inflammatory drugs (NSAID) and painkillers. Spinal manipulation also appeared better for improving short-term function.

“At the moment, spinal manipulation is considered a second-line or adjunctive treatment option in international guidelines,” said lead study author Sidney Rubinstein of the Vrije Universiteit in Amsterdam.

According to Rubinstein: “these results would suggest that spinal manipulation is certainly on-par with these other recommended therapies, and can be considered an option”.

chiropractic manipulation treatment of low back pain

Lower-back pain is one of the leading causes of disability and doctor visits for adults worldwide. It often goes away within a few weeks. But when it persists, lower-back pain might be treated with spinal manipulation, medications , heat, exercise or physical therapy.

Spinal manipulation is often done by chiropractors but may also be offered by physiotherapists or physicians. It involves manually moving joints of the spine to increase joint motion. Manipulation also stimulates the nervous system in order to release tension on the surrounding muscles. Chiropractic manipulation is often used for back and neck pain as well as for headaches.

For the current study, researchers focused on the gold standard for determining the effectiveness of medical treatments: randomised controlled trials. These compare outcomes for patients who are randomly assigned to a specific treatment or to a dummy treatment or no treatment at all.

Spinal Manipulation More Effective than Massage

Chiropractic manipulation worked better for pain relief than non-recommended interventions like light tissue massage, the current analysis found.

“Spinal manipulation may decrease pain from muscle strain, inflammation and spasm in your back muscles and/or impact the way that your body perceives pain through either the brain or the spinal cord,” said Christine Goertz, chief executive officer of the Spine Institute for Quality in Oskaloosa, Iowa.

“The most common side effects resulting from spinal manipulation are mild to moderate joint or muscle pain and/or stiffness,” Goertz, who wasn’t involved in the study, said by email. “These symptoms generally go away on their own within a day or two.”


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