Do you need to see a chiropractor if you have low back pain?

You are not the only one who has ever visited a doctor to treat back pain. Around 85% of people suffer from back pain that is severe enough to warrant a visit to a doctor. It is quite common, but the exact cause is not always known. It is not possible to find a single treatment that will work for all low back pain. Doctors' recommendations can vary for these reasons. Standard care includes rest, stretching, exercise, heat, and pain relief, as well as time. Chiropractic care is also recommended by some doctors. The good news? Most people who have recently experienced back pain feel better in a matter of weeks, sometimes within days.

What is the purpose of chiropractic care?

Doctors may refer back-pain sufferers to physical therapy right away. Many people suffering from back pain visit acupuncturists or massage therapists. There are many experts who disagree on the role of chiropractic care. However, there aren't many studies that provide high-quality evidence to support this approach. There are many questions about the role of chiropractic care. Should it be part of routine care? Is it something that should be reserved for those who have not improved with other treatments? Is chiropractic care more effective for some people than others?

These questions have far-reaching implications beyond academic debates about the quality of chiropractic care. It is estimated that low back pain can cost up to $200 billion per year in the US, including missed work and care costs. This is a major cause of disability around the world. We need a non-opioid, effective, and safe treatment for low back pain in the face of the opioid crisis.

Recent research on chiropractic care for low back discomfort

JAMA Network Open published a 2018 study that examined the benefits and disadvantages of chiropractic care in treating low back pain. Researchers studied 750 active-duty military personnel with back pain. Half of the participants were randomly assigned to usual care, which included self-care, medications, and physical therapy. The other half received up to 12 chiropractic treatments.

After six weeks, patients are eligible for chiropractic care.

• Reports of less intense pain

• Experiencing less disability and greater improvement in function

• Higher satisfaction rates were reported for their treatment

• You will need less pain medication.

Although there were no reported side effects, 10% of chiropractic patients experienced stiffness or other symptoms. Similar complaints were reported by five percent of people who received usual care.

Each study has its limitations

This study is no exception. Although this study suggests that chiropractic care might be beneficial for low back pain, there are some issues with the study that make it difficult to know. Take, for example:

• It lasted only six weeks. Most new-onset back pain will improve by the end of six weeks, regardless of whether treatment is used. We will need to do a longer study for those suffering from more severe back pain.

• There were very few differences in the quality of care between people who received chiropractic and those who received usual care. It is not clear how significant such a difference would have been, nor whether it would be worth the small cost of chiropractic care.

• This study was conducted on a mixture of people who had new or long-standing low back pain as well as those with a variety of types of pain, including pain from a pinched nerve, muscle spasm, or other causes. The results could have been different if the study only included people suffering from a muscle spasm or people who are obese (rather than military recruits). It's difficult to generalize these results to all people with back pain.

• The majority of study subjects were younger (average age 31), and men (77%). All of the subjects were healthy enough to pass the military fitness test.

• The treatment that the subjects were being treated with was known to them. This could lead to a placebo effect. The response could also have been due to the fact that the spinal manipulation was performed with more attention and time. These factors might not be important to someone who is just looking for relief.

• The study was limited to people who wanted chiropractic care.

The results could have been different if any of these factors were different. It is possible, for example, that "usual care", if a larger population with chronic low back pain was studied, might have been a better option.

Bottom line

The new study supports chiropractic care for low back pain. It's important that you recognize the limitations of this study and remember that side effects from chiropractic care were more common in those who received it. Chiropractic care is not free, but insurance coverage is increasing.

This will not be the final study on chiropractic care for low-back pain. However, until we learn more, I will continue to offer it in my treatment options.