If you have lower back pain and are seeing a medical doctor, perhaps it’s time to see a chiropractic doctor too.
Why?
Chiropractic care is scientifically more valid, safer and cost effective than traditional medical care for lower back pain. But don’t just take my word for it.
A 1993 study commissioned by the Ontario Ministry of Health recommended patients with lower back pain be managed by chiropractic doctors, not medical doctors.1 Yes, you read that right: Lower back pain treatment should be moved from medical doctors to chiropractic doctors. This has long been supported in the literature, and medical doctors are beginning to realize this too.
I have established working relationships with a handful of medical doctors in my area. One day late last year, a primary care physician, who also happens to be a chiropractic patient, showed up for his scheduled appointment waving a research article. He proceeded to say, “Paul, have you seen this article yet? It’s from a medical journal I subscribe to. It has some good support for chiropractic care and recommends that we use it in the management of low back pain.”
Of course, he already knew the benefit; we had previously worked together on a number of mechanical spine pain cases. I appreciated him bringing in the article, and I was happy to know that, according to the Journal of American College of Physicians, chiropractic treatment was now part of new clinical guidelines in the management of lower back pain.2
Many are quick to “lump” all manual therapies such as muscle release techniques, exercise and spinal manipulation together. Chiropractic spinal manipulation is unique in that it has both a physiologic and neurologic effect on the body. The procedure can facilitate movement of the joint, relieve pain, increase circulation, and relax and improve muscle function. I’ve heard it said that “you cannot use rehab alone to correct a dysfunctional joint,” which may be in part the reason for improved outcomes with treatment that includes chiropractic spinal manipulation.
In the past, a medical doctor’s general approach for treating lower back pain typically included a prescription (often for opioids and muscle relaxants) and a course of physical therapy. Chiropractic spinal manipulation was rarely part of the equation. A 2011 study compared different treatments for recurrent or chronic lower back pain. The study concluded that chiropractic care resulted in:
- 25% decrease in disability duration of first episode compared to physical therapy
- 250% decrease in disability duration of first episode compared to medical physician’s care
- 9% decrease in opiod (narcotic) use during maintenance care with physical therapy care
- 3% decrease in opiod (narcotic) use during maintenance care with medical physician’s care
- 19% decrease in average weekly cost of medical expenses during disability episode compared to physical therapy care
- 32% decrease in average weekly cost of medical expenses during disability episode compared to physical therapy care
- 21% decrease in average weekly cost of medical expenses during disability episode compared to medical physician’s care
The authors from the study concluded that “patients suffering nonspecific work-related low back pain who received health services mostly or only from a chiropractor had a lower risk of recurrent disability than the risk of any other provider type.”3
An additional study suggested that “simply adding chiropractic spinal manipulation to your current treatment regimen for spine related disorders has been shown to offer a significant clinical advantage in pain reduction and reduced disability increasing effectiveness from 17% to 73%!” 4
In day-to-day practice I’m mindful to use a variety of tools including some muscle release techniques and supportive exercises. I think a multi-pronged approach can certainly achieve even better and more long-standing improvements, but not to the same degree as they would without chiropractic spinal manipulation.
The moral of this story is that if you have back pain and haven’t been to a chiropractor yet, you may want to find one. (Who knows, that chiropractor may very well already be co-managing care with your doctor).
References:
- The Effectiveness and Cost Effectiveness of Chiropractic Management of Low Back Pain. Pran Manga and Associates. University of Ottawa, Canada – 1993.
- Noninvasive Treatments For Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Amir Qaseem, MD, PHD, MHA, et. al. Annals of Internal Medicine. 2017: 166(7):514-530
- Health maintenance care in work-related low back pain and its association with disability recurrence. Cifuentes, M., Willets, J., & Wasiak, R. (2011) Journal of Occupational and Environmental Medicine, 53(4), 396-404.
- Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain. Results of a Pragmatic Randomized Comparative Effectiveness Study. Spine Volume 38, Number 8 pp 627-634.
