Back pain: Will chiropractic treatment help?

For many people, low back pain follows a fairly predictable course. Nagging back pain lasts a few weeks — maybe letting up temporarily when you take a pain reliever — and then it goes away.

So where does chiropractic care fit into the picture? That's up to you.

What the researchers say

Low back pain may have many causes. In most cases of injury or strain, there's no magic cure. It simply takes time for your back to heal. Back pain lasts just as long if you go to a chiropractor, if you go to a physical therapist or if you seek no treatment at all. But treatment of some type — either chiropractic or conventional — might make you more comfortable as you wait for your back to heal.

Researchers say chiropractic manipulation and conventional medical care are about equally effective for relieving acute low back pain. In one study, chiropractic manipulation was found to relieve back pain better than a sham therapy in which therapists only imitated chiropractic manipulation.

What does a chiropractor do?

Chiropractic treatment is based on the concept that restricted movement in the spine may lead to pain and reduced function. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease back pain.

During an adjustment, chiropractors use their hands to apply a controlled, sudden force to a joint. This maneuver often results in a cracking sound made by separation of the joint surfaces — not, as many people think, by "cracking joints." Although this sound is common, it doesn't have to occur for the treatment to be successful.

Chiropractors may also use massage and stretching to relax muscles that are shortened or in spasm. Many use additional treatments as well, such as ultrasound, electrical muscle stimulation and exercises.

Is it safe for everyone?

Chiropractic care is generally considered safe, but it's not appropriate for everyone.

• Don't seek chiropractic adjustment if you have osteoporosis or symptoms of nerve damage, such as numbness, tingling or loss of strength in a limb, hand or foot.
• If you have a history of spinal surgery, check with your surgeon before consulting a chiropractor.
• Manipulation of the neck may be hazardous if you've had a stroke or you have a history of vascular disease.
• If you have back pain accompanied by fever, chills, sweats or unintentional weight loss, see a medical doctor to rule out the possibility of an infection or tumor.

If you're considering chiropractic care

If you'd like to try chiropractic care to treat your low back pain, a little preparation can help you get the most from your treatment.

• Consult your doctor. Talk to your doctor about the type of specialist best able to treat your back pain. In addition to chiropractors, many osteopathic physicians and some physical therapists have training in spinal manipulation.
• Make it a team approach. As with any medical specialist, select a chiropractor who's willing to work with the other members of your health care team.
• Arrange a consultation. Before you make a treatment appointment, arrange a consultation with the practitioner — either in person or by phone — to find out how he or she might address your back pain. Make sure you're comfortable with the recommendations, including how many sessions you'll need. For acute low back pain, four to six sessions are typically enough.
• Understand the risks. When limited to the low back, chiropractic adjustment has few risks. However, manipulation of the neck has been associated with injury to the blood vessels supplying the brain. Rarely, neck manipulation may cause a stroke.

Think prevention

A little care and attention can help you keep back pain at bay. Maintain a healthy weight. Exercise regularly. Sit up straight. When you lift something heavy, let your legs do the work. If you smoke, ask your doctor to help you develop a plan to quit. Smoking reduces blood flow to the lower spine, which can hinder the healing process.

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