Chiropractic care is safe and effective for older adults with back pain, according to new research.1 To better understand the risk and benefits of chiropractic care in older people, SpineUniverse spoke with lead author of the report Cheryl Hawk, DC, PhD, who is Professor at Texas Chiropractic College in Pasadena, Texas.
Q: Is chiropractic care safe for older people?
Dr. Hawk: Chiropractic care is among the safest interventions for the care of back pain. The risks of a serious problem after a chiropractic adjustment would be similar to the risk of having a serious problem after an immunization—extremely small. However, minor side effects lasting up to about 3 days are very common, most commonly muscle soreness and stiffness. These side effects are similar to those you get when you begin an exercise program. People have a smaller risk of serious side effects from manipulation and manual therapy than they do from medications taken for the same conditions. You should always discuss any side effects from the treatment with your chiropractor right away.
Dr. Hawk: Chiropractic care has been used for over 100 years to help patients with back pain. One of the best advantages of trying chiropractic care first is that you can avoid the risk of side effects due to taking medications for pain. Opioid drug addiction is a serious crisis in America. Trying nondrug therapies, like chiropractic care first may help to reduce the high rates of opioid addiction in the USA.
In fact, the latest treatment guideline for low back pain (from the American College of Physicians),2 specifically states that people should try nondrug options first. The health risks of pain medications are even greater for older adults than for younger people, since many older people have other conditions that affect their health, and their bodies process drugs more slowly. Also, many drugs, particularly opioids, increase older people’s risk of falls, which is a very serious risk in this age group.
Q: What questions should I ask my chiropractor before receiving treatment?
Dr. Hawk: When first talking with a chiropractor, ask what type of treatments he or she might use for your back pain. Chiropractic care includes many different nondrug approaches in addition to spinal manipulation, including other types of manual therapy as well as exercise. You should ask the chiropractor to explain or illustrate the type of spinal manipulation he or she uses (many chiropractors have photos or can demonstrate what they do), so that you feel comfortable with it. If you don’t feel comfortable with the treatment, feel free to ask if there are alternate types of manipulation he or she could use—there are many different ways to do spinal manipulation for maximum patient comfort, and achieve the same goals.
Q: What should I tell a chiropractor about my medical history, medications, and spinal condition?
Dr. Hawk: First of all, since chiropractors are trained to take a thorough patient history, including questions about medication, past injuries or surgeries, and any recent changes in your health, most likely you won’t have to volunteer this information. You will be asked about your medical history on a patient intake form. Then the doctor will ask you more questions in person. Be sure to share all health information about previous and current conditions, medications, history of injuries and surgeries or other treatment, and recent changes in your health, even if you think they are not important—they might be.
The chiropractor will also ask what makes your pain better or worse, and whether you’ve had changes in strength, recent falls, or balance problems, changes in your bowel or bladder function and other related health factors like sleep and eating habits. The chiropractor should then perform a thorough physical examination, including your neurological system, to make sure that spinal manipulation is right for you. He or she will also see what types of maneuvers make your pain worse or better. The chiropractor will use all this information to develop a treatment plan that is specific for you to help you meet your goals for returning to a normal lifestyle.