All patients need to know if a therapy will help them. The aim here is to present the latest research on whether chiropractors help with back pain.
‘Lower back pain (LBP) is now the number 1 condition across the world in terms of years living with a disability’ (Hotz-Boendermaker et al 2016). Few people really understand how valuable chiropractic can be on their road to recovery.
Chiropractors often use spinal manipulation as a core part of treatment. Indeed, this is what they are famous for. They specialise in assessing where to treat, what technique to use and how much force is necessary. They also have in-depth medical training to make the correct diagnosis.
Let’s have a look at the latest peer-reviewed studies from around the world:
In a randomised controlled trial in 2013, 18-35 year old active military personnel with LBP were tested (Goertz et al). The results show that chiropractic care significantly decreased pain and improved physical functioning when added to standard medical care. The medical care usually involves the use of medications. On its own, medical care showed less improvement than when combined with chiropractic care. This is great because it shows that these different therapies can work well in fusion.
In 2010, another randomised control trial tested 41 patients receiving treatment (Bishop et al). They found that those receiving chiropractic treatment experienced significantly greater improvements with LBP than those only using standard medical care.
Chiropractic treatment significantly reduces spinal stiffness and improves the spinal muscle thickness (Wong et al 2015). This is great news for those with LBP and it’s interesting to note that the reduction of intrinsic muscles, for example, multifidus because of the pain. This is common sense for all those who’ve experienced LBP and how stiffness, range of motion and strength all get reduced. Chiropractic can help!
A systematic review of 14 separate studies, Mesner et al (2016) found that the success of treatments increased with multiple sessions. Many patients wonder how long their treatment schedule should be. Talk to your chiropractor and ask him/her about it.
As with many scientific fields, there is research that challenges the everyday experience of chiropractors. It is only fair to give a balanced picture by showing an example of it here. In 2011, a Cochrane systematic review was made of available randomised controlled trials to assess the effects of chiropractic treatment on LBP. They looked at function, improvement and patient satisfaction (Walker at al). It included 12 different studies and concluded that chiropractic intervention ‘slightly improved pain and disability in the short term and pain in the medium term’ (Walker at al) for recent LBP. However, compared to other treatment with other therapies, no significant difference was noted.
Again, please ask your chiropractor about how they can help with LBP. As with most things, chiropractic care helps many people, but won’t help everyone. Use your common sense and do your own research then discuss it with an expert.
References:
Bishop, P.B., Quon, J.A., Fisher, C.G., and Dvorak, M.F. (2010) The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Journal of Spine. Volume 10 (12), p. 1055-64.
Goertz, C.M., Long, C.R., Hondras, M.A., Petri, R., Delgado, R., Lawrence, D.J., Owens, E.F. and Meeker, W.C. (2013) Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study. Journal of Spine. Volume 38 (8), p. 627-34.
Hotz-Boendermaker, S., Marcar, V.L., Meier, M.L., Boendermaker, B. and Humphreys, B.K. (2016) Journal of Spine, Volume 41 (11), p. E667-73.
Mesner, S.A., Foster, N.E. and French, S.D. (2016). Implementation interventions to improve the management of non-specific low back pain: a systematic review. BMC Muskuloskeletal Disorders, Volume 17(1), p. 258.
Walker, B.F., French, S.D., Grant, W. and Green, S. (2011) A Cochrane review of combined chiropractic interventions for low-back pain. Journal of Spine. Volume 36 (3), p. 230-42.
Wong, A.Y., Parent, E.C., Dhillon, S.S., Prasad, N. and Kawchuk, G.N. (2015). Do participants with low back pain who respond to spinal manipulative therapy differ biomechanically from nonresponders, untreated controls or asymptomatic controls? Journal of Spine, Volume 40 (17), p. 1329-37.
