Chiropractic technique may not be effective for lower back pain

Jun 28 2011
Individuals with lower back pain are often told to try non-invasive treatments first before considering spine surgery. While this is generally true, it is also important to know which conservative treatments are the most useful.

While short bed rest, anti-inflammatory medications or hot and cold compresses are typically effective for mild injuries or early stage back conditions, things become less clear when it comes to physical therapy or chiropractic interventions.

A new exercise regime of any kind, but especially one undertaken by individuals with back pain symptoms, should always be discussed first with a healthcare provider. Moreover, physical therapy exercises are typically done under the supervision of a trained professional.

Chiropractic interventions are performed by a doctor of chiropractic, and while many techniques work well and provide long-lasting benefits, not all of them are effective for lower back pain.

For example, Dutch scientists found that although spinal manipulative therapy (SMT) provides relief of back pain, the overall benefit is small. The procedure, which can be performed either by a
a chiropractor or physical therapist, involves twisting, pulling or pushing the patient's spine to realign the discs or bones and lessen discomfort.

However, the study's results showed that the benefit is not only small but it also lasts only short-term, usually wearing off after about a year. Before arriving at their conclusions, the researchers reviewed outcomes of 26 clinical trials of the usefulness of SMT in adult patients with chronic low back pain. All studies were randomized, so that some patients were assigned to SMT, while others received another type of treatment, like exercise, physical therapy or placebo.

In conclusion of the report, which appeared in the journal Spine, the researchers wrote that "high-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with low back pain."

Put another way, "[t]here is evidence that SMT is neither superior nor inferior to other effective treatments for patients with chronic low back pain," said Sidney M. Rubinstein, lead researcher of the study.

Individuals for whom conservative treatments fail may consider a minimally invasive spine surgery, as there is increasing evidence that this type of procedure provides better clinical outcomes compared to traditional spinal fusion or even artificial disc replacement.

Chief benefits of endoscopic surgery include small incision resulting is a small scar, lower risk of infection or blood loss and a shorter recovery period.

However, any decisions regarding a course of treatment for chronic back pain should be ultimately made after consultation with a healthcare provider.

Statistics suggest that persistent back pain is the most common cause of disability among Americans younger than 45 years old. The condition causes at least 1 percent of the U.S. working-age population to be permanently disabled, and has been cited as the second most common reason for a doctor's visit for a chronic condition as well as one of the top causes for hospitalization.