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Spinal Manipulation Recommended for Low-Back Pain

by | December 4, 2007

Published in Healthy Living News – December 2007

Spinal manipulation is an effective form of treatment for lower back pain, according to the American Pain Society and the American College of Physicians. The October 2nd edition of the Annals of Internal Medicine included new information that is intended to be used to help guide the diagnosis and treatment by family doctors and other physicians who care for people with low back pain. These guidelines emphasize a conservative approach overall and recommend spinal manipulation as one of the non-pharmacological options that is best supported by research.

Over half of all Americans experience low back pain in a given year and it is one of the most common reasons to miss work. Low back pain is the second most common reason to visit a doctor, after upper respiratory infections. People spend over $50 billion per year on low back pain and overall, the cost of back pain in the US is estimated to be over $90 billion with missed work and decreased productivity among other factors that increase the cost. Chiropractors treat back pain using spinal manipulation, therapeutic exercises, nutritional counseling and other therapies in their non-invasive, non-pharmaceutical approach to health-care. With so much being spent on low back pain in the United States, it is good to know that research studies show that chiropractic care is cost effective in addition to providing results. Recent studies in the Journal of Manipulative and Physiological Therapeutics found that chiropractic care can have better outcomes while costing the same as traditional medical care and chiropractic care is more effective at treating low back pain during the first year of symptoms. In 2003, the medical journal Spine showed that spinal manipulation was more effective at short-term relief of chronic spinal pain than many medications.

The authors of the new guidelines recommend that anyone whose low-back pain does not improve with self-care “should consider the addition of nonpharmacological therapies with proven benefits.” The therapies that have “proven benefits” for chronic, long-standing low back pain include spinal manipulation, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, yoga, cognitive-behavioral therapy, or progressive relaxation. Spinal manipulation is the only non-pharmacologic therapy recommended for acute low back pain, according to these new guidelines.

Each of the other therapies listed have been used for years to help individuals cope with pain. For the guidelines, scientists categorized the research available to determine if there was conclusive proof for the effectiveness of each therapy. The other non-pharmacological therapies recommended in these guidelines do not have the strength of evidence that spinal manipulation has to support the treatment of sub-acute or chronic low back pain. Also, spinal manipulation was the only non medication therapy recommended for treatment of acute low back pain.

Chiropractic physicians are well trained to diagnose and treat lower back pain. Before a doctor of chiropractic becomes licensed, he or she must undergo a rigorous education in biomedical sciences, which is similar to the training of medical doctors. In some areas of study, including anatomy, physiology and rehabilitation, chiropractors receive more hours of instruction than most medical doctors or physical therapists. This training allows a doctor of chiropractic to function as a specialist in neuromusculoskeletal disorders. This extensive education prepares chiropractic physicians to diagnose health care problems, treat the problems when they are within their scope of practice and refer patients to other health care providers when appropriate. Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints.

While chiropractors treat many more conditions than low back pain, the fact remains that chiropractic care has more research that proves it is helpful for low back pain than any other condition chiropractors treat. Spinal manipulation is the main treatment method for chiropractic physicians and they perform over ninety-four percent (94%) of all spinal manipulations in the country.

If your low back pain does not improve quickly, a visit to a chiropractor may be exactly what you need. Even if you have had low back pain for a long time, often patients often begin to see results shortly after beginning to see a chiropractor.

Dr. Bryan D. Royer works for Harmony Chiropractic Center, Inc. and has been practicing chiropractic medicine in the Toledo area since 2005. In 2004, he graduated summa cum laude as the class salutatorian from the National University of Health Sciences. Dr. Royer graduated from a post-graduate program in functional neurology and he has taken extensive post-graduate classes in clinical nutrition and impairment ratings for disability evaluation. He is available for group lectures on a number of topics and he is willing to answer any questions related to health and wellness. More information can be found at HarmonyChiroCenter.com or you may call Dr. Royer at 419-517-5055.

To find a chiropractor, go to www.acatoday.com and click the “Find a Chiropractor” link.


Chou R. Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):505-14.

American Chiropractic Association – www.acatoday.com

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