From the Guidelines
Chiropractors can effectively treat acute low back pain through spinal manipulation therapy, as well as other evidence-based treatments such as massage and exercise prescription. According to a clinical practice guideline from the American College of Physicians, published in the Annals of Internal Medicine in 2017 1, spinal manipulation was associated with a small effect on function compared to sham manipulation. Additionally, low-quality evidence showed that massage moderately improved short-term pain and function compared to sham therapy for subacute low back pain.
Some key evidence-based treatments provided by chiropractors include:
- Spinal manipulation therapy: applying controlled force to joints of the spine to improve joint mobility and reduce muscle tension
- Soft tissue therapy (massage): to relieve muscle tension and promote relaxation
- Exercise prescription: to strengthen and improve flexibility, as well as promote better alignment and movement patterns
- Posture and ergonomic advice: to prevent future issues and promote overall spinal health
These treatments are most effective for mechanical back pain caused by muscle strain or joint dysfunction, as supported by the guideline 1. It is essential for patients to consult with a medical doctor for serious or persistent symptoms, especially if accompanied by neurological signs or symptoms. The combination of spinal manipulation, massage, and exercise prescription can provide significant relief for acute low back pain, and chiropractors can play a crucial role in providing these evidence-based treatments.
From the Research
Evidence-Based Treatments Provided by Chiropractors
- Chiropractors provide evidence-based care that includes high-velocity low-amplitude spinal manipulative therapy (SMT) for acute low back pain (LBP) 2.
- The use of spinal manipulation is supported by evidence for reducing symptoms and improving function in patients with chronic LBP, as well as acute and subacute LBP 3.
- Chiropractors may also use a combination of interventions, including exercise, to treat LBP, which can speed and improve outcomes, as well as minimize episodic recurrence 3, 4.
- However, the evidence for the use of manipulation for patients with LBP and radiating leg pain, sciatica, or radiculopathy is limited 3.
- Chiropractors may not always adhere to evidence-based guidelines for acute LBP, such as minimizing the use of plain x-ray and encouraging patients to stay active 5, 6.
Specific Interventions Used by Chiropractors
- High-velocity low-amplitude spinal manipulative therapy (SMT) is a common intervention used by chiropractors to treat LBP 2, 3.
- Exercise is also used in conjunction with SMT to speed and improve outcomes, as well as minimize episodic recurrence 3, 4.
- Chiropractors may also provide advice to stay active, which is an important aspect of managing acute LBP 5, 6.
- However, the use of x-ray referral is not always in line with evidence-based guidelines, and chiropractors may need to improve their adherence to these guidelines 5, 6.